Waystar Holding Corp. (WAY) Earnings Call Transcript & Summary

Please welcome Head of Investor Relations, Edward Parker.

Well, good afternoon, everyone, and welcome to Texas. I actually grew up in Austin, not far from here. So as a duly designated representative of Lone Star State. I'm very happy for us all to be here. And so thank you for all those in the room for making the trip and then also for all of those on the webcast joining us virtually. I'm Edward Parker, Head of Investor Relations at Waystar. And before we get started, if you'll indulge me, I need to review our safe harbor statement. Today's presentation contains forward-looking statements, including expectations regarding our future financial performance, growth, margins, the development and commercial impact of our AI and automation capabilities. These statements involve risks and uncertainty that may cause actual results to differ materially from those we discuss today. For a full discussion of those risks, please refer to our most recent annual report on Form 10-K and quarterly reports on Form 10-Q filed with the SEC, all of which are available at investors.waystar.com. Okay. So for those of you who haven't met me, I joined Waystar just this summer, but I actually knew Matt and our CEO last summer before -- sorry, excuse me, serving as an outside adviser. And when I spent more time with Matt and the team and the business, the more convinced I actually became of the opportunity in front of Waystar. And I knew at that moment that I wanted to be a part of it. And fortunately, the team was willing to have me. So my hope here today is by the end of the afternoon, you'll have a deeper understanding of Waystar, our innovations and our vision for the future of the revenue cycle. We have an outstanding agenda plan for you today. We're going to kick things off with Matt, our CEO. From there, William Chan, Brendan O'Connor and Sean Joyce will discuss the products, technology and innovation that differentiate Waystar. Then Todd Woods will discuss how we bring those capabilities to market. We'll then take a short break. And then you'll be able to hear directly from some of our clients and our client panel, which is one of the moments I'm most looking forward to. After that, we'll open it up to Q&A. We have plenty of time for questions. So I ask that you hold Q&A to the end of the program. And then following that, we are all going to grow over together to the Waystar Innovation Lab. We're going to have the opportunity to see many of our products and capabilities discussed today in action. And for all of those joining us here today in San Antonio, I hope you stay and stick around for dinner afterwards as well as this evening's True North events. So with that, it's my pleasure to introduce Waystar's Chief Executive Officer, Matt Hawkins.

