What You Should Know
– Healthcare payment provider Waystar has announced the introduction of agentic intelligence to its cloud-native platform, marking a pivotal step toward the industry’s first autonomous revenue cycle.
– Powered by the Waystar AltitudeAI™ engine and a dataset comprising 7.5 billion annual transactions, the new agentic network is designed to execute defined tasks and learn from outcomes with minimal intervention, significantly reducing administrative friction for providers and patients.
Agentic Intelligence: The Next Evolution of AltitudeAI™
While generative AI focuses on content creation, Waystar’s agentic intelligence acts as a dynamic, end-to-end network that continuously operates within clinical and financial workflows. This system activates the “right AI at the right time” to address the most complex priorities in healthcare payments.
Key Capabilities of Agent-Powered Workflows:
- Proactive Clinical Justification: Expedites prior authorizations to ensure more accurate and timely reimbursement.
- Revenue Protection: Integrates documentation, coding, and charge capture to prevent denials before they occur, driving predictable cash flow.
- Automated Corrections: Recommends claim corrections automatically based on historical denial insights to ensure compliance.
- Intelligence-Powered Appeals: Accelerates recovery through automated clinical appeals, increasing productivity while lowering costs.
Agentic AI in Action: Relieving the 2030 Nurse Shortage
A critical milestone in this launch is a new agentic workflow specifically designed to reduce the administrative burden on clinical staff. As health systems brace for widespread nursing shortages by 2030, Waystar is using AI to automate the manual work associated with clinical documentation integrity (CDI).
- Advanced Reasoning: In seconds, the agentic AI analyzes full medical records, prioritizing the 30,000 most relevant data points.
- Automated Documentation: The system automatically pre-populates correction requests with the necessary supporting clinical context.
- Measurable Impact: Early results demonstrate an approximately 40% reduction in manual correction workload, allowing clinicians to pivot back to high-value patient care.
“Waystar AltitudeAI prevented billions of dollars in denials last year,” said Matt Hawkins, Waystar Chief Executive Officer. “With that momentum, agentic AI built on an unparalleled proprietary dataset accelerates our vision for the industry’s first autonomous revenue cycle platform and advances our mission to simplify healthcare payments for providers and their patients.”
