Waystar

aid: waystar
url: https://raw.githubusercontent.com/api-evangelist/waystar/refs/heads/main/apis.yml
name: Waystar
kind: company
description: Waystar is a healthcare payments and revenue cycle management (RCM) software company that operates a national
  clearinghouse connecting providers to payers. Its cloud platform spans financial clearance (eligibility, prior authorization,
  patient estimation), claim management, payment and remittance management, and denial prevention and recovery. Waystar exposes
  integration through REST APIs, web services, HL7, sFTP/batch, RPA, and X12 EDI transactions (270/271 eligibility, 276/277
  claim status, 837 claims, 835 remittance/ERA, 278 authorization). API access is delivered through a partner/developer program
  at developer.waystar.com; detailed endpoint specifications, sandbox credentials, and authentication (HMAC-SHA256 / OAuth
  2.0) are gated behind registration and a signed partnership, so the API surface below is modeled from Waystar's public product
  and developer-portal descriptions and the underlying X12 standards rather than from a published OpenAPI definition.
image: https://kinlane-images.s3.amazonaws.com/shared/apis-json/apis-json-logo.jpg
tags:
- Healthcare
- Revenue Cycle Management
- RCM
- Clearinghouse
- Healthcare Payments
- Medical Billing
- X12 EDI
- Eligibility
- Claims
- Remittance
created: '2026-07-04'
modified: '2026-07-04'
specificationVersion: '0.19'
apis:
- aid: waystar:waystar-eligibility-verification-api
  name: Waystar Eligibility Verification API
  tags:
  - Eligibility
  - Benefits
  - X12 270/271
  image: https://kinlane-images.s3.amazonaws.com/shared/apis-json/apis-json-logo.jpg
  humanURL: https://www.waystar.com/our-platform/financial-clearance/eligibility-verification/
  properties:
  - url: https://developer.waystar.com/
    type: Documentation
  - url: https://www.waystar.com/our-platform/financial-clearance/eligibility-verification/
    type: SignUp
  description: Real-time and batch insurance eligibility and benefits verification, exchanging X12 270 inquiries and 271 responses
    to confirm coverage, plan details, copays, deductibles, and service-type benefits before a visit. Endpoints are modeled
    from Waystar's Eligibility product and the 270/271 transaction set; concrete paths are provisioned through the partner
    program.
- aid: waystar:waystar-prior-authorization-api
  name: Waystar Authorization & Referral API
  tags:
  - Prior Authorization
  - Referrals
  - X12 278
  image: https://kinlane-images.s3.amazonaws.com/shared/apis-json/apis-json-logo.jpg
  humanURL: https://www.waystar.com/our-platform/financial-clearance/authorizations/
  properties:
  - url: https://developer.waystar.com/
    type: Documentation
  - url: https://www.waystar.com/our-platform/financial-clearance/authorization-referral-status/
    type: Documentation
  description: Automates prior authorization and referral determination and status, modeled on the X12 278 health care services
    review request/response. Covers submitting authorization requests, checking auth/referral status, and returning determinations.
    Waystar layers RPA and payer-portal automation on top of EDI where payers lack a transaction. Modeled from public product
    docs.
- aid: waystar:waystar-patient-estimation-api
  name: Waystar Patient Estimation API
  tags:
  - Patient Estimation
  - Price Transparency
  - Financial Clearance
  image: https://kinlane-images.s3.amazonaws.com/shared/apis-json/apis-json-logo.jpg
  humanURL: https://www.waystar.com/our-platform/financial-clearance/coverage-detection/
  properties:
  - url: https://developer.waystar.com/
    type: Documentation
  description: Produces pre-service, good-faith patient cost estimates by combining eligibility/benefit data, contracted rates,
    and procedure codes to support price transparency and up-front patient collections. Modeled from Waystar's financial clearance
    product; not backed by a published OpenAPI definition.
- aid: waystar:waystar-claim-management-api
  name: Waystar Claim Management API
  tags:
  - Claims
  - Claim Submission
  - X12 837
  image: https://kinlane-images.s3.amazonaws.com/shared/apis-json/apis-json-logo.jpg
  humanURL: https://www.waystar.com/our-platform/claim-management/claim-manager/
  properties:
  - url: https://developer.waystar.com/
    type: Documentation
  - url: https://www.waystar.com/our-platform/claim-management/claim-manager/
    type: Documentation
  description: Submits, scrubs, edits, tracks, and manages professional, institutional, and dental claims through Waystar's
    clearinghouse, modeled on the X12 837P/837I/837D claim transaction set. Includes claim creation, validation against payer
    edits, submission, and lifecycle management. Endpoints are modeled from the Claim Manager product and 837 standard.
- aid: waystar:waystar-claim-status-api
  name: Waystar Claim Status API
  tags:
  - Claim Status
  - X12 276/277
  - Tracking
  image: https://kinlane-images.s3.amazonaws.com/shared/apis-json/apis-json-logo.jpg
  humanURL: https://www.waystar.com/our-platform/claim-management/claim-monitoring/
  properties:
  - url: https://developer.waystar.com/
    type: Documentation
  description: Queries and monitors claim status across payers, modeled on the X12 276 status inquiry and 277 status response
    - returning received, accepted, pending, denied, and paid states. Supports both real-time inquiry and automated status
    monitoring. Modeled from Waystar's claim monitoring product.
- aid: waystar:waystar-remittance-era-api
  name: Waystar Remittance & ERA API
  tags:
  - Remittance
  - ERA
  - X12 835
  - Payment Posting
  image: https://kinlane-images.s3.amazonaws.com/shared/apis-json/apis-json-logo.jpg
  humanURL: https://www.waystar.com/our-platform/payment-management/remit-manager/
  properties:
  - url: https://developer.waystar.com/
    type: Documentation
  description: Retrieves electronic remittance advice (835/ERA), payments, and adjustments for automated payment posting and
    reconciliation, with raw X12 835 artifacts and parsed JSON. Modeled on the X12 835 transaction and Waystar's Remit Manager
    product; concrete endpoints are partner-provisioned.
- aid: waystar:waystar-denial-management-api
  name: Waystar Denial & Appeal Management API
  tags:
  - Denials
  - Appeals
  - Recovery
  image: https://kinlane-images.s3.amazonaws.com/shared/apis-json/apis-json-logo.jpg
  humanURL: https://www.waystar.com/our-platform/denial-prevention-recovery/denial-recovery/
  properties:
  - url: https://developer.waystar.com/
    type: Documentation
  description: Identifies denied claims, exposes denial and remark codes and explanation-of-benefits detail, and supports
    appeal creation, packaging, and resubmission workflows. Modeled from Waystar's denial prevention and recovery product;
    not backed by a published OpenAPI definition.
common:
- type: VulnerabilityDisclosure
  url: security/waystar-vulnerability-disclosure.yml
- type: DomainSecurity
  url: security/waystar-domain-security.yml
- type: LinkedIn
  url: https://www.linkedin.com/company/waystar
- type: Website
  url: https://www.waystar.com/
- type: Documentation
  url: https://developer.waystar.com/
- type: SignUp
  url: https://www.waystar.com/clients-partners/
- type: Login
  url: https://www.waystar.com/login/
- type: Plans
  url: plans/waystar-plans-pricing.yml
- type: RateLimits
  url: rate-limits/waystar-rate-limits.yml
- type: FinOps
  url: finops/waystar-finops.yml
- type: Blog
  url: https://www.waystar.com/feed/
maintainers:
- FN: Kin Lane
  email: kin@apievangelist.com