Practice Fusion vs Waystar

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Our analysts compared Practice Fusion vs Waystar based on data from our 400+ point analysis of Medical Billing Software, user reviews and our own crowdsourced data from our free software selection platform.

Practice Fusion Software Tool

Product Basics

Practice Fusion is a comprehensive software solution designed to streamline electronic health records (EHR) management and other essential tasks for healthcare providers. It is particularly well-suited for small to medium-sized medical practices due to its user-friendly interface and robust functionality. The software offers significant benefits, including improved patient care coordination, enhanced data accuracy, and efficient workflow management.

Popular features of Practice Fusion include customizable charting, e-prescribing, patient scheduling, and billing integration. Users often appreciate its intuitive design and the ability to access patient information quickly and securely. Compared to similar products, Practice Fusion is frequently praised for its ease of use and affordability, making it an attractive option for practices with limited resources.

Pricing for Practice Fusion typically falls within a moderate range, often based on a per-provider, per-month model, which allows for predictable budgeting. This payment structure ensures that practices can scale their usage according to their needs without incurring prohibitive costs.

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Waystar (formerly Navicure or ZirMed) is a cloud-based solution for managing a health organization’s revenue cycle. Over 25,000 hospital organizations and health clinics use this system to track patients' revenue from their first visit until their final balance has been paid.

It’s ideal for health care organizations of all sizes. It helps providers get paid faster and more accurately by automating tedious billing tasks, improving claim accuracy and offering in-depth reporting tools that uncover areas for efficiency gains.

Popular features include eligibility checks, claims submission and tracking, denial management, and analytics dashboards. 

Users praise Waystar for its user-friendly design, ability to reduce billing errors, and seamless integration with other practice management systems.

While pricing varies based on factors like practice size and specific feature sets, the vendor offers a subscription model with fees based on metrics like claim volume.

