Waystar vs NextGen Enterprise

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Our analysts compared Waystar vs NextGen Enterprise 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.

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.

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NextGen Enterprise helps multi- and single-specialty practices handle clinical and administrative tasks like appointment scheduling and revenue management. It provides practice management, charting, telehealth, a patient portal and analytics tools.

Its comprehensive features, specialty-specific content and scalable design make it a valuable asset for practices seeking to enhance their operational efficiency and improve patient outcomes.

Potential users should be aware of the initial setup and learning curve associated with implementation. Additionally, it doesn’t provide robust integrative capabilities.

Pricing is based on a subscription model, with costs varying depending on the practice size, number of users and specific features selected.

To explore other popular solutions that NextGen Enterprise offers, visit our NextGen Enterprise company page.

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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.
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  • Streamline Note-Taking: Keith M. Nord, MD, an Orthopedic Hand Surgeon with Sports Orthopedics & Spine conducted between 1,500 and 2,000 visits after using “Ambient Assist” (AI-powered notetaking tool). He no longer faces a "massive stack of notes" at the end of each day, and can now leave the office by 5:00 pm, contributing to a better work-life balance and preventing burnout.
  • Improve Care Quality: Intuitive behavioral health templates allowed clinicians at Arizona Youth and Family Services (AYFS) to easily complete clinical tasks and record client encounters in detail, helping them streamline documentation process. The platform also provided real-time data, including cancellation and no-show rates, which allowed AYFS staff to monitor and address these issues.
  • Boost Financial Performance: Syracuse Community Health Center achieved a 20% improvement in net collections over 12 months and a 10% decline in gross denials. Additionally, their total A/R days decreased by more than 20% over 12 months, with total insurance A/R days averaging 26 days.
  • Increase Patient Engagement: OrthoTennessee, serving over 300,000 patients annually, quickly achieved a 68% patient enrollment rate after implementing NextGen PxP Portal.
  • Meet Regulatory Requirements: If you’re worried about keeping up with regulatory compliance, you can’t go wrong with NextGen Enterprise. According to our analysis, it scored 91 for platform security and compliance. The system helps you follow FHIR, HIPAA, HITECH, MIPS, Meaningful Use and ONC-ATCB standards.
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  • 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.
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  • SOAP Notes: Record reasons to visit, social, family and diagnostic histories, vitals, physical exams, assessments/plans, and medications using the SOAP format. Use HPI (history of present illness) templates to document the patient's reason for visit, including onset, duration, severity, associated symptoms, and aggravating/relieving factors.
  • Templates: Use pre-built templates for patient visits, progress notes, procedures, patient intake, consent forms and letters. Tailor these or create new ones to perfectly fit your specific workflows.
  • Ambient Assist: Use smart AI technology to listen in on your patient conversations, capturing key information and automatically creating notes in your system.
  • Mobile App: Review and sign documents, view schedules and see high-level patient overviews (medications, allergies, past medical histories, etc.) Document patient visits using voice-to-text functionality. Save and prescribe frequently used medications with a few clicks.
  • Order Entry: Order labs, diagnostics and immunization from the CPOE bar on the patient’s chart. Click on order search to see your common orders.
  • Regulatory Reporting: Automate MIPS/MACRA data collection and reporting to demonstrate quality measures, improve outcomes and earn incentives. Collect and submit Uniform Data System (UDS) reports for FQHCs and eligible providers to track clinical quality measures and other HRSA-required data.
  • E-Prescribing: Launch the state-run Prescription Drug Monitoring Program (PDMP) database with a single click. Verify formulary coverage and benefits while writing the prescription. Initiate prior authorization requests directly from the prescribing window with pre-populated information. Securely transmit prescriptions to pharmacies nationwide through the Surescripts network.
  • Population Health: Collect patient data from EHRs, lab results, claims and health information exchanges. Use AGC, HCC or ASCVD risk algorithms to sort patients into different risk categories based on their health conditions, demographics and other factors. Analyze this data to look for anything that might be missing or doesn't quite add up. It could be a lab test that wasn't done, a prescription that wasn't filled or a recommended screening that was missed.
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Product Ranking

#43

among all
Medical Billing Software

#9

among all
Medical Billing Software

Find out who the leaders are

Analyst Rating Summary

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Analyst Ratings for Functional Requirements Customize This Data Customize This Data

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Claims Management Compliance And Security Dashboards And Reports Insurance Payments Management Medical Coding Mobile Capabilities Patient Payments Management Platform Capabilities Point Of Care Pre-appointment Management 100 92 88 100 100 76 75 94 91 93 0 25 50 75 100
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Analyst Ratings for Technical Requirements Customize This Data Customize This Data

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User Sentiment Summary

Excellent User Sentiment 315 reviews
Good User Sentiment 1475 reviews
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.

79%
of users recommend this product

NextGen Enterprise has a 'good' User Satisfaction Rating of 79% when considering 1475 user reviews from 4 recognized software review sites.

n/a
4.4 (17)
4.6 (116)
3.7 (155)
4.5 (199)
4.0 (1264)
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3.9 (39)

Awards

Waystar stands above the rest by achieving an ‘Excellent’ rating as a User Favorite.

User Favorite Award

SelectHub research analysts have evaluated NextGen Enterprise and concluded it earns best-in-class honors for Medical Coding.

Medical Coding Award

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.
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Improve Patient Care: Get access to complete and up-to-date patient records, including medical histories, allergies, medications and test results for data-driven and informed decision-making.
Streamline Routine Workflows: Automate scheduling, billing and documentation processes to reduce administrative burdens and free up time for patient care.
Enhance Medication Safety: Set automated alerts to check for drug interactions, allergies and dosage errors to significantly reduce adverse drug event risks.
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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.
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Complex Implementation: Demands time and resources for implementation, customization and staff training.
High Initial Costs: Requires significant investment in software, hardware and training.
Dependence on Technology: Creates reliance on technology, which can be problematic during system downtimes or technical failures.
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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.

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Our research analysts, after evaluating several solutions, awarded NextGen Enterprise with best-in-class honors for Insurance Payments Management, Medical Coding, Medical Billing Services, Notes and Templates, and Deployment Options.NextGen Enterprise provides EHR, practice management and patient experiene modules that support 2000 workflows and content for 30 specialties including cardiology, dental health, neurology, primary care and more.Intutive EHR tools make it easy for doctors and nurses to document patient visits. You can even use AI for note-taking. And with the mobile app, you can access patient info and chart on the go.The platform really shines when it comes to practice management. It automates a ton of time-consuming tasks like eligibility verification and billing, so your staff can focus on what really matters: patient care. Plus, the built-in analytics give practices valuable insights to improve efficiency and, ultimately, the bottom line.Patient engagement is also a key focus, with the NextGen PxP patient portal empowering patients to actively participate in their healthcare journey. They can schedule appointments, request refills, view test results and even message their doctors securely.One area that the system lacked was its integrative capabilities. It scored 77 in our analysis, lower than other popular products like athenahealth (93) and Cerner Ambulatory (88). That means you will need to connect barcode scanners, clinical decision support tools, prescription management systems and others via API.

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