Waystar Launches AI Tool to Detect Payer Take-Backs and Recover Lost Provider Revenue

The new solution is part of Waystar’s AltitudeAI suite and uses AI and automation to scan claims and remittance datasets, identify recoupment activity, and match adjustments to original claims.

Waystar has rolled out a new artificial intelligence (AI) capability designed to help healthcare providers detect and recover revenue lost due to payer recoupments, commonly referred to as “take-backs.” The development comes as providers face increasing financial pressure from payment adjustments and claim denials.

According to company estimates, recoupments cost providers more than $1.6 billion each month. In parallel, claim denials continue to rise, with providers losing over $48 billion in net revenue in 2025 due to final denials and uncollected patient payments.

The new solution is part of Waystar’s AltitudeAI suite and uses AI and automation to scan claims and remittance datasets, identify recoupment activity, and match adjustments to original claims. This enables providers to detect previously untracked revenue losses and pursue appeals more effectively.

Waystar processes over 7.5 billion healthcare payment transactions across its platform, which serves more than 30,000 clients and over 1 million providers. The company leverages this large dataset to uncover patterns and systemic drivers of revenue leakage.

CEO Matt Hawkins said payer recoupments often occur months or years after initial payments are made, making them difficult to track. These “silent denials” typically require extensive manual effort to investigate, with providers often lacking visibility into which claims were impacted or why adjustments were made.

The company reports that its AI tool can reduce reconciliation time by more than 80% while providing full visibility into recoupments. In one early adopter case, a health system with approximately $4 billion in annual revenue identified $32 million in previously undetected recoupments. The process would have otherwise required an estimated 27,000 hours of manual work.

Recoupments have been increasing at twice the rate of overall claim volumes over the past three years, adding to the administrative burden on providers. Waystar’s tool aims to streamline this process by presenting actionable insights in a simplified format, enabling faster decision-making and appeals.

The current version does not fully automate the appeals process, but the company plans to expand capabilities over time. The solution was developed in collaboration with a group of healthcare organizations, including large health systems and ambulatory providers.

Waystar continues to expand its AI capabilities following its acquisition of Iodine Software, with a broader goal of building a more automated revenue cycle management platform.

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