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Product Insights

  • More Accurate Treatment and Diagnosis: Get health analytics to help recognize patient patterns and recommend treatment leading to proper patient care. Documenting medical information electronically ensures less susceptibility to handwriting and legibility mistakes. 
  • Increased Productivity and Efficiency: Increase revenue without sacrificing quality care by using templates and automatic favorite lists to speed up patient visits. 
  • Patient Involvement: Engage patients throughout the treatment process by enabling them to view their medical history, exchange messages with physicians and create customized health plans online using the patient portal feature. 
  • Full Certification: Practice Fusion meets certification requirements like ICD-10 codes, meaningful use, ONC and HIPAA. It continuously monitors the medical industry for any changes and provides automatic updates. 
  • Risk-Free Implementation: Decide if the software is a good fit with a free trial. Implementation is quick, with minimal disruption. Users can elect to learn the solution themselves and can receive one-on-one EHR training to help customize the software. 
  • Risk-Free Implementation: Decide if the software is a good fit with a free trial. Implementation is quick, with minimal disruption. Users can elect to learn the solution themselves and can receive one-on-one EHR training to help customize the software. 
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  • Enhance Revenue Capture: Prevent lost revenue due to billing errors or missed opportunities with automated rules engines and advanced analytics. AnMed Health collected $931K in total rebilled and estimated additional revenue.
  • Boost Patients’ Financial Experiences: Use online payment portals to reduce payment friction. Renown Health reduced AR days by half while achieving a 3.8x increase in patient adoption of PatientWallet for payment management.
  • Streamline Claims Management Workflows: Achieve clean claims rate, reduce denials and automate claim submission processes with claim management capabilities. CPA Lab achieved 98% clean claim rate after using the solution.
  • Make Data-Driven Decisions: Access real-time dashboards and customize KPIs to improve financial and operational performance.
  • Optimize Revenue Cycle Management: Automate repetitive tasks like eligibility checks, claims scrubbing and payment posting to save time. Integrate with third party applications to consolidate financial data for efficient RCM processes.
  • Ensure Scalability and Adaptability: Adapt to industry changes and the growing needs of healthcare organizations.
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  • Charting: With efficient charting, speciality-specific templates and automatic favorite lists, physicians can search for diagnosis codes by keywords to track a patient’s health data over time and monitor treatment progress. 
  • Scheduling: Easy scheduling lets patients manage appointments online, including automatic reminders regarding upcoming visits and automated recurring appointments. 
  • E-Prescribing: Order and send prescriptions anywhere, manage medical orders and pharmacy communication electronically, and take care of refill requests for any recurring medications with a two-click prescription refill tool. 
  • Patient Portal: Patients can look at medical information and view lab results at any time. They can also access education materials as well as population health information to better understand their health and treatment. 
  • Billing and Payment: Patients can receive billing statements and update payment information, while physicians can create superbills by automatically pulling information from chart notes. It can also verify insurance providers and scrub claims of any errors before submission. 
  • Labs and Imaging: Integrate with hundreds of labs like LabCorp and Quest as well as imaging services like X-ray, CT scan and ultrasound. 
  • Practice Administration: Consolidate tasks and custom reports, as well as refer patients electronically with their complete medical record. Communicate using secure messages that fulfill meaningful use standards or use HIPAA compliant faxes to go paperless. 
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  • Financial Clearance: Verify patient insurance eligibility, secure necessary authorizations and present clear cost estimates.
    • Eligibility Verification: Instantly check patients’ insurance coverage and benefits, eliminating delays and potential errors. Automatically re-verify clients’ eligibility after data update. Apply payer-specific rules to interpret eligibility information accurately.
    • Coverage Detection: Access customizable dashboards and reports to gain visibility into potential billable coverage. Use advanced algorithms and a vast payer database to streamline coverage discovery, reducing manual effort.
    • Patient Estimation: Incorporate factors like contracted rates, insurance benefits, deductibles and out-of-pocket maximums to generate reliable estimates of a patient's financial responsibility. Share clear, easy-to-understand estimates with patients, building trust and minimizing billing surprises.
    • Authorizations: Secure necessary approvals from insurance payers before rendering specific services, treatments or medications. Monitor authorization requests statuses (pending, approved or denied) in real time. Generate and track referrals to specialists or other facilities, ensuring compliance with payer requirements.
    • Charity Screening: Analyze patient financial data (income, assets, etc.) against established charity care policies to quickly determine potential qualifications. Pull relevant financial information from multiple sources (credit reports, public records or patient self-attestation) for a comprehensive assessment.
  • Revenue Capture: Prevent billing errors, uncover missed charges, and eliminate undercoding and upcoding.
    • Charge Integrity: Use complex algorithms and rules engines to scan billing codes (CPT, HCPCS, etc.) against documentation to identify missing or potentially inaccurate charges. Identify instances where codes may not fully align with services rendered, minimizing compliance risks and potential audits.
    • DRG Anomaly Detection: Analyze patient data to compare the assigned DRG against what the documentation supports. Identify mismatches that could result in underpayment or overpayment. Flag DRG anomalies for review and correction before claims submissions.
    • DRG Transfer: Analyze historical claims data to uncover potentially under-coded or missed TDRGs. Automate claims recalculating processes and refile them with the correct TDRG code, recovering what was rightfully owed.
  • Claim Management: Streamline claim submission and tracking processes.
    • Claim Manager: Automatically scrub claims for errors, omissions and inconsistencies (missing modifiers or invalid codes) before submission. Help staff efficiently prioritize claims needing review or action (pre-edits, denials, etc.).
    • Monitoring: Pull and update claim status details directly from payer portals. Access dashboards to gain an up-to-the-minute view of where claims stand in the process (submitted, in progress, paid or denied) for individual claims or across the whole A/R.
    • Attachments: Securely transfer medical records, prior authorizations, EOBs, and other supporting files directly into the system. Process multiple attachments simultaneously, especially for high-volume situations.
  • Payment Management: Simplify patient and payer interactions with convenient digital payment options, clear estimates and automated payment posting tools.
    • Payer Reimbursement: Use intelligent algorithms to match payments from payers to the specific claims they were intended for, even with partial payments or complex scenarios. Quickly locate and download ERAs for review or reconciliation.
    • Patient Payments: Send digital bills and automated reminders, encouraging on-time payments. Enable patients to view balances and make payments using credit cards, debit cards or bank transfers.
    • Agency Manager: Access vendor scorecards for analyzing agency activity and results. Employ reconciliation tools to assign each overdue account to the appropriate collection agency.
  • Denial Resolution: Mandate pre-submission validation on all claims to reduce the volume of preventable rejections and denials. Identify trends and patterns of denied claims to make strategic changes to processes, documentation or workflows.
  • Analytics and Reporting: Focus on critical indicators like denial rates, A/R days and clean claim rates.
    • Medicare Analytics: Bypass manual processes and access Medicare's FISS system directly within the platform. Get clear claim status with easy-to-understand reason codes. Use worklists to prioritize denied, rejected, or RTP claims for rapid follow-up.
    • Compliance Reporting: Monitor and report on key quality measures like MIPS and HEDIS mandated by CMS (Centers for Medicare & Medicaid Services) and other payers. Automatically retrieve the latest CASPER reports directly from CMS.
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Product Ranking

