Waystar expands AI-powered agentic revenue cycle tools

Healthcare payment software company Waystar is taking another step toward building an autonomous revenue cycle, unveiling new agentic capabilities that leverage the company's AltitudeAI.

Waystar will now offer autonomous claim resolution, conversational performance intelligence and agentic clinical documentation. The system will also enable AI agents tailored for the patient financial experience.

The company said its AltitudeAI and agentic workflows were built using Waystar's payer connectivity and proprietary data encapsulating more than 7.5 billion transactions and involving around 60% of U.S. patients.

"By combining AI with the breadth of our data, payer intelligence, and connected workflows, Waystar increasingly identifies what needs attention and deploys specialized agents to pursue resolution," Matt Hawkins, Waystar's CEO, said in a statement. "As the system of action for healthcare revenue cycle, we are helping providers reduce administrative work, accelerate financial outcomes, and fundamentally change how they operate."

For example, the autonomous claim resolution process is intended to help providers tend to rejected and denied claims. The AI agents will have insight into payer responses and be able to apply intelligence that helps them determine the next best action. From there, the agents will be able to resubmit eligible claims.

Waystar said this process will require "minimal human intervention."

The company will also deploy AI agents within its analytics capabilities. The system already offers insights into operational and financial performance data, but Waystar said its agents will make data analysis less manual. Users can now query conversational AI for insights into trends, root causes and financial impact.

Waystar said the agents' early adopters have seen a 75% reduction in the time spent on performance analysis.

Meanwhile, AltitudeAI will be expanding across clinical documentation workflows, Waystar said. The agents will be able to analyze around 30,000 data points within the medical record and synthesize that information to make recommendations. The company said it anticipates the agents will reduce review time by about 25%.

Finally, Waystar unveiled AI functionality to serve patients, which now account for more than $556 billion in annual out-of-pocket healthcare spending. Agents will be able to guide patients through their financial responsibility, including outlining how much they owe, where those charges come from and how they can resolve their balances.

This announcement comes as leading revenue cycle vendors work their way toward a fully autonomous revenue cycle. Earlier this year, Waystar launched AI prior authorization capabilities, denial prevention tools and systems that support charge capture.

In April, the company also released new AI designed to identify silent denials from post-payment adjustments.

Other health IT companies are getting in on the action. Just last week, R1 RCM announced plans to require Humata Health, a company that specializes in AI-powered prior authorizations.

Sara Heath is an executive editor at Xtelligent Healthcare Media, where she covers patient engagement, healthcare policy and health IT.