Okay. Hey, good afternoon, everybody. We're thrilled you're here. And I know many of you, and so it's nice to see you in person and some I haven't met. And so I'm thrilled to get a chance to connect with you as well. As Edward said, we're really grateful that you would make the trip to San Antonio. Is this anybody's first time here that's here in person? So a few. I mean San Antonio is a famous place. Willie Nelson and George Strait have made San Antonio famous, if you like country music, and there's a lot of things here culturally. We're grateful that you'd make the trip with us. And I want to set the stage for why here right now. And that is because every year, we do a client conference. We call it Waystar True North. We typically will have it the last part of August through the middle part of October. That's when we see a lot of clients having availability to join us. And so we felt like it was natural for us to host it here to host our inaugural Investor Day here on the front end of that because it would give you as investors and analysts covering Waystar a tremendous opportunity, not only to meet the broader management team, but to meet with clients. And we can't wait for you to be able to interact with clients and get hands on with our technology. As we jump in, I think what you'll hear from us is you'll meet talented leaders across our organization. We'll bring a few key messages to life that I'd love to just underscore at the outset. And at the end, we'll recap to make sure that we have punctuated these key points. The first is you'll hear us talk about Waystar's market leadership and the innovation that is powering our long-term growth trajectory. We're delivering significant value based on the outcomes that we measure that drive strong ROI and strong client retention and relationships. You'll hear us talk about that. And we're also therein laying the foundation for long-term value creation for shareholders. And we'll work to tie all of that together so you can think about and understand how we think about our business. Just a little bit on True North. We've already been at work. We began last night hosting a Waystar Advisory Board meeting and dinner our advisory board has grown by about 20% to 25% year-over-year. So today, we have nearly 60 organizations that are represented on our advisory board. We work with a fantastic group of hospital-based decision-makers and large ambulatory provider decision-makers some from some of the nation's finest institutions. And several of them, you'll hear from today on our client panel discussion. These are people that run large and impressive organizations and they understand the value of a revenue cycle partner like Waystar. They are meeting now. And so while you'll meet some members of our leadership team, there are other members of our leadership team that are basically spending time with them in breakout sessions, learning about their input, sharing with them some of the same things that we'll show you today in our innovation lab, helping them get hands on with our technology and then incorporating what they have to say back into our solutions. This evening, you'll also see, once we finish the Investor Day, we'll host an open reception for all folks that are joining us for the Waystar True North Client Conference. This is the fourth year of that conference. We hosted the first 2 years in Orlando in mid- to late September last year in Nashville. And this year, we moved it to a larger property that could accommodate more of our clients. This will be the largest client gathering that we've ever had. And so they've -- many of them have traveled to San Antonio, and we're grateful that they are here. And I just would say a couple of things that are interesting to note as part of that client conference, and that is record attendance this year. We have over 40 client-led sessions where they will be best practice sharing, talking about how they're using the Waystar platform to their peers. And we work to not only promote community because it drives retention, but promote peer-to-peer sharing because it also actually drives cross-sell and upsell of incremental solutions on our platform. They are all accompanied by several dozen Waystar team members. These are product leaders, solution specialists and those that are very close to our technology to make sure that we create a very important and powerful event. We like to say that we pack a lot in just a couple of short days. We try to have some fun and create some good memorable experiences with our clients, and we'll do the same with you. But one thing that I've heard and perhaps you have, too, is that innovation in health care occurs at the speed of trust. Health care is a highly regulated industry. And the penalties for being wrong are very high. And conversely, there's very low tolerance for errors. And so in a highly regulated space, it's valuable to create client trust and referenceability because then that helps us to grow and ensure that our innovation is adopted. We've earned that trust over time and through moments like this. So we're really grateful that you'll have first-hand experience to see our clients and be able to interact with us as we go about leading this client conference. Before I move on, I'd like to take a moment to recognize Alpana Wegner, who is here with us today. Alpana, if you're here, you probably had a chance to say hi to [indiscernible], but she's standing here in the background for those that are participating virtually. And I'm thrilled to welcome her as our CFO. She joined Waystar about 3 weeks ago now. And while she's not presenting today, I hope that you will you'll have the opportunity to introduce yourselves to her if you're here. She brings experience leading publicly traded companies, public software businesses. And she brings a strong combination of financial and operational acumen and discipline and business judgment to Waystar tar. So I'm really looking forward to partnering with her. We've already gotten off to a great start. She's spending her early weeks, meeting with the various teams, meeting with a few clients while she's here, which is fantastic. And then diving deep into our strategy and opportunities. And one thing I'd highlight here is that we've also heard terrific feedback from you as our investors and analysts, some of you have asked us questions or provided feedback around disclosures that we make. As a management team, we're committed to continuously improving how we communicate our business to investors and helping shareholders best understand our strategy, performance and the opportunity that we see forming over time. Alpana will be a very important partner in that effort as she gets deeper into our business, and we look forward to responding and being responsive to the feedback that you've shared with us. Also today, I'm thrilled and delighted to welcome Amit Khanna to Waystar. Amit, if you're here, will you stand and just raise your hand as well. This is breaking news. Amit will join Waystar as our Chief Product and Technology Officer. He'll be working closely with a fabulous team of leaders some of whom you'll hear with today and also with William Chan, who, as you know, was a co-founder of iodine and plays the role of Chief AI Officer at Waystar today. You'll hear from William, you'll hear from Sean Joyce. You'll hear from Brendan O'Connor and our Fantastic group of leaders. And Amit will be joining us there. A little bit about Amit. He's an incredible software leader they'll be deeply focused on helping us drive our innovation platform and vision for the autonomous revenue cycle, as you'll hear me highlight. Amit joins us from Salesforce, where he led health care business and he built and delivered agent force for health care. So he's got a very strong viewpoint on AI and on the convergence taking place between product and technology and even more accelerated product launches and delivery. And so we welcome him and we'll be excited to introduce him to this investor and analyst group. Okay. So now let's get down to the star of the show, so to speak, the incredible growth map in front of us. And what we're relentlessly focused on doing. Today is about giving you a deeper understanding of our opportunities and why we believe we are ideally positioned to execute on our value proposition to use all the trust and the goodwill that we have generated to propel us forward to future growth and innovation and shareholder return. If you take anything away from today, I hope it's these 3 things: First, we are creating category leadership in what we do now, we're going after a very large and growing market, and I'll describe that to you in more detail in just a moment. That market is continuing to grow. And as you may have heard me say, we were anticipating and dreaming about these days 7 or 8 years ago. And we're thrilled to be able to see the momentum for me in our business that we do today. And you'll also hear us talk about the fact that we have the right platform, and we'll spend some time talking about our platform and telling you what we mean by our software platform and also why we feel like we have the right people to execute on our game plan, just as you've seen us now execute for several quarters on our game plan to create value for clients and again, value for shareholders. Waystar's system of action, our platform brings together mission-critical workflows, proprietary data and integrations across the health care ecosystem that gives us tremendous insight and visibility to what's going on in health care. The third thing that I'd love for you to take away and from today's discussion, as we get through all of it, is that we have the right vision for where the future is headed. And that as you think about the -- what our clients who are provider organizations want, they want to be able to consume the benefit of -- but the vast majority of them do not have the resources or the ability to take an LLM model and form AI themselves, cyber secure it, integrate it, and then deploy it in their organizations. As we did some third-party research recently, we've learned that the vast majority nearly 90% would rather consume AI through a trusted vendor relationship from a group that they trust. And so we feel like we have the right vision and are forging the path to allow our clients to consume AI in a construct they understand. And that is something that we'll refer to as the autonomous revenue cycle. So let's look at Waystar's growth trajectory and where it starts. We've talked a lot about these numbers. We talk about we're serving over 1 million providers across our platform today. That number has actually grown substantially. We only focus on the revenue cycle. And we are experts in the field of what we do, and you'll see us start to kind of bring these data points together through sustained investment through deep client partnership through continuous innovation, we have a purpose built a platform that we know works to help providers create value. And our focus is to give us a distinct understanding of how revenue moves from billing all the way through to collection and reimbursement, where that revenue runs into friction and where AI can do a better job at driving better outcomes. Today, we're actually trusted by more than 1.5 million providers. That's a 50% increase in just 2 years since we went public. And we like to say that every incremental provider that we help helps us be that much smarter, helps us create a more robust network that can help the next provider and further strengthen our network. Likewise, we're serving more than 32,000 clients while we reach approximately 60% of the U.S. patient population today. One out of every 3 U.S.-based hospital discharges flows through our covered entity. It naturally comes to us, and we have the right to custody that information and use it on a proprietary basis. In fact, in more than 90% of our client contracts, we have the right to custody that information to improve product and to use it inhibit compliant and careful ways. This scale is growing. Today, you see us talk about 7.5 billion insurance transactions that we're processing. That number has increased to nearly $8.5 billion. So we're growing and improving our reach. And again, every incremental transaction we process makes our network that much more robust, and you'll hear us talk about that in just a moment. We feel like we have a resilient base in a market that's primed for transformation, one of the things that I've mentioned a time or 2 is we've seen retail, we've seen financial services. We've seen other industries go through a digital transformation. And sometimes people ask me, well, Matt, where are we on this journey toward more transformation in health care. We feel like there's still tremendous opportunity in front of us to bring technology to bear that will help to transform the market. We believe we have a differentiated platform. We have multiple levers of growth, as you'll see me highlight, and a proven model that combines growth and profitability allow us to strengthen our balance sheet and to create value for shareholders. We know that revenue cycle pressure is intensifying as transformation opportunities manifest themselves in this market. And there are some interesting statistics that you would know very well. There's -- we know that provider operating margins have been low for some time. One of the common feedback points that we hear from providers is they're constantly tasked to do more with the same resources or less because their margins are so constrained. We know on the payer side, though, there's constraint taking place there. And payers are using things in the billing and collection process, things like eligibility at the health plan and patient level to deny claims. They're using prior authorization as an instrument to manage medical loss ratios. And increasingly, what you'll see is industry talk about automating aspects of prior authorizations, but reserving payers' rights to manage prior authorizations for more complex or medical necessity-based authorizations, and they'll use that as a lever to evaluate whether or not they should accept a claim for adjudication or deny it. We know that. And because of our deep expertise in this area, that's informed our strategy, and I'll try to draw that out here in just a second. This tension creates friction, and we've talked about this a lot. It's nearly $0.5 trillion of friction that exists in the system today. That's not being used toward patient care or patient initiatives. And in fact, providers are bearing most of the complexity here. I was with a group the other night at dinner, and they mentioned that their biggest complaint or concern is that they have nearly 70% staff turnover on an annual basis. And I ask, where are those people going to work. They're going to other hourly type jobs. And so they're constantly trying to train new employees that understand the depths of the revenue cycle. So anything we can develop technologically that simplifies that, that creates more anticipation to prevent areas of occurring, reduce the likelihood that a human needs to be involved in high-volume, low-complexity tasks, it becomes very important. You can see some of these other alarming statistics. And they're very real. I was talking to a lady who is a very impressive revenue cycle leader. She's a client of ours at a major children's hospital. And they -- this may get into the details, but I just want to illustrate the bad debt write-off taking place. They order a vitamin D test for every single child they care for. They think it's best practice clinically. And what she is concerned about is payers will sometimes reimburse that and sometimes they won't. They'll actually change their rules all the time. So what she's instructed her staff to do in this impressive children's hospital because the physicians want to order the vitamin D test, they think it's best practice clinically. So they'll order the test, knowing that sometimes payers will reimbursed sometimes they won't. And in between time, they'll write it all off as bad debt because they'll never reach out to the patient and ask the patient to pay for it. So that sounds really archaic and [ Optus ], but those are the types of things that are actually happening in the system and providers and patients ultimately bear the burden there. That makes way for a substantial market opportunity. You hear us talk about a $20 billion-plus addressable market that we are going after, it's a target-rich environment. It's punctuated by existing solutions in the market today, some of which are legacy and, quite frankly, ripe for disruption. We're aware of competitors. Some of you have asked me at the start of the meeting, are you aware of a certain competitor that's under financial duress, Yes, we are. We don't talk about them by name, but we're aware of embedded in this addressable market opportunity is a lot of chance for us to help clients and prospects and those we don't work with yet, embrace modern technology. We believe that this market that we're after today is only the beginning. And because right adjacent to the market that we are serving is a services market. We develop software. And increasingly, we're getting asked by clients, can we develop AI for them that will automate high-volume, low complexity work that could be addressed by AI because rather than by staff or rather than buy point solutions that don't interconnect and aren't cyber secure on their platform. So what you'll hear us focus on today from our leaders in innovation will be actually the pursuit of this much larger addressable market opportunity. It's 2x the size all in of what we've been pursuing thus far. And we're already making progress in delivering value as we deliver agents that automate tasks and begin -- we're able to begin to monetize those and create unique ROI for our clients. I'd like to spend just a second here talking about our platform because we often refer to it, we were very intentional about building this platform. It is -- starts on the one end when -- sometimes you'll hear it called the front end of the revenue cycle. Other times, you'll hear it called the pre-encounter, begins with basically a patient financial clearance, understanding who the patient is. Do they have insurance? Do they -- when we go to work, we'll automate the eligibility and test for that. If not, will help detect insurance coverage for a patient. Well then, given the details at the health plan level, will alert the provider on whether or not they actually have to get a prior authorization in order to deliver a health service and expect that the insurance company will reimburse it. So this is the pre-encounter over here. We facilitate co-payment collection and patient cost estimation, and I'll walk back and forth a little bit, if that's okay for just a second. We're market leaders on the pre-encounter side. We're also walking over here as well, and I hope I don't pull a hamstring. We also are market leaders on the back side, the back end, often referred to as the post encounter. So we process claims better than anybody in the industry were typically ranked first in the industry, what we do here. Our first pass claim acceptance rate is market leading. And what's interesting is, and the trend that we see is -- and I hope you don't mind an extra second here, because we're really good at claims, management, claims monitoring and clean claim submission that creates accuracy in the adjudication process and a higher likelihood that, that claim does not get denied, but rather successfully remitted. Doing that at scale makes us really smart, all the way back over on this side. So we -- given the volume that we process, we can often estimate patient payment what's required of a patient as they engage in their financial responsibility prior to the patient actually receiving the health service. So sometimes you'll hear us talk about shifting everything left. The biggest transformational trend in health care taking place is to shift work to this side pre-care because it creates a more consumer-like experience for patients. And each of us are a patient or we know someone who has been. And so we -- this is kind of intuitive to us. We acquired a business called Iodine. Last October, we announced the signing of that acquisition. And William, is just a fabulous partner to us and a co-founder of that business. It sits in the middle. Beginning with utilization management, clinical documentation integrity revenue capture and leading to some other exciting opportunities like auto coding than things that you may not see here. But when we bought that business, and we felt so fortunate to be able to bring it together with Waystar. I described it as the perfect missing puzzle piece. We were market leaders on the front. We're market leaders on the back and bringing in to our business has created market leadership and also has given us visibility because there's a compounding benefit when you don't just do a point solution that does one thing. If you're -- and this is important for you that are covering the industry and you that are investors with a lot of noise out there because a lot of people are saying things in revenue cycle, and it makes it sound like they're doing all this stuff, but they might only be doing patient payments or they might only be doing prior authorizations. But how could you successfully do a prior authorization, if you don't actually process the claim and understand the grounded source of payment truth on the claims management side. So you could -- that's something that's so important to understand. So that's why you hear me sometimes say the claims management suite is the heart and soul of what takes place in the revenue cycle. Basically, what we're doing, given how accurately we're deploying AI on our platform and what we're integrated in uniting is we're getting a view across the revenue cycle that's unrivaled. Not only are we getting clinical data, coupled with financial and administrative data brought together. But the breakthrough -- Tom getting excited about this. The breakthrough is we're able to observe work on a proprietary basis. And it's observing that work and then designing workflows in the depths of the billing and collection process. That is what's going to lead to breakthrough transformation. And so we're able to actually reverse engineer the payer adjudication process and anticipate what's going on there as an example. We're able to integrate financial and clinical interactions that lead to better outcomes for the clients that we serve and reduce the patient payment friction. Why? Well, because we're pulling it from 90 days post encounter and post health care delivery in many cases, all the way back over. And now burning some calories too, all the way back over to here, that's valuable. And we're happy to go further into this, and you'll hear from our team later today, but I just wanted to highlight that to you that we think that our platform, there's nothing like our platform in the industry that's solely focused on the revenue cycle that brings all commercial payer, all government payer, all patient payments into a single integrated view that becomes powerful for the providers that we serve. Ultimately, we know what providers care about. They care about driving outcomes that makes sense to them, lowering the cost to collect, improving payment accuracy, getting paid faster and increasing their payment yield. That's what they care about in a nutshell. And on top of all of that, by integrating all these capabilities on a single platform, we are displacing clients where they may -- in client settings, we're displacing several point solutions because part of our messaging is there's a compounding benefit when you use all of our solutions are more and more of our solutions together, and you'll hear our team highlight that. The next era of revenue cycle is more automated and more autonomous. The era that we're living through today is punctuated by manual work, high human touch. It's statically configured. So we'll send out or vendors that we compete against. They'll send out a rules package update once for the next 30 days, and I hope they're right. We're sending out 500 updates plus to our network on a quarterly basis. So we're -- that's more than 1 a day. and it's not static. But the historic workflow has been reactive in FTE constrained. What we're doing today is as you see us utilize AI, we're bringing more intelligent automation to the platform that is predicting, preventing, prioritizing work and assisting inside the workflow. And where we're headed is toward this autonomous revenue cycle, where the attributes of that will be autonomous orchestration more highly automated than it is today, self-optimizing and learning. So every transaction we process, if we know the grounded source of payment truth or we learn that what we did when the prior authorization didn't lead to an accurate payment, we learn and heal and self-diagnosed. And we're looking ahead to a future that is more agent-led with an expert human in the loop that's working 24/7, not just on the weekdays from 9 to 5. So as I said, this future is powered by proprietary data and proprietary observations on our platform because we see things across and through the workloads. We're continuously learning and creating insights and intelligence. We're orchestrating agents. And increasingly, you'll hear the team talk about that intelligently harnessing agents together because we understand the workflow, and we touch each end of it, allowing us to bring more and more agent orchestration One of the things we know providers care about is the expense of tokens. There's a lot of dialogue in the industry about large language model use. Not everything has to be done with a large language model. And so part of what they look to folks like us for is smart orchestration, when to deploy a large language model versus when to deploy a small language model or other forms of AI that are far less expensive on behalf of the client. That's an important area of value creation for Waystar long term. And increasingly specialized agents, you may hear the expression atomic level agents. These are small purpose-built agents that -- there may be hundreds of them that are working next to each other with a high degree of specialty doing a very small task that you harness together across the revenue cycle. And finally, traceability, compliance and adaptability becomes super important. We know that LLMs have the propensity or possibility of hallucinating or allowing for bias to creep in, one of our jobs is to ensure that the data being used filters out those biases and we check on that and monitor that closely to ensure that our client. We can help a test almost like a blue check box, a test that the data that our clients are using is traceable that they understand the grounded source of that data and the reimbursement process. Okay. So all of this leads to informing how we think about our growth engine. And our starting point for growth is something I'd like to highlight for just a second. We have a strong track record of creating terrific retention. So we start there when you think about the building blocks of our growth, 97% plus gross revenue retention, and it's been that way for many years. We're grateful for the sticky relationships that we create with clients. That means they like what they're using, and that allows us to cross-sell and upsell them on even further ability, further capabilities. You'll hear Todd Woods, our Chief Commercial Officer, talk about that. We're also always focused on adding new clients to our platform and have a track record of doing that. When you look at our business today, about 60% of our bookings are existing client-related cross-sell and upsell, and about 40% are coming from new clients. That varies from quarter-to-quarter. But in the midst of seeing our bookings progression and the size of the annual contract value, the average annual contract value for us increase. It's nice to know that we have a proven growth model that helps us win with current clients as well as add new clients. And certainly, we benefit from higher utilization in an annual price increase program given the value that we're creating for our clients. That gives us confidence in the long-term low double-digit revenue growth target that we are building toward and aspire toward as well as the 40% plus adjusted EBITDA margin target that we have highlighted since we've been public, you'll note that every quarter, we've been public, we've delivered on high double-digit revenue growth or -- excuse me, low double-digit revenue growth and adjusted EBITDA margin that's been higher than the 40% target that we've highlighted. We're a rule of 50 company, and we're proud of that. And that position ultimately allows us to generate free cash flow. We have about an annual target rate of about 70% conversion from adjusted EBITDA to free cash flow, varies a little bit by quarters, but again, a strong track record of that type of conversion. That gives us capital to invest in growth. You'll hear about some of our innovation and growth initiatives, strengthen our balance sheet. We have the ability to delever our balance sheet by about a full turn a year. Today, our net leverage ratio sits at 2.5x. And with every quarter, we're delevering it further and further and certainly to return capital to shareholders. When I think about the 5 most important things -- or excuse me, the priorities for me as a business leader, one of the most important things that I think about are how we allocate capital as a business. And there's 5 known ways to do that. Certainly, organic growth and innovation is a top priority. We believe that we're in a unique market opportunity and need to invest in capitalizing on this moment. And we're continuing to invest in the capabilities and innovation that deepen client value. We know that and expand our long-term growth. In addition to organic growth, we're continuing to reduce debt and strengthen our balance sheet, and we expect to continue that trend over the next year. And we're grateful for the business model that gives us the -- for just the opportunity to do that. I said to earlier in the audience that financial stability becomes a competitive advantage in the market that we're in and it gives us opportunity to compete in the market because we have resources that we can help our clients embrace and use AI in thoughtful ways. And we're also focused on returning capital through the share repurchase program that we have launched at the end of May, and we'll continue to evaluate that as we go forward. and see how we're trading and walk through the merits of us strengthening that program or putting capital to work in its highest and best use to create value for shareholders. Obviously, there's disciplined M&A that we can prosecute. We regularly assess M&A opportunities. We feel like in this environment that we're in right now, the top 3 listed here are our top priorities. Before I turn it over to the team today, and I can't wait for this. I've been looking forward to this for a long time because I want you to meet our team. I'd like to just leave you with 3 thoughts again. First, we're creating category leadership in the revenue cycle in a market that's undergoing what we believe is once in a generation transformation. And we're leading that transformation and have the opportunity to continue to do so. Waystar is built for this moment. Our status in their revenue cycle is essential to the health care ecosystem. Clients trust us. They want to work with us. We have the platform technology, data and network required to define the future of the autonomous revenue cycle. Second, you're going to spend the rest of the day with people and clients behind this story. You'll hear directly from our leaders and about our innovation and our growth path, and I look forward to that. And lastly, we believe that the opportunity ahead of us is powerful. And so we have a clear strategy. We have significant runway and I'm excited about the opportunity to have you here with us. We thank those that are participating virtually as well. And with that, I'll turn the time over to our product and technology leaders, William Chan, Brendan O'Connor and Sean Joyce. Thanks, guys.

