Home > Medical Billing Software > Waystar > Waystar vs EZClaim

Waystar vs EZClaim

Last Updated: November 18th, 2024

Our analysts compared Waystar vs EZClaim 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.

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Product Basics

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.

EZClaim provides management solutions designed for small- and medium-sized offices to help simplify payment and scheduling processes. It offers cloud-based as well as on-premise deployment options. It integrates with third-party EMR and EHR systems such as AxisCare, ElationHealth, WebPT and more.

It supports regulatory standards outlined by HIPPA and stores patient data in a secure location. Users can identify billing issues and recode statements to resolve errors.

$100 Monthly

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$149 Monthly

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Tailored to your specific needs

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Product Insights

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.

Improved Efficiency: Automates repetitive tasks, reducing manual data entry and freeing up staff for more critical activities.
Enhanced Accuracy: Minimizes human errors in billing and coding, ensuring claims are submitted correctly the first time.
Faster Reimbursements: Streamlines the claims process, leading to quicker payments from insurance companies.
Comprehensive Reporting: Provides detailed financial and operational reports, aiding in better decision-making and strategic planning.
Regulatory Compliance: Keeps up-to-date with the latest healthcare regulations, ensuring your practice remains compliant with industry standards.
Patient Satisfaction: Reduces billing errors and improves communication, leading to a better patient experience.
Cost Savings: Lowers administrative costs by reducing the need for extensive manual labor and paper-based processes.
Scalability: Easily adapts to the growing needs of your practice, whether you are a small clinic or a large healthcare provider.
Data Security: Employs robust security measures to protect sensitive patient information, ensuring compliance with HIPAA regulations.
Integration Capabilities: Seamlessly integrates with other healthcare systems, such as EHRs and practice management software, for a unified workflow.
Customizable Workflows: Allows for tailored workflows to match the specific needs and processes of your practice.
Real-Time Updates: Provides real-time updates on claim statuses, enabling prompt follow-up on denials or rejections.
Training and Support: Offers comprehensive training and ongoing support to ensure your team can effectively utilize the software.
Revenue Cycle Management: Enhances overall revenue cycle management by optimizing each step from patient registration to final payment.
Patient Portal Access: Facilitates patient engagement by providing access to billing information and payment options online.

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.

Billing: Send electronic statements to patients via TriZetto or BillFlash, ensuring smooth transactions. Review, approve, reject or edit statements from a single screen. Auto-post ERAs to process payment information quickly. Link documents to help navigate across related files promptly. Set up physician libraries to help submit error-free claims. Send ANSI 837 5010 claim documents to clearinghouses or directly to payers.
Revenue Cycle Management: Outsource billing to firms, like Achane Medical Billing, Elite Billing Resolutions, Ramey Consultancy Services LLC, Prohealth Billing Solutions and more, to help identify reimbursement issues and data entry errors.
HIPPA Compliant: Conduct risk analyses to identify potential data breaches. Identify patients by accessing ePHI (electronically protected health information) to avoid disclosing confidential documents.
Patient Statements: Classify and label patients for internal tracking purposes. Export statements into CSV, PDF, HTML or RTF file formats. Allow patients to pay electronically via eBill or ePay.
Scheduling: Add resources to schedules to help simplify workflows. Switch to the calendar view and double-click on timeslots to schedule appointments. Create and save appointment templates to help save time. Set time blocks to avoid scheduling conflicts. Add patients to waiting lists to help fill canceled slots and improve patients’ experiences. Print patient receipts directly from the payment screen.
Task Management: Track rejections or billing issues to help streamline follow-up processes. Create tasks from EDI files or patient claims from the quick access grid. Mark tasks as assigned or completed to update employees. Add, modify or remove column headers from the task access tab using drag-and-drop functionality. Gain detailed overviews of jobs using the find tool. Set reminders to help meet deadlines.
Centralized Database: Access data from anywhere, at any time. Perform data backups regularly to avoid losing important information. Update documents to keep everyone on the same page.
Integrations: Integrate with existing EHR systems and other platforms such as Practice Fusion, WebPT, Amazing Charts, ReminderCall and QuickEMR.
Reporting: Generate and print reports to help provide quality patient care. Analyze financial statements to help make operations economically efficient. View patients’ historical data to avoid misdiagnosis. Evaluate operational metrics to help streamline budgeting processes.
Widgets: Customize the home screen as per business needs. Click the refresh button to update widget data. Switch to tile view to access information at a glance.

Product Ranking

#43

among all
Medical Billing Software

#62

among all
Medical Billing Software

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Analyst Rating Summary

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User Sentiment Summary

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.

91%

of users recommend this product

EZClaim has a 'excellent' User Satisfaction Rating of 91% when considering 67 user reviews from 1 recognized software review sites.

4.6 (116)

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4.5 (199)

4.55 (67)

Awards

Synopsis of User Ratings and Reviews

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.

Simplified Claim Scrubbing: Users praise EZClaim's ability to automatically catch errors that could lead to claim rejections, saving them time and frustration. It's like having an extra set of expert eyes reviewing your claims before submission.

Intuitive User Interface: Many users find EZClaim's software easy to navigate, even without prior experience with medical billing software. They appreciate the straightforward design and logical workflow.

Improved Claim Submission Speed: EZClaim enables users to submit claims electronically, significantly reducing the time it takes compared to traditional paper-based methods. This allows for faster payment processing.

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.

Claims Rejection Issues: Users have reported frequent claim rejections due to errors or missing information, leading to delays in reimbursements.

Software Glitches and Bugs: Some users have experienced software glitches and bugs that disrupt workflow and cause frustration.

Poor Customer Support: Users have expressed dissatisfaction with the responsiveness and helpfulness of customer support, making it difficult to resolve issues promptly.

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.

Is EZClaim really easy to claim as the best in its class? Recent user reviews suggest EZClaim is a mixed bag. Users praise its intuitive interface and robust features, particularly the automated invoice generation and payment reminders, which streamline billing and save valuable time. However, a recurring criticism targets its steep learning curve, making it less "EZ" than its name suggests, especially for those unfamiliar with medical billing software. Some users find the pricing structure complex and expensive compared to competitors like Kareo and AdvancedMD, which offer more transparent pricing models. EZClaim seems best suited for established medical practices with dedicated billing staff who can invest the time to master the software and leverage its advanced features. Smaller practices or solo practitioners on a tight budget might find its complexity and cost outweigh its benefits.

Screenshots

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Head-to-Head Comparison

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FAQ

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