Healthcare payment software maker Waystar again outperformed analysts’ estimates in the third quarter as the company builds out new artificial intelligence capabilities and drives growth by adding new customers and selling more of its platform to existing clients.
Waystar brought in $325.6 million in Q3 revenue, up 21% from the same period a year ago, according to its Q3 financial results published Monday afternoon. It beat Wall Street analysts’ estimates by 0.46%.
During Q3, the company reported $181 million in subscription revenue, up 34%, while provider revenue grew 28% to reach $243 million. Patient revenue came in at $82 million, up 5% year-over-year and volume-based revenue grew 8% to $143 million.
Waystar ended the quarter with 1,488 clients generating more than $100,000 of trailing 12-month revenue, up 14% year-over-year. Year-to-date bookings grew 25% year-over-year.
Waystar reported net income of $31 million and GAAP net income per share of 16 cents. It also reported adjusted EBITDA of $139.3 million and non-GAAP earnings per share of 44 cents.
Waystar provides healthcare payment and revenue cycle management tools to 30,000 clients, representing over 1.5 million distinct providers. Its platform processes over 8.5 billion healthcare payment transactions annually, representing more than $3 trillion in gross claims, according to CEO Matt Hawkins. Waystar says its clinical intelligence spans approximately one-third of U.S. hospital discharges. In 2026, Waystar added more than 100 direct connections to health plans, supporting nearly 50 million transactions annually, executives said.
Hawkins told investors and analysts during the Q3 earnings call that the quarter “reflects strong progress” on three strategic priorities of “driving broader adoption of the Waystar platform, extending our reach through partners and integrations, and advancing AI and innovation.”
“Our near-term roadmap includes more than 20 planned AI capabilities, accelerating the autonomous revenue cycle vision to reduce manual work, automate increasingly complex tasks and improve financial and operational outcomes for our clients,” Hawkins said.
Waystar is focused on using AI to reshape the RCM process with a vision of building an "autonomous revenue cycle" that can reduce manual work, automate increasingly complex tasks and improve financial and operational outcomes for healthcare organizations, executives said.
In Q3, Waystar launched an autonomous claim resubmission capability that interprets payer responses, applies payer-specific intelligence to determine the next action and autonomously resubmits eligible rejected claims with minimal human intervention, Hawkins said.
"Based on early adopter results and the initial claim types supported, we estimate this capability could autonomously resubmit up to $5 billion in previously rejected claims annually with the potential to eliminate more than 400,000 hours of manual work each year," he said.
The company is also targeting mid-cycle processes. "We're combining Waystar's financial data, payer intelligence, workflows and connectivity with Iodine's clinical intelligence to bring greater automation earlier in the revenue cycle," Hawkins noted.
The company acquired AI-driven RCM company Iodine Software a year ago to add its clinical intelligence capabilities to Waystar's software. Iodine bookings exceeded management's year-to-date plan by 74% in Q3, Hawkins said. Iodine's CDI and prebill anomaly detection products generated nearly $30 million in bookings through Q3, including about $15 million during the quarter, and have a combined pipeline exceeding $100 million.
The company is winning bigger, broader deals in the healthcare market, Hawkins asserted. Large health care organizations increasingly look to Waystar to support more of the revenue cycle through a single connected platform, he said on the call. "Within our large client cohort, which we define as clients generating more than $100,000 in LTM revenue, the average client now uses approximately five Waystar product modules. With more than 30 modules across six product families, we see significant opportunity to continue driving broader platform adoption within these relationships," he said.
Hawkins added the company “secured the largest new client win in Waystar’s history” during Q3.
“In a competitive process, a major East Coast health system representing approximately $7 billion in annual net patient revenue selected Waystar's full platform across patient access, mid-cycle, and back-end revenue cycle operations,” he said. “The organization plans to replace more than 20 separate vendors with Waystar as it simplifies its technology infrastructure and streamlines operations.”
Moreover, Hawkins said the company is expanding its reach with “strategic channel relationships,” with an emphasis on the ambulatory market—noting an expanded partnership with a leading physical therapy practice management system that expands Waystar’s reach to “nearly 4,000 providers across more than 2,500 sites, representing approximately 17 million claims annually.”
“Decisions like these reflect the trust we've built with channel partners, the breadth of our platform, and our ability to deliver real ROI,” Hawkins said.
Alpana Wegner, who took over as Waystar’s chief financial officer in August, said large client relationships “now represent approximately 75% of revenue,” adding the company is seeing momentum across growth in number of clients, strong bookings and implementation backlog expansion.
But larger, broader platform implementations have longer revenue conversion times, which can extend to 12 to 18 months, Wegner noted. This creates a longer period between booking and recognized revenue. The company reported that the backlog of larger deals, those in excess of $100,000 in annual sales, was up more than 50% year-over-year.
In response to a question from an analyst about the disconnect between bookings and revenue growth, Hawkins said, "We are seeing strong demand. We're not seeing a change in the competitive environment or our win rates, and we're pleased with that," adding that the company sees a "long-term double-digit opportunity to drive revenue."
For its full-year outlook, Waystar management forecasted revenue of $1.277 billion to $1.287 billion, with a midpoint of $1.282 billion. Adjusted EBITDA is expected to be between $543 million and $549 million for fiscal 2026.
The company expects slower, near-term revenue growth, forecasting fourth-quarter revenue of approximately $323 million, representing growth of about 6%.
Ryan Daniels, group head of healthcare technology and services at William Blair, wrote in an analyst note that Waystar delivered strong results on both the top and bottom line. "We continue to expect solid organic growth going forward. While investor focus may turn to the very modest (0.2%) reduction in sales guidance, we believe strong profitability, solid bookings performance, and robust free cash flows will continue to lead the stock higher over time; we maintain our Outperform rating," he wrote.
Daniels wrote that Waystar remains a "category leader in end-to-end RCM software... leveraging its competitive position and scale advantages to enhance the platform with innovations that drive client value. Moreover, we believe innovation momentum is driving an uptick in pipeline activity, size, and bookings performance, highlighted by a continuation of strong win rates and an uptick in larger deal sizes."
Daniels also noted that concerns over AI risks and "end-market noise," such as weaker healthcare volumes and Medicaid and ACA exchange lives moving to uninsured status, are "overblown."
Waystar is positioned to capitalize on the AI-enabled transformation of RCM via stronger pricing, an expanding total addressable market and increased value-add for clients, he said. "We continue to view the sales model as highly recurring (and visible) and do not anticipate any major AI-related competitive disruption as providers continue to turn toward trusted and fully integrated partners for RCM solutions," Daniels wrote.