Thank you, Matt. Thanks, everyone, for joining us today. I really appreciate you all taking the time. I'm William Chan, I'm the Chief AI Officer, and I have the honor of leading our AI innovation here at Waystar. I'm also the one of the co-founders at Iodine, which joined Waystar last year. And alongside with me today, you'll hear from 2 of my colleagues, Brendan O'Connor, Executive Vice President of Product Management. And Sean Joyce, Executive Vice President of Software Engineering. Now both Sean and Brendan have spent years building and advancing the Waystar platform. They know our technology, they know our clients' workflows. And they know how to address the top priorities that is on everyone's minds, right? Today, we're going to discuss the advantages that we have built here at Waystar and how our AI-powered road map is driving significant outcomes for our clients. Waystar's advantage really starts with the platform itself, right? The platform brings together several advantages that are quite honestly difficult to replicate, right? It's the breadth of our network. It's proprietary data deep workflow integration and end-to-end capabilities across the entire revenue cycle. We combine that foundation with the right AI for the right use case whether it's machine learning, generative AI, predictive and even now agentic AI. We use all of that, and we operate and deploy AI across the full revenue cycle. We support patient access before the encounter, we'll connect financial and clinical workflows during care delivery and manage claims, payments, recovery and patient financial engagement after the encounter. Now what makes Waystar powerful is that these are not disconnected point solutions, right? They operate across a unified platform with connected workflows, a shared intelligence and a comprehensive view of how one activity, right, in one part of the revenue cycle can and probably affects, another -- and another part of the revenue cycle. Across all of this, our analytics brings that visibility together, giving providers a clearer view of performance across the enterprise and determining right, when action needs to be taken. Now intelligence that has learned from one workflow, as I mentioned, informs what happens next. It's also guiding future decisions and performance across the platform. Revenue cycle is a long connected chain of activities. If any link across this chain breaks, reimbursement is at risk. That's what we don't want to have happen to our clients, right? Because Waystar sees across the entire workflow across this chain, we can increasingly help providers identify issues earlier prevent avoidable friction from occurring and move from a reactive approach to proactively ensuring everything is correct from the start. That's our goal, right? Ultimately, this is the outcome that matters. We want to make sure that our clients get paid appropriately for the care that they deliver. Now this -- the breadth of the Waystar platform has created a set of structural advantages. These things have compounded over time and shape how we in the product and technology team think of how we're going to build and scale innovation, right? I'm going to talk a little bit about the 4 pillars of our competitive moat, and I'm also going to drill down a bit more on how these pillars empower our product and technology strategy. So first off, a mission-critical infrastructure. Like I mentioned before, Waystar is deeply embedded in the workflows that our clients rely on every day to get paid. Our platform services issues, guides decisions and even initiate corrective action through the use of a genetic AI. This is important because what this means is Waystar is the revenue cycles system of action. This is where work gets done. Second, unmatched proprietary data. The breadth of our platform gives us access to a unique combination of transaction data clinical data, workflow signals or what's happening or what's not happening across the way, and payer behaviors and ultimately, outcomes. It's the ground truth. We are unique in the sense where we have the ground truth the signal that says what eventually happened to a claim, right? These signals help us improve existing solutions. Clearly, we want to keep building on what we've got. And they provide and help us identify opportunities for entirely new capabilities. Third pillar, our extensively deployed network, right, Waystar spans a broad collection of payers, providers, patients. What this does is it gives us visibility into billions of transactions, like Matt said, 7.5 billion to 8.5 billion transactions, right? And decisions that are across -- that are occurring daily across the health care payments landscape. It's this scale that helps us identify patterns, understand root causes and determine where intervention can have the greatest impact. Lastly, fourth, it's deep domain expertise. This is something that comes with a lot of experience and time, right? Revenue cycle is what Waystar does. It is extraordinarily complex. It's highly regulated. And it's constantly changing. Our teams understand the financial, clinical and operational context behind these workflows that are constantly changing and morphing, right? That expertise is critical for us to determine the technologies, the workflows and the applicable AI that should be used to solve these problems. Our domain expertise shapes our platform architecture that continuously evolves. We're incorporating models and technologies from the leading technology and AI companies to drive performance and ultimately, deliver outcomes for our customers. So taken together, right, these 4 pillars create what we believe is a self-reinforcing advantage, right? It's this foundation that creates the conditions for Waystar to realize the autonomous revenue cycle vision. All right. I'd like to pass it on to Brendan.

