Waystar Holding Corp.

Good day and thank you for standing by. Welcome to the Waystar Third Quarter 2025 Earnings Conference Call. At this time, all participants are in a listen-only mode. After the speaker's presentation, there will be a question and answer session. Please be advised that today's conference is being recorded. I would now like to hand the conference over to your first speaker today, Sue Dutley, Vice President of Investor Relations. Please go ahead.

Thank you, operator. Good afternoon, everyone, and thank you for joining Waystar's third quarter 2025 earnings call. Joining me today are Matt Hawkins, Waystar's chief executive officer, and Steve Oreskevich, Waystar's chief financial officer. This afternoon, we issued a press release announcing our financial results and published an accompanying presentation deck. You can find these materials at investors.waystar.com. Before we begin, I'd like to remind you that this call contains forward-looking statements which are predictions or beliefs about future events or performance. Examples of these statements include expectations of future financial results, growth, and margins. These statements involve a number of risks and uncertainties that may cause actual results to differ materially from those expressed in these statements. For a full discussion of the risks and other factors that may impact these forward-looking statements, please refer to this afternoon's press release and the reports we file with the SEC. all of which are available on the IR page of our website. Any forward-looking statements made on this call are only as of today and will not be updated unless required by law. We will also discuss certain non-GAAP financial measures. These measures are intended to provide additional insight into our performance and should not be considered in isolation or as a substitute for financial information prepared in accordance with GAAP. We have provided reconciliations of the non-GAAP financial measures included in our remarks to the most directly comparable GAAP measures, together with explanations of these measures in the appendix of the presentation slide deck and our earnings release. With that, I would like to turn the call over to Matt.