#21

among all
Medical Billing Software

#43

among all
Medical Billing Software

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User Sentiment Summary

Good User Sentiment 461 reviews
Excellent User Sentiment 315 reviews
75%
of users recommend this product

Practice Fusion has a 'good' User Satisfaction Rating of 75% when considering 461 user reviews from 4 recognized software review sites.

91%
of users recommend this product

Waystar has a 'excellent' User Satisfaction Rating of 91% when considering 315 user reviews from 2 recognized software review sites.

4.8 (17)
n/a
3.7 (46)
4.6 (116)
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4.5 (199)
3.7 (383)
n/a
3.5 (15)
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Awards

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Waystar stands above the rest by achieving an ‘Excellent’ rating as a User Favorite.

User Favorite Award

Synopsis of User Ratings and Reviews

Data Safety: All users who mention files and data noted the safety of sensitive medical data as a key benefit.
User-Friendly: About 93% of users referencing usability reported that the product is easy to use and navigate.
Accessibility: According to 89% of reviews on this aspect, the product is highly accessible due to being web-based.
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Robust Integration Capabilities: Integrate with EHRs, medical billing solutions and practice management systems to eliminate duplicate data entry.
Easy-to-Use Dashboard: Gain a centralized view of key metrics for quick insights on claim statuses, denial rates and reasons, and A/R aging.
Comprehensive Revenue Cycle Management Suite: Eligibility verification, coding, payment posting, and analytics and reporting tools help practices streamline revenue management processes.
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Customer Support: About 95% of reviewers mentioning support indicated that customer service is inefficient and unresponsive.
Outdated: Over 85% of users referring to this aspect noted that the product requires updates in terms of tools and features.
Speed: Updates, glitches and a crowded interface slow down work, according to 70% of reviews about speed.
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Steep Learning Curve: Training can be time-consuming and disruptive to practice’s workflow initially.
High Cost: Initial expenses (setup and software licenses) can be significant.
Complex Secondary Claims Submission: May require manual workarounds, resulting in reimbursement delays.
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User reviews from the past year paint a mixed picture. While some users praise its intuitive design and comprehensive features, others express frustration with its customer support and pricing. Practice Fusion stands out for its user-friendly interface, which makes navigating the system a breeze, especially for those new to electronic health records. Its robust feature set, including charting, e-prescribing, and billing, caters to a wide range of practice needs. However, some users report encountering difficulties with customer support, finding it unresponsive and unhelpful. Additionally, pricing concerns have been raised, with some users finding the system expensive compared to competitors like Athenahealth or Kareo. Overall, Practice Fusion seems best suited for smaller practices seeking a user-friendly, all-in-one EHR solution. However, practices with more complex needs or those prioritizing responsive customer support might want to explore alternative options.

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Waystar's core strength lies in its ability to automate repetitive, error-prone tasks within RCM. This can free up significant staff time for higher-value work, and reduce costly mistakes that lead to denials or missed revenue. Additionally, analytics tools appear robust, providing insights that can drive better decision-making around process improvement and resource allocation.However, smaller practices may find the cost and complexity prohibitive. Additionally, like any cloud-based system, maximizing Waystar's value will require ongoing training and attention to updates.

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