Sounds good. Yes. Thank you, William. I'm going to build on that foundation a bit by highlighting 2 of our most powerful competitive differentiators: connectivity and data. Waystar sits at the center of a broad health care payments ecosystem connecting providers to thousands of payers and deeply integrating into the practice management and EHR systems. On the payer side, we connect with over 5,000 payers, giving us broad visibility into payer reimbursement behavior policy changes and adjudication patterns as they evolve. At the same time, we're integrating with over 500 EHR and practice management systems that our clients rely on every day. That integration really matters because providers do not have to leave their core workflows to benefit from Waystar intelligence. Our users can leverage Waystar intelligence in our UI or we can bring that intelligence into the PM or EHR systems. And ultimately, those 2 sides of the network reinforce one another. More payer connections create more payer-specific signals, deeper workflow, integration gives us more context for how those signals should be applied. And together, that enables smarter automation and more preventative action. And that connectivity advantage is a critical prerequisite for how AI can perform well at scale, and it's a moat we've established over nearly 20 years. The natural extension of the connectivity though, is proprietary data. As Matt alluded to, we very intentionally built a set of end-to-end capabilities that are best of breed across the entire revenue cycle continuum. And that breadth drove adoption at scale. Scale has expanded our network, and that network generates one of the richest and proprietary health care data and revenue cycle assets in the industry. So today, as we've noted, our platform facilitates more than $8.5 billion health care transactions annually, reaching approximately 60% of the United States patient population. And we see the clinical data from roughly one in every 3 U.S. inpatient hospital admissions every year. To put that into perspective, our footprint is multiple factors larger than the largest health systems in the United States, and it dwarfs those of point solutions in the market as well. So it's very important to highlight, though, that the value is not just in the volume of the data, but what matters is the breadth of visibility it gives us across settings of care, geographies, workflows and reimbursement patterns. We see activity across primary care, post-acute care, acute care and nearly all other ambulatory specialties. And that's important because each of those environments behaves very differently. Payer rules differ, documentation differs, utilization patterns differ and ultimately, payment behaviors differ. And so our context is what makes the data the most powerful. We can identify patterns earlier, understand them more precisely and apply those insights back into the workflow. We are then leveraging that scale payer behavior intelligence across our network. So as Matt said, reverse engineer the payer adjudication systems at the planned level. That allows us to predict prevent and increasingly use agentic technology to eliminate denials and rejections before they can possibly occur. We're also learning in real time as we process millions of transactions daily. So again, the advantage is not simply that Waystar has a lot of data. It's that we have broad real-time and highly contextual data that's generated from the workflows were already tightly embedded in and we have the ability to translate that data into action. That's an important distinction as AI becomes more deeply embedded across the revenue cycle. So I'm going to turn it over to Sean, who will talk to you a little bit more about how our technology architecture helps facilitate those advantages.

Thanks, Brendan. Now that you understand the scale of our data and connectivity advantage. I'd like to spend a few minutes to show you how we build that advantage into our platform. Now much of our road map draws on data from across the patient encounter. And every meaningful agentic use case that we're building either updates of record or predicts -- makes a prediction based on cross revenue cycle data. We have built Altitude AI on a shared data foundation, so intelligence can move across the revenue cycle, decisions can be coordinated and every agent can act with the same underlying context. At the base of our 4 tier architecture, agentic architecture, we bring together clinical information, claims and transaction data, payer policies, learned adjudication behavior and 2.5 million claims, rules and edits based on decades of experience. To predict the denial before a claim is submitted, we must understand the payer the policy, the clinical record, the claim edit history, the observed behavior from similar transactions. And then built on these heterogeneous data sets, we have formed our intelligence layer. Applying predictive models to score potential actions, rank work by value and evaluate how our agents perform. The next tier in our architecture is what makes our platform truly agentic orchestration layer. Now earlier William was describing revenue cycle as a chain of processes, and it is, but it's more complex in that it's also this graph of actions, task run in parallel, they repeat, they rely and depend on one another for success. Our orchestration layer determines the next best action and routes work to the appropriate capability. This is increasingly important as the revenue cycle becomes more autonomous. Intelligence may originate in one part of the platform, while the action that needs to occur has to happen in another part of that platform. The interconnectedness, this is the heart of our design. It's a system of agents that understand the revenue cycle coordinate actions across workflows and learn from its outcomes. So let's zoom in on the intelligence layer for a second. One of the things that we've learned, one of the more important things that we've learned from our data is that payer behavior is not interchangeable. Each payer adjudicates claims differently, each apply policies differently. Those behaviors also shift over time. This variability has led to us -- has led us to create a model architecture that is uniquely designed to solve the challenge of the revenue cycle. Built on our common data foundation, we have a portfolio payer-specific models each trained to understand the unique patterns and behaviors of an individual payer. This is how the scale of the Waystar network becomes a true competitive advantage. Building a payer-specific model requires deep claim volume within that data segment. Without it, you're forced into creating generalized models that average away the very behavior you're trying to capture. Our network volume is what makes this segmentation possible. Here's a straightforward example here. For the same category of denied claims, we have one major national payer in our data, denying claims at the full claim level, about half the time. We have another very large national payer that denies at the claim line level. Now that's different than denying at the full claim. This is at the line level. And that happens about 90% of the time. These are meaningfully different behaviors. Our platform accounts, for those distinctions, serves the right model, and the provider doesn't have to think about which model is behind the prediction. Beyond that, when one of these payers changes its adjudication behavior, and they do change their adjudication behavior. We see that change, and we retrain that model independently without impacting the rest of the portfolio. The scale that Brendan described, it's not valuable simply because we have more data. It's valuable because it unlocks an entirely different and more effective way to solve this problem. Before I turn the mic back over to Brendan, I'm going to show you one more way AI is creating leverage for Waystar. And this time inside our own engineering organization. AI is now embedded in every part of our software development process. It's accelerating coding, testing, expanding test coverage and documentation. It's improving the pace of integration engineering and quality assurance it's become core to how we build software. Our mantra, as we made the transformation to an AI-first organization was that we're not going to measure success based on tool adoption or token usage. These are inputs to that process and transformation. We are only going to measure success based on outputs. When we compare data for the first half of 2026 to previous years, we're seeing right now 15% more commits per engineer. And each of those commits is about 1.6x more code per commit. Now commit is a version and validated addition to our source code. It's one of the building blocks of software development. When you bring those together, that's about 1.8x more software output per engineer. That productivity translates into faster product development, more capacity to test and scale new ideas and more time for our engineers to focus on the hardest and most valuable product problems. Importantly, this accelerates how quickly innovation reached our clients. A really great example is the launch of our recruitment manager product. And I think we'll have some demos and some more details in our innovation lab. It is a particularly tricky problem and one we hear from our customers that they were increasingly feeling the pain. Recruitments are often called silent denials. They're a form of take-backs. And when people really dive in on this problem, they're often shocked like this is possible within revenue cycle. Customers had a problem, we brought a solution. We used our AI-first development process in order to launch this product. Our initial estimate, we started with 14 months that we expected to develop it. And we delivered it in under 6. We cut the time from idea to launch by more than 50%. The product we built is now helping providers reduce the time for them to reconcile recruitments by more than 80%. That's 2 layers of leverage using AI. It helps us build differentiated solutions faster. And those solutions are then using AI within the product to automate and create significant productivity gains for our customers. The combination gives us more capacity to innovate, shortens the path from idea to client impact and strengthens the pace at which we can extend the Waystar platform. Now I'll turn it back to Brendan to show you where that innovation is taking the product portfolio next.

Sounds good. Yes. Thanks, Sean. So we're going to go through a few examples in our product road map. We're going to show you where we're applying those advantages across the platform and across the revenue cycle today. And so for the remainder of 2026 and 2027, we're focused on prioritizing opportunities where Altitude AI can drive the greatest workflow and financial impact across the revenue cycle. And I am really excited because we're going to share a few of these examples, but then we're going to go right behind me to the innovation lab in a little bit, and you're going to see these come to life. You're going to have a chance to see the product, feel the product, understand what this is all about. On the front end of the revenue cycle, we're advancing an omnichannel billing agent designed to make the patient financial experience more personalized, more efficient and easier to navigate, and we're utilizing data across the platform. to make a differentiated offering relative to what endpoint solution can build in the patient financial experience realm. In mid-cycle, we're extending our agentic capabilities into coding and clinical documentation, helping CDI teams reduce manual review and better align documentation with coding workflows. We're also applying a genetic and predictive AI to emergency department status decisions using observed patient trajectories to help teams make faster, more informed decisions in real time. And on the back end, we're continuing to push further upstream in the claims process, so shifting left in claims. Our denial prediction capabilities are increasingly helping identify missing information before a claim is submitted so providers can address issues before they ever turn into denials. And we're also advancing automated claim resubmission, which is a really important step towards the autonomous revenue cycle because this allows those eligible rejected claims to be resubmitted automatically with significantly less manual or human intervention to what's historically been available. And so across all of these areas, we're also making intelligence across the Waystar platform easier to access. We're introducing conversational analytics that allows our clients and their staff to ask questions of the revenue cycle data in natural language, understand what's happening very quickly, why it's happening and get recommendations on what they can do to improve their processes to drive the greatest possible impact. And so the common thread across our entire road map is very simple. We're leveraging cross-platform integration, payer behavior intelligence, and AI to reduce manual intervention and improve outcomes across the entire revenue cycle. But importantly, we understand that innovation does not just improve the product. It's also creating multiple paths to greater monetization across the platform. And we see that happening in 2 ways. First is through share of wallet expansion within the solutions our clients already use. As we add new intelligence, automation and workflow capabilities, we can drive more transaction volume, introduce premium pricing and deepen adoption across the platform. Automated coverage detection is a really good example of this. It builds on our existing eligibility verification capabilities to identify additional insurance coverage more effectively leveraging our internal proprietary database, which can increase transaction volume, but also expand the value of our eligibility and financial clearance offering to our clients. Personalized patient payment discounts is another great example. We're using AI here to tailor payment options to patients based on their various affordability and financial scenarios, and we can help improve patient collections in the process of doing this. So not only are we driving a better more transparent and affordable patient financial experience. We're leveraging a bell, and we can prove that we're driving better payment outcomes in aggregate for those clients, and that's a better solution for both sides of the network. The second path to incremental monetization is category creation. Here, AI is allowing us to introduce new products and new workflows to solve problems that have historically been too manual, fragmented or difficult to address via software. Prebuilt anomaly detection is a strong example of this. This is a mid-cycle solution where AltitudeAI connects clinical documentation, coding behaviors and patient data to identify high-impact opportunities before a claim is submitted. And that creates meaningful value for clients while also expanding our aggregate opportunity in the mid-revenue cycle. Recruitment manager is another great example. Sean just called this out, but this is a new offering that's identifying and addressing a problem that has historically required significant manual effort. So we're automating identification and reconciliation of those payer takebacks. And in doing so, we're helping providers reduce reconciliation time by nearly 80% and again, introducing a new product to the market and a new monetization opportunity for Waystar. So importantly, innovations like these can also support pricing models that are more closely aligned to the value we're generating for our clients as well. So when you step back, we feel the model is very compelling. Organic investment in the platform, data and AI can deepen monetization of existing products, increase share of wallet and create new revenue opportunities for Waystar. So William, I'm going to turn it back to you to close this out. Thank you.

