Waystar Review

Proactively Identify Your Sources Of Revenues And Collect Owed Revenues

Among the features offered by Waystar is that it aids healthcare providers and professionals in ensuring that they are able to identify and collect the revenues owed by patients and payers or insurers. The platform provides rich, accurate, and actionable intelligence in order for users to proactively implement insurance verification. They will be able to identify the procedures, services, and items that are covered by the health plans of patients.

They can also verify which procedures, services, and items are billable to self-pay patients and to their health insurance plan providers. This is because Waystar can automatically detect hidden coverage. Hidden coverage refers to those unusual items that are covered by a health plan. Meanwhile, individuals can be classified as self-pay patients if they are required to pay portions of the bills as specified under their health plans. By enabling users to determine where their revenues are coming from and what payment obligations patients and payers/insurers have, they can generate revenues faster and better.

Maintain Revenue Integrity By Detecting Issues In Medical Coding

Revenue integrity is another great feature included in Waystar. The purpose of this feature is to help healthcare providers and professionals prevent instances of revenue loss due to issues and mistakes in medical coding and inaccuracies in the claims they are submitting to payers or insurers. Waystar has the ability to instantly pinpoint cases of undercoding. Undercoding occurs when healthcare professionals generate incomplete codes as they document the billable services and procedures they provided to their patients.

In medical coding, codes are assigned to services, procedures, cases, and conditions so that healthcare professionals can charge their services and procedures accurately; and this method is very useful for filing reimbursement claims. Undercoding is a mistake or error in medical coding in which the full scope of the work or service delivered by the healthcare professional or the medical facility he or she belongs to is not reflecting in the billable codes provided. Waystar alerts users so they can quickly spot undercoding issues, flagging claims that are undercoded. Waystar is also backed up by a team of expert auditors that can assist them in reviewing and analyzing undercoded claims and help them understand how such claims can impact the way they generate revenues.

Automated Insurance Claims Management

Waystar is built with automated claims management workflows that accelerate insurance claim filing, review, submission, and monitoring. The platform has a claim scrubbing feature that permits users to check if their claims are accurate and error-free before they submit them to insurance companies and providers. It also sends messages that are written in plain English language, suggesting ways for rectifying issues, mistakes, and errors in claims.

Waystar, moreover, can be integrated with commonly used systems in the healthcare industry such as practice management, health information, and electronic health/medical record systems. As a result, claims can be reviewed and modified directly within the tools users are utilizing regularly. After they are done submitting their claims, they can easily check if they were approved or denied by the respective insurance providers. Waystar also makes it easy for users to work on claims that were denied. They can set up workgroups to be in charge of fixing issues and errors in the denied claims as well as monitor the progress of the workgroups as they perform their tasks.

Anticipate Claim Denial And Revenue Loss

The revenue cycle management platform is equipped with predictive capabilities. The platform uses machine-learning algorithms that can help users anticipate how likely their claims will be denied as well as predict instances of revenue loss that may happen. Because of this, they will be able to reduce denials and implement ways to avoid revenue loss and leakage.

Gain Insights Into Payer Contracts

Waystar enables users to gain insights into payer contracts. It offers payer contract management and analytics features that let them organize all payer contracts and review contractual terms in a central place, assess the true value of contracts, find out if payers are adhering to the terms specified in the contracts, and improve how they negotiate with payers. The revenue cycle management platform allows them to perform contract modeling by which they will be able to create various what-if reimbursement scenarios and discover the possible impact of payer contractual terms on their bottom line. They can set baselines and key performance indicators and use them to measure the performance of payer contracts.

Accelerate Patient Payment Collection And Improve Patients’ Financial  Experiences

Summing it up, Waystar is designed to speed up the process of collecting payments from patients and optimize patients’ payment experiences. Users can set up a workflow so they can automatically receive and collect payments. The platform makes it possible for them to prepare estimates for payments that are collected through a session-to-session basis, a billing method wherein the payment is collected during the time a particular service or session is provided. In addition, Waystar gives the ability to make arrangements for payments that need to be collected after claims are adjudicated and decided upon as well as create plans for patients who have outstanding balances.