Thank you, Sue, and good afternoon, everyone. In Q3, Waystar continued its strong momentum, achieving solid revenue growth and profitability. This performance was anchored by healthy client retention and expansion reflecting our leading position in modernizing the healthcare payment process. Our cloud-based AI-powered software creates compelling value that drives meaningful ROI, strengthens client financial outcomes, and improves transparency in the cost of patient care. Let's review a few key highlights. Reflecting strong execution, Waystar delivered another quarter of double-digit revenue growth and strong margins, outpacing our guidance on both measures. Revenue grew to $269 million, representing 12% year-over-year growth with an adjusted EBITDA margin of 42%. On October 1st, Waystar completed the acquisition of Iodine software, expanding our reach to more providers uniting clinical, administrative, and financial data, increasing the total addressable market, and unlocking new opportunities to drive profitable growth. We announced innovations across our AI-powered platform and engaged hundreds of healthcare's top technology and industry leaders at Waystar True North, our annual client conference, to foster connection, celebrate success, and ensure our product roadmap continues to meet providers' needs today and in the future. At Waystar, the mission is clear, to simplify healthcare payments. The healthcare financial system is complex, fragmented, and administratively heavy, and Waystar is modernizing it through a cloud-based platform that streamlines the entire process. Our technology helps providers get paid faster, more accurately, and with less administrative burden, so they can focus on what matters most, delivering quality patient care. Purpose-built for healthcare, our platform integrates with more than 500 electronic health records and practice management systems. This extensive integration enables us to serve over a million providers nationwide of all types and sizes. And we believe Waystar's impact is unmatched. Waystar leads the market in advanced automation and intelligence, leveraging AI-powered workflows, unrivaled data assets, and meaningful innovation. Our powerful software fuels industry-leading client satisfaction and is transforming the financial and administrative engine of health care. As the industry seeks greater efficiency, transparency, and value, we believe Waystar is positioned to capture a vast and durable growth opportunity for years to come. Turning to the completion of the iodine software acquisition, Waystar has taken a major step forward in our mission. The addition of iodine expands our total addressable market by more than 15%, accelerates innovation, and strengthens our ability to drive durable, profitable growth. We've also welcomed nearly 150 health systems representing more than 1,000 hospitals to our client base. Iodine brings proven AI-powered mid-cycle capabilities, including clinical documentation integrity, utilization management, and pre-bill anomaly detection. With Iodine now part of Waystar, we're uniting clinical, financial, administrative, and payer data in a single intelligent platform. By infusing these capabilities and data into our software, we're extending and compounding the value Waystar provides before, during, and after care. Our platform and access to this tremendous data spans every stage of the revenue cycle, powering AI insights, automation, and accuracy that enable complete, compliant, and defensible claims, accelerating reimbursement and strengthening provider financial performance. We estimate that Iodine accelerates portions of our product roadmap by nearly two years as we deliver the next generation of clinically informed AI-powered capabilities. We are pleased to have Iodine founder, William Chan, now serving as Waystar's chief AI and product officer. In this role, William is shaping the future of the Waystar platform and advancing our innovation agenda. He is joined by several senior leaders and domain experts from Iodine who bring deep clinical and technical expertise to accelerate our progress. To give you a sense of what's ahead, we envision a future where AI continuously scans data identifying anomalies across patients, providers, and payers, automating tasks, validating documentation accuracy, and predicting and delivering financial outcomes. This is the path toward true autonomous AI in healthcare revenue management. And ultimately, we believe these innovations will power the future of the healthcare system. Waystar recently hosted its sold-out client conference, Waystar True North, convening more than 500 revenue cycle leaders, one of the largest gatherings of decision-makers in the industry. At the conference, we highlighted client results that generated meaningful ROI and strong performance. A few examples of client impact include reduced prior authorization submission time by 70%, within weeks of implementation at a large regional health system, achieved a four times ROI for a major nonprofit health system through lower denials and higher revenue capture, and increased point of service cash collections while redeploying the equivalent of 10 full-time employees to higher valued work at a large Midwestern health system. These outcomes reinforce the scalability and financial impact of the Waystar platform and our ability to deliver sustainable, profitable growth. Also at Waystar TrueNorth, we convened the Waystar Advisory Board, senior executive decision makers and early adopters of Waystar software from leading provider organizations who provide invaluable insights that fuel our innovation and help shape our strategy. Our discussions reflected the realities providers face today, rising utilization, accelerating denial rates, and ongoing workforce shortages that continue to pressure margins. Many are turning to AI, seeking technology to drive greater efficiency, reduce administrative waste, and deliver the financial transparency that builds trust across all stakeholders. Despite this progress, key barriers remain, Most notably, data fragmentation. Much of the healthcare data is siloed or locked in unstructured formats, such as clinical charts and notes, PDFs, lab reports, and images, limiting the effectiveness of AI. An MIT study found that nearly 95% of AI initiatives rely on incomplete or inconsistent data. The result? Without high-quality data, AI doesn't create efficiency. It creates more work. The second challenge is integration. Providers need technology that operates seamlessly within their current systems and workflows. Without interoperability, the value of AI remains unrealized. And finally, cybersecurity remains critical as AI becomes more deeply embedded in clinical and financial processes. Secure, compliant data management at every point of contact is essential. These challenges underscore the need for a unified, intelligent, and trusted platform, and this is where Waystar is uniquely positioned to lead. An independent market study ranked Waystar the number one trusted vendor among top competitors, recognizing a sustained commitment to data protection client experience, and innovation. Insights from the Waystar Advisory Board and independent studies reinforce our differentiated position and confirm the growing demand for a unified, intelligent, and trusted platform. We continue to build client confidence and deepen relationships that drive expansion, accelerate adoption, and power the next generation of innovation across the platform. At the heart of Waystar's differentiation is innovation. Our platform advances continuously with hundreds of new capabilities launched each quarter to improve automation, accuracy, and ease of use. Twice each year, new product capabilities are unveiled through the Innovation Showcase, highlighting how the platform is advancing to meet providers' needs. Launched at Waystar TrueNorth, our fall innovation showcase introduced new AI-powered capabilities that address some of the most pressing challenges in healthcare, including denial prevention and recovery and patient financial care, driving better outcomes for providers and the patients they serve. The important advancements we announced include denial prevention, Waystar Altitude AI targets the 60% of denials that are preventable, reducing time related to critical prevention work by 95% for a mid-sized health system and building on our industry-leading 98.5% plus first pass clean claim rate across our client base, accelerating reimbursement and improving cash flow. In denial recovery, Waystar is addressing the $20 billion annual denial problem. Waystar Altitude AI enables providers to create hundreds of appeal packages simultaneously, more than 90% faster than before, driving double-digit increases in overturn rates for early adopters and improving reimbursement speed and accuracy. And patient financial engagement. To address the $17 billion uncompensated care gap related to patient collections, Waystar's cost estimation capability is seamlessly integrated within our patient digital experience to increase pre-service patient payments, accelerate cash flow, and reduce uncompensated care. Client feedback on these innovations has been very positive, validating our roadmap and reinforcing the growing demand for AI-powered automation. This innovation continues to build client confidence and deepen long-term relationships that drive adoption, expansion, and sustained growth across the Waystar platform. Trust remains central to our success. Following Waystar TrueNorth, attendees reported a 93% confidence level in Waystar as a trusted partner. That confidence is reflected in our performance with strong net promoter scores and a net revenue retention rate of 113%. The number of clients generating more than $100,000 in trailing 12-month revenue grew to 1,306 in Q3, an increase of 11% year over year. And the market is taking note of our progress. We were proud to receive two prestigious awards during the third quarter, powerful validation for Waystar, Fast Company named Waystar one of the best workplaces for innovators in North America. And the 2025 Stevie Awards named Waystar Healthcare Company of the Year and honored us as the top-ranked payments solution. In closing, sustainable transformation in healthcare requires a strong foundation. We believe Waystar's industry-leading, AI-powered platform is that foundation. the essential differentiated choice for providers seeking to simplify healthcare payments and achieve better outcomes. Waystar's momentum is strong and accelerating as we advance our mission and capture a large expanding market opportunity. We are operating with discipline and delivering results, building a rule of 50 plus software business with the ability to compound revenue and profitable growth. With that, I'll turn it over to Steve to walk through the financial details from the quarter.