All right. Thank you, Brendan. So Waystar is already helping our providers apply predictive generative and agentic AI across the revenue cycle. You already heard examples of that. Sadly, the broader industry still depends heavily on manual work. It depends on fragmented processes and very disconnected data. That, unfortunately, is the norm. And that is why we believe that Waystar is at such an important inflection point with our platform and the AI that is before us. A genetic AI gives us that ability to move beyond automating simple individual tasks and towards coordinating work across the entire workflow. So Waystar is deploying specialized agents into high-value use cases today while connecting those agents through shared data, shared intelligence and orchestrating all of that together, right? This allows work that has historically dependent on labor-intensive processes to move into technology. So what happens is provider teams will spend less time on manual administrative work and then more time overseeing exceptions and high-value priorities. What that means is as this shift occurs, we believe that a greater portion of the overall revenue cycle spend becomes addressable food technology. So Waystar is ushering in that autonomous revenue cycle future because the capabilities required to enable this future are the same advantages that we have been building for years, right? To sum it all up, our connectivity creates more signals, right? These signals then strengthen our proprietary data. And it's that data that improves our intelligence. And then because we're deeply embedded across the revenue cycle workflows, we can then translate that intelligence directly into action and automating that to deliver meaningful outcomes for our clients. So this is the compounding advantage behind the Waystar platform. Thank you. And now I'll introduce you to Todd Woods, Waystar's Chief Commercial Officer. Over to you, Todd.

