Prerequisites

• Have a Waystar account with a Username / Password that can access the Waystar API

• Be familiar with Primary / Secondary Insurance in Sunwave

• Be familiar with Primary / Secondary Subscriber in Sunwave

• Be familiar with NPI Registry - https://npiregistry.cms.hhs.gov/search

Configuration and Data Setup

The following sections will walk you through the different configuration / data items the Waystar integration uses.

Waystar Configuration

There is a new administrative screen under Practice Setup

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The following fields are required:

• Username / Password - Your Waystar credentials that can access the Waystar API

• Inquiring Provider Name - The doctor or facility that will be making the benefits request in the format of First Last name

• Inquiring Provider NPI - The NPI number for the doctor or facility that will be making the benefits request

When Save is clicked we validate the Username / Password is correct by doing a test call to Waystar with with a dummy request from their documentation. We cannot validate the NPI at this time because more specific patient or opportunity data is needed to complete a valid request.

Insurance Provider

In order to use Waystar you must fill out the Primary or Secondary Insurance sections. In order to do this an insurance provider must be filled out. This can be configured through the Billing -> Insurance Provider screen.

Below is an example of an insurance provider:

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The following fields are required for Waystar:

• Name

• Payer Id

You can get this data from multiple sources; but Waystar customers can access a search feature in there console by going to Patient Tools -> Eligibility -> Payers

List of Waystar Payer IDs:

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Patient / Opportunity General Information

The following fields are required by Waystar:

• First Name

• Last Name

• Date of Birth

Patient / Opportunity Insurance Information

Once the Insurance Provider has been configured we can fill in the Patient / Opportunity insurance and subscriber information. This data has two flavors Primary & Secondary. To keep this document simple Primary is shown; but Secondary is the same thing.

The following fields are required:

• Insurance Provider - This is the insurance provider on their medical card that was configured above

• Member Id - This is the insurance policy number on their medical card

The following fields are optional:

• Patient Relationship to Subscriber - Waystar technically requires this field; but if the participant is “self”, then this can be left empty. The empty field will default to the “S” value which stands for “self”.

Waystar VoB Component

In the form editor there is a new Waystar component. You can add this by clicking Actions and selecting Add Waystar. If you hover over the component, you will see a tool tip display with an edit option. Clicking this brings up a modal window that will allow you to choose if this component pulls the Primary or Secondary insurance information.

This form also has access controls. The RUN NEW WAYSTAR button is only available to people that have Read and Write access. This can be configured in Practice Setup -> Roles

Running Waystar

If you have reached this point, all the hard work is done. What’s left is to click theRUN NEW WAYSTAR button. Below is an example of a valid response. According to Waystar, different providers will send back different information and they respond with what they are given. If certain plain data is not provided, users may still have to call the insurance provider.

Below is an example of me changing my Provider to an incorrect one:

Waystar attempts makes requests to this provider bust depending on how that provider sends back errors they may or may not be useful to an end user. If this happens they should check the following:

• Waystar Configuration - Check the NPI Number is valid

• Patient / Opportunity - Check that the First Name, Last Name, & Date of Birth are all filled out and accurate

• Insurance Provider - Check the Name and Payer ID are valid

• Insurance Information - Check the correct provider is selected and the Member ID is valid

Attached is a list of payers provided by Waystar that require enrollment to be completed in order for eligibility to be functional.

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