All right. Well, good afternoon, everybody. My name is Todd Woods. I'm the Chief Commercial Officer here at Waystar. And I first want to thank you all for being here, and I want to thank you for your interest in our business. Since this is our first time together, I thought I'd spend just a minute and introduce myself to you. And I promise it will just be a minute. I've been a part of this business for 24 years. I was fortunate enough to be a part of a group that founded a business called Navicure, which is the first business that makes up the waste or platform. I was able to be part of that startup. We did a few private equity rounds and then our IPO in 2024. It's been a wild ride, and it's been an awesome ride. In every single stage of our company's life cycle, I've been a commercial leader focusing on our go-to-market engine. When I think about our business, and I think about how you heard from William and Sean and Brendan a little while ago. And we talked about the power of our platform. We talked about the scale of our network, and they talked about the innovation that continues to expand our leadership in the space. It's those 3 things -- it's literally just those 3 things that allow me to talk to you today about the durability of our growth model. And so when we think about how our system is evolving and how we're extending that leadership, it's important for us to understand how all of those things come together. And so that's what I'm going to spend the next 20 minutes talking to you about. I'm going to discuss how those advantages get us to the growth model that we have today. And you're going to see that our opportunity is pretty broad. We're not limited to one type of provider. We're not limited to one workflow. We're not limited to one single care setting. We operate across a very, very large, fragmented health care space. But what's interesting is that in that fragmented space, the challenges that our clients face are remarkably consistent. They need to get paid faster. They need to get paid fuller. They need to get paid more accurately and they need to do all of that with less administrative effort. So these challenges, the challenges that I just spoke about, they create a significant opportunity for us here at Waystar. That's the power of our commercial model. We take Waystar's breadth of our unified platform. We changed it into durable growth. We win new clients. We deepen relationships with existing clients and both of those expand our addressable market every single day. So I take a step back, it's important for us to understand the breadth of the market that we serve and the consistency of the needs within that market. We serve health care organizations across the continuum. It's a very wide range of care settings, from large acute health systems to big ambulatory practices to post-acute skilled nursing facility on down to that single ambulatory provider in Greenville, South Carolina. And ultimately, all of the patients that those constituents serve. Now with that breadth going across all of those different care settings, we interact with a whole bunch of different folks. We interact with multiple decision-makers across every single organization. Sometimes it's the CFO and the financial team. Sometimes it's the CIO and the IT group. Sometimes, it's the CMO and the medical staff. And increasingly, in our platform deals, it's all of them. So they're all entering the conversation about what can Waystar do for us. They all bring different perspectives and while those organizations may look different and the buyer may change, the underlying problems they are trying to solve are remarkably consistent, and they are increasingly trying to get to a common set of priorities. They want to lower the cost to collect. They want to accelerate reimbursement. They want to improve staff efficiency. They have to protect and create a highly secure technology environment and they want to create greater financial clarity for all of their patients. We are recently in a large health system in the Southeast and they were a large hospital system. They had just acquired 4 big specialty ambulatory practices. They also acquired an ambulance and transportation business. They were building a PT and behavioral health business. And so while the common -- well, the hospital use the common EHR, and that's common EHR, you guys are all very, very familiar with, the practices and the clinics in the transportation company in the behavioral health center, they used very, very highly specialized EHRs. So they had no way to synchronize the common workflows. They had no way to sync the common reporting and they had no way to sync to a common user experience. In fact, the only thing that was common was how uncommon all of their stuff was. And so they quickly identified Waystar as the connective tissue for the entire health system as soon as the leader said, Waystar could be the connective tissue I immediately wrote that down and said I like that. I'm going to use that for a presentation. So James, thank you for the connective tissue comment. But what we did is we provided them a single unified view across their entire enterprise. That's one platform, one workflow and one user experience. And what I want you guys to understand is that our platform was purpose-built to address the needs across the entire revenue cycle and across every single care settings. It gives us multiple points of entry into a very broad market and we solve common problems that are created in mission-critical challenges. So when you look at what has to happen between delivering care and collecting payment you can easily see how issues arise. You could see it on all of the product sets that Matt showed you earlier. As a patient, we expect the sequence of events to be pretty straightforward. And I would argue with you clinically, it actually is pretty straightforward. However, the financial journey is increasingly complex. So let me give you just a real-world example. Patient falls down, person falls down the stairs. Ambulance comes and pick them up, take them to the hospital, clinician sees them, orders, X-ray, maybe an MRI, they get those results back, clinician develops a care plan, puts a cast on the knee, maybe a couple of people sign it. They spend a lot of time figuring out what color the cast is going to be. But after that, then there's prescriptions, there's crutches and then there's PT. This happens all the time. It's really straightforward. And the clinical process is fairly standard. But the reality is between each one of those interactions, the touch points for the revenue cycle are highly complex. It's a highly complex set of processes that the provider has to manage in order to get paid for the care that they deliver. So that journey starts in order for them to get paid with doing things like getting accurate information. So they've got to try to run an eligibility check. Maybe they have to do a prior authorization. Maybe they're going to want to give the patient an estimate. And then they're going to want to collect the appropriate co-payer deductible. In the middle of the journey, the clinician has to document what they did during the visit, doing things like clinical decisions. All of that leads to accurate coding, but that's not done. The journey is actually just beginning. All of that information has to flow to the insurance carrier correctly. Claims need to be clean before they go out. If there is a denial or rejection, those have to be identified and addressed. And the sooner they do it, the better. And after all of that, after all of that, once payment is received from the payer, if there's a balance, then the provider has to go and try to contact the patient for the remaining balance. So just a show of hands. When you get your first statement from your provider, how many of you guys pay it in the first one? You are lying. Yes, none of us. I'm in the business, and I rarely will pay it for the first time because I don't believe that it's right. So multiply all of our interactions by thousands and thousands of patients that are seen every single day. The point I'm trying to make is that each step has its own set of challenges and every step builds on the next and affects the next. A miss authorization can lead to a denial. Incomplete documentation can lead to a lesser -- can lead to lesser revenue and a claim error or denial can impact the speed at which they can collect. So for providers, those breakdowns, they carry a real cost. It's more manual work. It's slower cost to collect or slower speed to collect, Revenue is trapped and in some instance, as lost all together. We are purpose built to handle this situation. We are purpose-built for these challenges. From the start, our thesis was and still is today, Waystar the system of action. In order to be the system of action, we have to understand the provider's technology environment. And the EHRs and other clinical systems, they play an essential role. They're really good at what they do, but they are the system of record. They capture who the patient is, they capture what happened during the visit, and they capture all of the clinical information associated with that encounter. We play a very different role. A highly critical and highly complementary role. We're the system of action for the revenue cycle. We bring the EHRs to life by connecting them to the outside world every single step of the way on the patient's financial journey. We take the data generated from our over 5,000 payer connections where we're transmitting back and forth in real time every single day. We're processing over 7.5 billion transactions, and we have every single claim that we process since day 1. And oh, by the way, 60% or more of the patients in the U.S. are coming through the Waystar network. That gives us an advantage. An irreplaceable advantage because we use that data to inform the workflows that are required to deliver care from care to reimbursement received. That's unique to us. And this happens before, during and even after the patient encounter. So for our clients, this value is critical. Lower cost to collect more accurate reimbursement, fewer denials, all with less effort. Now the health care technology space is complex, and we believe we have a right to win in the fragmented technology landscape. The complexity of the revenue cycle has left many providers managing highly, highly inefficient technology environments. It's very, very common for providers to have multiple point solutions, managing the same portion of the revenue cycle. We hear from clients all the time. I just heard from last night at dinner. They say, we are looking to Waystar to help us simplify our technology stack. We need Waystar to be part of our optimization strategy. that ask to help them optimize that creates real opportunity for us. So in a typical client environment, if they buy the entire Waystar platform, they can get rid of 15 or more different point solutions, all with one vendor. Last week, we were with an academic medical center on the East Coast. And they're using a popular EHR, again, all one that you're very, very familiar with. And after a full day of analysis on their own, they turned to us and said, if we implement the entire Waystar stack, we can get rid of 32 vendors. Think about that, 32. That's 32 different software packages. That's 32 different interfaces someone has to manage. 32 different support organizations, 32 different contract renewals, 32 different pricing models at oh, by the way, none of that happens at the same time. So by delivering all of our solutions in one single platform, we give providers a clear, clear path to simplify disparate technology stack. And from a commercial standpoint, that trend falls right into our strengths. That's why I believe we are so well positioned as the industry consolidates into a handful of strategic partners. It earns us the right to win. And just as importantly, it earns us the right to win new business as well as grow in existing relationships. So now you're probably wondering, well, how the heck do you guys do all this? How do we grow? So because we solve meaningful challenges at every single stage of the revenue cycle, we have multiple ways into a client relationship. We've seen a tremendous increase in the appetite for clients to utilize the entire Waystar platform. We're seeing this more and more and more, and we're seeing it quarter after quarter after quarter. But the beauty of our model and what's important is that we also have the ability to meet clients where they are. They can deploy a few solutions right out of the gate and then land and expand with us over time. And that's a very, very important part of our strategy. We enter clients where they are, where we see the most acute need. We solve that problem. We demonstrate meaningful value. We delight those customers along the way. And by doing that, it creates such an experience and the clients see such great value. That's a natural path for us to increase product expansion and our wallet share. This is a wildly critical component of our go-to-market engine. So while the pain points and the priorities that we solve are remarkably consistent, the way clients buy is very different. It depends on care setting, size, complexity of the organization. Our go-to-market model, this is really important, is not one size fits all. We have spent 25 years building a commercial engine specifically designed around how health care buys. We have specialized team. We have distinct sales motions. We have ironclad playbooks for every single segment of the market that we serve. In our Hospital and Health Systems segment, we have experienced executives pursuing large platform-level deals. These are sophisticated buyers typically with long sales cycles. But what I'm proud of is today, we serve 16 out of the 20 top hospitals on the U.S. News Best Hospital list. It's a really powerful message that we send to the market when the majority of the hospitals in the country trust and see value in the Waystar platform. If we then move to our ambulatory business, we've got a distinct sales motion there as well. We sell direct with dedicated teams. And I want you to understand that those deals are often 7 figures in annual contract value as well. These clients span a wide array of care settings. It could be a large ambulatory practice. It could be a skilled nursing facility. It could be a surgery center. It could be a physical therapy clinic. But despite all of those differences in each one of the care settings, the challenges they face are pretty common. They want to get paid faster. They want to get paid fuller and they want to do it all with less effort. So in the end, in this highly fragmented portion of an ambulatory market, we combine a high-velocity sales motion with an extensive channel network, which Brendan mentioned earlier, that allows us to reach providers efficiently and also at scale. Those channel relationships are really, really important to our growth engine. Our channel partners do more than just connect with us. We do joint go-to-market efforts. We support clients together. We do joint campaigns. We embed the War technology into their stack. We have over 500 EHR integrations. That reinforces the model and gives us a right to win. We make sure we can support a highly integrated workflow, allowing the customer to choose where they want to enter it for themselves. And whether that client is an Epic or Oracle Health or MEDITECH or one of the 200 or more ambulatory EHRs, our ability to integrate into their existing environment makes it easier for them to adopt our solutions and then expand with us over time. Lastly, we've built strong relationships with BPOs and other RCM companies. We enable them to bring the waster technology forward to the set of customers that they have that we've decided to outsource their revenue cycle. Many of the top BPOs in the country utilize the Waystar platform. They utilize it as the backbone of their offering. And that just strengthens our position and it strengthens their value position to the market. This dedicated motion, regardless of care setting, allows us to bring a unified, consistent value proposition to whatever customer segment we're in, but we've tailored the commercial motion to how each segment buys. This model gives us extreme confidence in the repeatability of the Waystar growth engine. So I'm going to give you a quick 3 real-world examples. The first one is a new client. They bought a new -- they went full platform with us. It's a community health system, the 7-figure deal in annual recurring revenue. That opportunity was driven by their need to consolidate vendors. Their tech stack was a mess. They called it was Spaghetti. We were able to give it all one single platform. Second one is another academic health system. They expanded their offering with us. They were on a few solutions. They ended up expanding their contract with us. They did that in large part because the value that they saw and the results that they saw from the products that they initially bought helped fund the new ones. And so that expansion increased the ARR of that client for us by 5x. As Matt said, satisfying clients is a top priority for us. They trust us, they rely on us, and that drives their desire to buy more solutions. The last one is a technology upgrade by a large skilled nursing facility, nationally known. They implemented our AltitudeAI stack. Many of you guys heard about that from William and Brendan and Sean. That client saw such a compelling value proposition in our solutions, that increased our revenue with that client by 3x. And it was really -- they were struggling to figure out what's real with AI and what's not. They relied on us to help them figure out their AI journey. They asked us to guide them through what's possible, and to provide what's possible in a secure environment, and then provide a road map for them on how to use the technology going forward. So that's 3 different case studies, but they all result in the exact same thing: one platform, one workflow, one user experience. That all plays straight into our strengths. So now this is where it all comes together. This is where it all comes together into our broader growth engine. We have earned a leading position in the market by consistently delivering value to our clients and delighting them along the way. That is our recipe, and it's very simple. As we add more clients, we see more data. More data informs our workflows across the revenue cycle. Our foundation provides us scale that sharpens the insights and the intelligence that we can deliver to those clients. Better insights deliver better client outcomes. And when those clients see the outcomes, they are more likely to expand their relationship with us and they're more likely to recommend us to their peers. It creates a very, very powerful compounding network effect. A broader client portfolio gives us more intelligence, more signals and more scale. More scale helps us improve performance. Better performance drives expansion, retention and client advocacy. On the hospital and health system side, getting referrals from your peers is about as good as it gets. And that is a very big part of our go-to-market model. So I'll wrap this up by saying I hope you can see that our growth story is not by accident. It's the result of 25 years of deliberate investment in a differentiated platform that has proprietary data assets and a broad commercial model with real-time payer connectivity. We are purpose-built to meet clients where they are in their journey, and we grow with them over time. If you remember one thing, we have multiple ways to enter a partnership with a client and we have multiple ways to expand it. And ultimately, our growth is in service to our purpose. And this purpose has guided us from day 1. Myself and Matt and Laura and others in the room, we're all sitting in a conference room as we develop this purpose. And that purpose is to simplify health care payments so providers can spend more time and more of their resources delivering care. And at the end of the day, at the end of the day, that combination of value, commercial execution, with the underpinning of our purpose, it gives us extreme confidence in our durability of our growth model. Now the good news for you is that you don't just have to take my word for it, you're going to hear from a number of our clients in a few minutes. So I'm going to wrap up by saying on behalf of the entire Waystar team, I want to thank you for your time this afternoon. I want to thank you for your interest in us. We appreciate you guys being here, and I hope you enjoy the client panel, which is coming in just a few minutes. Thank you.

All right. Good afternoon, everyone. My name is Lisa Osborne. I have the pleasure of running product marketing and communications here at Waystar. And I would like for you to join me in welcoming our same panel of clients who will be chatting with you for a little bit more today. So you guys can come up, please. All right. Well, thank you, everyone, for joining us, and thank you guys so much for being willing to come on stage with us and share a little bit more about your background and your experience. So we're going to dive right in. We have so much of the innovations that you heard today really come from hearing from these clients and other clients like it. We have our Waystar Advisory Board where we really dive into the solutions and what we're doing and getting that real-time advice. We just pull you guys off of that meeting to come here to stage with us. And we also have a very robust early adopter program where both WAB members and our broader client community engage with our product leaders and really dive in and test our solutions before we bring it to market. So really excited to have you guys. To get us started and kicked off, I would love for you each to introduce yourselves, maybe share a little bit more about the organizations you represent. And just to make this a little fun, how would you describe what you do to somebody who is not in health care? So Candice, I'll start with you.

Thank you. My name is Candice Davis. I'm the Chief Revenue Cycle Officer at EyeSouth Partners. We're based out of Atlanta. We're a private equity-backed managed service organization for ASCs and ophthalmology. We're roughly $1 billion in revenue, 15 states. How would I -- so...

Somebody who was not in health care? What do you do?

Wow. I get doctors paid.

Great. Wonderful. Lisa?

Lisa Griffin, Chief Consumer Officer at University Hospitals in Cleveland, Ohio. About 32,000-plus employers -- employees, the third largest health care system in Ohio. About $7.3 billion in yearly revenue and then about 1 billion unique visits a year. The second question is, how would I explain it? It is vendor management, the digital front door, all the way until a clean bill drops and all those services in between. So from nurse triage all the way through is -- falls under my purview.

Chris?

Okay. So I'm Chris Kiser, and I'm the Enterprise Vice President for Patient Access and Arrival for Advocate Health, which is the new company that was a merger of Atrium Health, which was based in Charlotte, North Carolina, and then Advocate Aurora based in Milwaukee and Chicago. As you can tell from my accent, I came from the North Carolina branch of that. And I'm responsible for all of the front-end activities, from the time an appointment is scheduled all the way through until we check them in at the facility. And I would say, if I was going to describe to somebody, it simply we start the party. We're patient arrival. If we don't get it right, it's wrong all the way through.

Genevieve?

Hello, everyone. My name is Genevieve Sagett. I'm the Chief Revenue Cycle Officer for SCA Health. We are an ASC management company. We manage roughly 350 ambulatory surgery centers across the country. We have just over $4 billion in net patient revenue. We've got -- we do about 1.4 million surgeries across the portfolio. And I think what I would say to describe my job is I go to bat for our patients against our insurance companies.

All right. Steve?

Good afternoon, everybody. Steve Burr. I am Senior Vice President, Revenue Cycle for CHRISTUS Health. And we are headquartered here in Texas in Irving. We have facilities in East Texas, West Louisiana, New Mexico. We have over 25 hospitals in Mexico. We're in Chile and Colombia. So we are an international company as well. We're roughly $13.5 billion in revenue. And pleased to be here. What I'd describe my job is end-to-end revenue cycle, from the patient intake through charge entry to coding to dealing with the claims and patient follow-up afterward as well. So all the way through the...

And I've talked to you guys so many times, and I know you guys are going to talk a lot more than I will, so I'm excited for that. Lisa, I would love to start with you and hear a little bit more about what problems were you looking to solve when you first came to Waystar and maybe a little bit about how that relationship started?

To get away from a fragmented system. So having 10 different vendor relationships to get to an endpoint. So we came to Waystar because we were saying, "Okay, Epic first, Waystar first." That's our premise now, and having Waystar as a vendor to solve those problems. So everything we say is with them. What's in it for the patient and what's in it for the employee? So choosing Waystar has allowed us to actually build systems that say, just click Book It. Waystar will do the work behind the scenes and you don't have to go in registration all the time. And so being able to accomplish that in health care is pretty huge. So we can be a registration scheduling organization. And being able to do that with our Waystar partner has allowed us with our Epic go-live to get $20 million back from Epic. Knowing that we could build systems and have everyone doing the same job. If you schedule, you register and you don't have to go into registration all the time. And think about with them. The patients that are self-pay or the patient that tells you, "I don't have my insurance card," having a system that actually goes and finds it for you where you're not waiting, making them self-pay, the system actually is intuitive enough to do that for you. And so I think that's just a piece of why we chose Waystar. The vendor partnership is another thing. And I'm trying to get all my things out now [indiscernible]. The biggest thing, I think, with Waystar is H.R.1 is coming. We just simply picked up the phone and we said, can you help us with the payers bring back the enrollment dates straight into our 271s? They started working with us with our payers. Even one of the payers had them update information that they import to us so we had everything we needed to be ready for this change that's coming. So I wanted to make sure I added that piece soon.

I love that. And it sounds like it's a lot about the partnership. Steve, I would love to follow up with you on that point. What problems were you guys looking to solve when you started with Waystar? And I think your start with Waystar is a little bit of an evolution too, right?

Sure, exactly. So I had been with the previous organization to CHRISTUS for 28 years, and we were a Waystar partner. And so I joined CHRISTUS little over 3 years ago. And at that time, we were trying to migrate from a system to Epic. And in that journey, we realized there were some deficiencies, things that I think we could do better. I had started to work with Waystar and established those contacts of where I felt like we could partner better and help my organization. And lo and behold, at that same time, this would have been February of '24...

Nothing happened in February of '24.

Nothing happened, right. We had a big event that happened in health care where probably one of the major claims providers had a data breach that affected 192 million people's records, and shut down our claims, as claims through a lot of other entities in the country. But in my world, your claims pipeline, that's your cash pipeline. And so we didn't have a lot of information. We didn't know is this going to be a 3-hour event or a 3-day event. Lo and behold, it was like a 3-month event.

A little bit longer.

But we didn't want to wait. We called Waystar right away. I said, hey, I know we're already talking. All our claims stopped. And I think it's a 3-month implementation. What do you think we could do in 3 days? And literally, he thought I was kidding. And then he says, let me call you back. So anyway, I know we've had a scaled-down version of what we would implement for claims. But when you look at a partner, and this is on a Thursday morning, Friday afternoon, I had my team, our IT team at CHRISTUS, we had the Waystar team, we're on a call, we're figuring this out. And we sent claims Tuesday morning. So literally, it was less than 3 business days. My team, the Waystar team, the CHRISTUS team worked through the night, 24/7, through the weekend. And it was skeletal, but we were sending claims lock, stock and barrel within 3 business days. And really saved our cash pipeline. And that's a partnership that you don't forget. It made a big difference. So that -- it truly is about partnership.

That's great. And I think, Candice, one of the things we've talked about is how the partnership, and I know that's a key theme in a lot of what you guys are saying, it's part of your strategy as you expand. Can you tell us a little bit more about that?

Yes. So as you all know, in private equity, you have to make sure you show a rapid return on your investment. And so we're a high-growth acquisition strategy. And part of being able to keep my commitment to my Board is consolidation and scalability. And so coming into this particular organization, it's the fourth one I've done, coming into this organization, you look at the tech stack and you say, okay, what foundation or infrastructure do I need to consolidate all of those acquisitions and those practices or other MSOs that we purchased? How do I get them standardized not only on workflows, but on a tech stack as well so that you can accelerate cash and you can begin to have some predictability around future valuations? And so what I did was I chose to partner with Waystar. Their full suite of products was exactly what my organization needed to build as that foundation. We started kind of at the very core of that particular time and then expanded as we grew as an organization. And so that integration playbook, it's repeatable. So because we started, again, at the foundational level and worked with Waystar and built out that standard, okay, I've got an affiliate coming on, here's the inflow volumes, here's what their EBITDA is, and all of the transactions that we have, we put it into our model and it spits it out 300 steps in our integration playbook. And within a matter of months, the Waystar team already knows, everything is transitioned, there's zero gaps in cash. It's really a beautiful thing. But it was built through that partnership and that trust of people that knew what they were doing on my side and operationally as well as the support and the willingness to do things very quickly, and being nimble at the same time to help us meet our needs, on the Waystar side.

I love that. And Chris, you got -- and I would love, Genevieve, to hear from you as well on this one. You haven't -- you didn't start your relationship with Waystar with everything, right? You expanded over time. So maybe tell me a little bit more about that journey and what that has looked like for you, starting with prior auth from there?

Sure, absolutely. So we actually started working with a company that was acquired by Waystar originally, I think, 17, 18 years ago. Had a great experience. And as our system has grown, our needs have grown, right? We went from being a regional health system in Charlotte, North Carolina to, with our latest merger, we're the third largest public health system in the country. So I mean, that size basically has vendors knocking on the door. So when we go to look at what we need to change or expand, we have, as we do these acquisitions, different people are using different systems. And the thought was, okay, we've done the prior auth products forever. They've been reliable. My biggest compliment for Waystar is, am I going to sit here and tell you Waystar is perfect? Absolutely not. Nobody is perfect. But what I will tell you is they will make it right and they will work hard and they will be honest with you about the expectations to have. A lot of vendors tend to oversell things. And there's never been an issue that we've had that Waystar hasn't manned up and helped us fix that problem. Even to the point of the executive leadership at Waystar, we have access to that team if something really needs to be escalated. That's not the case everywhere. So as we work through the prior auth products and had such great success with it, early adopters and all that fun stuff, we recently just bid out our [ RTE ] project, which is basically the RFP for that, that's your bread and butter. If you don't get your eligibility correct, then you've got problems. I mean you cannot get paid if you don't have the right insurance on the patient. And I'll be honest, I lobbied hard, I mean, because we enjoyed it. And when it went through all the right channels, we chose Waystar to be our new RTE. And what would have been RTE for Charlotte-based Atrium Health is now RTE for nationally-based Advocate Health. So that's how we had valued the partnership and basically the fact you all had lived up your commitments.

That's great. Genevieve, what thoughts do you have there?

Yes. I think what I would add and what I'm hearing from everybody here who's sitting here is there's a central theme, which is really Waystar looks at the entire revenue cycle and they look at it from start to finish. I think I can speak for all of us when I say we probably get at least a dozen phone calls, e-mails, reaches out through LinkedIn that says, hey, I've got this one product that does this niche service. Waystar does the entire revenue cycle start to finish. And they're thinking about how does revenue cycle work from start to finish and how can we fold in the product offerings into your -- whether it's a patient accounting system, an electronic health record, an EMR? And I think that for all of us is why we find Waystar so valuable. I can come to you and say, this is my issue today. How are you guys thinking about it? And I know that you're already thinking about it because you're not looking at it from one small lens. You're really looking at the entire revenue cycle pipeline and thinking about how do I start with, to your point, making sure that when a patient is going to present, that we've got the eligibility, we know whether or not they need an authorization, we've got to make sure their benefits are accurate. to literally get the claims out the door. You guys are a clearinghouse. You guys are the best clearinghouse we've ever had. It's like no comparison. And then how do we make sure we get that count, through the process posted. And we've got denials. We've got -- we think about the denial management tool. We've got recoups. How do we think about processing recoups? Because I'm sure all of us can agree that the recoup process is a nightmare. And Waystar has just really thought about we're not going to come in and just do one thing well. We're really going to look at the entire pipeline and do everything well. And literally, today, I was telling these guys, and my CEO reached out and said, "Hey, do you remember this teammate? He reached out and he's got this one little thing. Are you interested?" And I was like, no. Because that one little thing, then I have to think about how is it going to integrate to my patient accounting system? How is it then going to integrate, frankly, with Waystar? How is it going to integrate with all of my downstream systems that I have to worry about or any of my other IT platforms that I've created? I don't need that headache when I know that I've got a trusted partner in Waystar who can just come in and do it for me.

I want to piggyback on that as well too. It's also about customers for life on the opposite side of the table, right, just as much it is a partner for life. And so one of the things that we enjoyed working with Waystar was, to echo what Chris said, was making things right. Not everything is perfect all of the time, but they're not a jack of all and a master of none. And I think when I hear platforms that want to do everything or try to be everything to everyone, I get very skittish around that because you can only be good at certain things. The interesting thing with Waystar is that they go very deep in each of those individual products because they do understand revenue cycle. It's complex. It is not an easy thing to understand. But they take the time to listen. And that's another unique thing too that I respect fully from the Waystar leadership team, product manager who we've got, is in order to go deep and wide, they listen and they actually deliver the products that are needed, not just what's sexy on the cover of the magazine, if anybody reads those, of course.

I love that. Yes, go ahead, Steve.

I was just going to say I totally agree. And being in the industry as we've been, there's been a shift in that. We used to look for best of breed. We used to look for individual companies. But then as it's not as scalable, as the electronic medical record really came into being, those separate one-offs become hard to manage for us. And so I've seen a shift in even what I desire and my colleagues, is a platform partner. And I think we see that in Waystar. I think they've been very strategic and innovative in how they've grown. We were a Zirmed client way back when, which kind of became Waystar, right? And then we used a company called [ Comets ] for storing and other things. Well, Waystar merges with Comets. Chris has already mentioned Recondo. We were using Recondo, Waystar merges with Recondo. We were using Iodine, and Iodine merges with Waystar. They've made the right moves, in my opinion. In fact, I think Matt and team just follow what Steve Burr thinks.

We just follow your...

But I do think that they see who's the best of breed out there and they -- and does it fit with them strategically, both from the outcomes perspective, but then probably culture too? Because culture eats strategy for lunch. We all know that. But I think that you look at the culture of this company and how it dovetails with all of our partners here, it makes a difference. And that truly, I think, helps drive outcomes too.

Yes. That's great. And I think, Genevieve, you kind of touched on this. It sounds like we have very well established here. And you guys make my job really easy because I just sit back and let you talk. We've established here that the partnership is key. Obviously, AI is a hot topic. It's something we always talk about. Are you guys at a high level looking to add AI to your solutions? And my question is how? Like how do you do that? Do you do that with partners? Do you do that by looking at foundational models? Like how are you thinking about how you incorporate AI into your organization? Maybe, Genevieve, I'll start with you and then let others.

Yes. I mean it feels as if -- well, it is the hottest topic right now. My leadership team feels like revenue cycle has this incredible opportunity to have AI, what are you guys doing? The reality is, and I literally just had this conversation with my boss, who's our CFO, earlier this week, which was I am not going to go to a HIMSS conference and walk from booth to booth to find who's doing what AI and what does that look like. The reality is I'm going to come to Waystar and say, this is how we're thinking about this part of the revenue cycle, or this is what we're thinking about doing with this data. And how many times you guys heard us say, hey, you have so much of our data. How do we take that data and think about how are my claims processing? Which payers are giving me the hardest time? Which ones are denying me? What are they denying me for? How do I think about the contract management system and pair that up against the denials, right? So for me, as I said to my leadership team, I'm not going to go play hide and seek with whichever niche vendors are out there doing AI. Because every time I seem to talk to them, it's really just smoke and mirrors. "Oh, we've got this amazing product." Really? Tell me about it. There's nothing there, right? They want me to come in and help them build it, and I'm just not willing to do it when I already have a partner like Waystar.

Great. Lisa, anything to add there?

I think the biggest thing about AI, I mean, we're an AI -- we use AI even in our call center. What I think about when I think about War as a partner for AI is to have the conversations. We have meetings, business meetings with them so they can like be honest with what we're not doing well. And they told us in the very beginning, can you imagine thinking you're doing -- you're like best-in-class and then someone comes and partners with you and says, hmm, let's just show you the data. And they showed us the data in the first business meeting, and we were like, oh my goodness, we're not first-in-class. And so taking that same premise and loading those things that they do well today to tell us how we can get better. I mean our denials plummeted. I mean everything has moved and shifted in a positive direction because we listened to what we didn't do well. And they were willing, and we were willing to listen to them because they had been great partners. So I think because they have our data, they know how we operate, they know the market in health care overall, I think that AI is just a natural step for them. They can take that same data and synthesize it and where it can serve up to us well in the beginning. What we just asked them to do, and we just rolled a policy around it, is when you're out of network, what does that look like? And taking our patient population now and even the [ PAO ] data and going through and saying today, hey, Lisa Griffin, right now today is probably going to be a candidate for some type of financial assistance. When we did all this other work behind the scenes to figure it out, just using AI, translating that right upfront to us, so that we know right when we're dealing with the patient right from the very beginning, a lot of things we work on now on the back end. I think AI through Waystar is going to bring it all to the front end, all those things that revenue cycle did and trying to clean up. And on the back end, I think that AI is going to be the sweet spot on the front end with Waystar of making sure every bill goes out clean and that we get paid faster and that we identify things within our system early on in our patient population, early on, that may be an issue for payment for our patients or where we can help them early on. And I think that's where it's going to be the sweet spot of AI, really kind of generating those things in real time for us.

Yes. I think it's interesting the dichotomy between the slowness of health care -- health care is slow to change, regulatory change, payer change, and the rapid change of technology. And so it's so fascinating to watch those 2 come hand in hand. And you get to a point when you're running your organization or building your organization, in my case, where you do lean on others for certain competencies. And that's one of the things that Waystar has done exceptionally well for my organization and myself personally over the last couple of years is they have stayed ahead of the game. The innovation that they've done from just research and understanding what's on the cusp, what's coming and being proactive about reaching out to me saying, very similar to what you were saying, but more so like are you seeing this? It's what's going on in the industry? Are you aware of what's going on? How can we partner together? We have some tools, but maybe you can help us build something cooler. And so I think that to me is super important. I have a continuous improvement team and an AI team and whatnot within my division for rev cycle. And the first place we went was directly to Waystar and said, listen, you're our feeder system. Tell us what we need to know and where we need to go. It doesn't mean that we don't do the work on our own. We certainly do the diligence on our back end. But if I were looking from an outsider looking in, like that's the first place you go, is to your core processor of your transactions.

The claim kind of holds that source of truth, right, of the actual [indiscernible].

So firmly embedded in my operations, from the clinical side. We're really focusing right now, and I probably will be shot for saying this, not on the financial side, but on the clinical side. Because those outcome-based payment models and whatnot that are coming are coming from the way that particularly AI can and does handle doctors' visits or surgical visits or things like that. So we're really spending a lot of time focusing in that space.

And I love how much so many of you guys have been involved. I know, Genevieve, you mentioned recoupments, like that is an AI solution that you guys helped us build, right? Like SCA was critical to that development. I know, Lisa, we're -- you already expanded to add prebill, and now you're going to be working with us on the quality module as a part of that, all leveraging AI to get to that source of truth. Chris, I'm going to ask you, when you hear the autonomous revenue cycle, right, more than just a buzzword for us, what does that mean for you and for the future of what your teams are doing? And what gets you excited about that?

So it gets me excited because a lot of the things that people are doing today are waste of their time, to get paid. And that's the reality. I mean people that aren't in the inner workings of health care every day, one of my health care is so expensive, and yes, there's 500 reasons. But one of those reasons is we have to pay people to do administrative things that just are not necessary. So I mean, things like corrections that have to be made to claims, registration corrections because something -- either the patient gave you something that was incorrect or oftentimes the payer gives you something that's incorrect, so then you have to go behind them and correct that. So you've got somebody sitting there doing that work. And in the clinical world, for years, they've talked about highest level of licensure, right? Meaning to put that kind of in perspective for you guys, only when necessary do you want the RN emptying the bedpan. You want the medical assistant emptying the bedpan. Everybody needs to work to the highest level of their licensure. Well, it's no different with our teams. We have really smart, bright, intelligent people, and we have been doing some rudimentary tasks that an autonomous revenue cycle, it should do that for us. I mean it's a repetitive task. We know what it is. It takes a little bit of anticipation. That's where the AI comes in. And that's where even in some of the pilots and things we've done, we have increased our teammate satisfaction substantially because they can go work on the hard infusion oncology cases, not some CT scan that should easily be authorized.

What about you, Steve? What do you think about when you hear about the autonomous revenue cycle?

Well, my thoughts are it's going to have a tremendous impact on health care. I think AI in general, we were just talking last night, will have an exponential impact in terms of what we do and how we do it. But at the same time, AI right now is very much the wild, wild west. I think we've all seen the videos of the Chinese robots racing in China, and then one was faster than Usain Bolt and he ran into the wall. But at the same time, if we were building racecars, I would do everything I could to become faster. I would do everything I could AI or not. But we're dealing with patients' lives. We're dealing with patients' records. We have to be a little bit more guarded than other industries. And so I think our organization has put a lot of guardrails right now around the use of AI. But we want to partner with someone like Waystar who can help us with the test, the development. Where does it make sense to use AI and it's in a safer environment? So we're a little bit different than I think you see in other industries. But I do think that the gains are going to be exponential. But I think we're going to be a little bit slower out of the gate and then it's going to take off.

And it's going to just compound from that point.

I think maybe this is the time to also say, can we get our payers onboard? Because as revenue cycle leaders, a lot of our challenges are our payers, right? So to your point, is there a payer edit? Why do we have a payer edit? What is the point of the payer edit? We have unnecessary denials. You get denied for a medical record when the contract simply states you don't need the medical record, right? So I think our payers need to catch up just not only with their technology, but with how they're managing their business. And there's every reason why they want to delay and slow down payments. But if we're going to get to truly autonomous revenue cycle, we've got to make sure that both sides are here and ready to party. And I think one side right now is...

Not quite ready for the party. But we'll get them there. Well, guys, thank you so much for being a part of this panel. I am so grateful. Hopefully, you guys were able to get so much out of it. If I can have you guys maybe like a one-liner, as you think about the next 12 to 18 months, if you have your crystal ball, what do you think your relationship with Waystar would look like in the broader industry from that perspective? So maybe, Steve, I'll start with you and then we can come back this way.

I think the partnership I've had with Waystar over the last, gosh, probably 20 years now, I guess, has been great. And I think over the next 5 years, it's going to continue to grow and be even better.

Yes, I echo that. I know that we're moving forward with the recoupment module, we're going to be moving forward with the authorization module. And it's just you guys are there with us every step of the way to fix all of our challenges. It's not going to change.