Waystar Holding Corp.

Good day and thank you for standing by. Welcome to the Waystar Third Quarter 2026 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. To ask a question during the session, you'll need to press star 1-1 on your telephone. You will then hear an automated message advising your hand is raised. To withdraw your question, please press star 1-1 again. Please be advised that today's conference is being recorded. I'd now like to hand the conference over to Edward Parker, Head of Investor Relations. Please go ahead.

Thank you, Operator. Good afternoon, everyone, and thank you for joining Waystar's third quarter 2026 earnings call. Joining me today are Matt Hawkins, Waystar's Chief Executive Officer, and Alpana Wegner, 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 would 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 filed with the SEC, all of which are available on the investor relations 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 and 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'd like to turn the call over to Matt.

Thanks, Edward, and good afternoon, everyone. Thank you for joining our third quarter earnings call. Waystar delivered another strong quarter. Revenue grew 21% year over year and 10% organically. Adjusted EBITDA grew 24% with an adjusted EBITDA margin of 43%, and we generated $115 million in unlevered free cash flow. We ended the quarter with 1,488 clients generating more than $100,000 of trailing 12-month revenue, up 14% year-over-year. Commercial activity reflected healthy demand and robust bookings across the business. We are establishing larger, broader client relationships as large healthcare organizations increasingly look to Waystar to support more of the revenue cycle through a single connected platform. We made meaningful progress across our product roadmap, including new AI powered and agentic capabilities that advance our vision of creating the industry's first economist revenue cycle. This quarter reflects strong progress against our three execution priorities, driving broader adoption of the Waystar platform, extending our reach through partners and integrations and advancing AI and innovation. First, driving broader adoption of the Waystar platform. We're expanding our relationships with existing clients and moving further upmarket with new clients. Our connected end-to-end platform gives us the opportunity to support the entire revenue cycle. 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. Second, extending our reach. We're expanding our distribution through strategic partners and deeper integrations that bring Waystar into more provider workflows. Across our ecosystem of more than 200 channel partners, we have added more than 20 new integrations this year that expand our reach and create new opportunities for growth. Third, advancing AI and innovation. We're advancing our product roadmap across the Waystar platform, including expanding our position in the mid-cycle and bringing new altitude AI-powered and agentic innovations to market. 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. We delivered another quarter of strong commercial momentum. Year to date bookings grew 25% year over year, demonstrating continued demand and solid execution across the business. Let me bring that momentum to life with a few examples of what we're seeing in the market. This quarter, we secured the largest new client win in Waystar's history. 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. The organization plans to replace more than 20 separate vendors with Waystar as it simplifies its technology infrastructure and streamlines operations. We're also seeing strong momentum within our existing client base, which accounted for approximately 60% of our year-to-date bookings. One example is a large Texas-based help system that selected our pre-bill anomaly detection solution, expanding its relationship with Waystar and displacing two incumbent vendors. This organization already uses Waystar across claims management, patient access, and Clinical Documentation Integrity, demonstrating our ability to broaden strategic relationships across the revenue cycle. This is also a great example of the opportunity we saw in bringing Waystar and Iodine together. By combining Waystar's financial data, workflows and connectivity with Iodine's clinical intelligence, we're creating differentiated capabilities that allow us to solve more complex problems for our clients and expand our relationships over time. We're seeing that strategy translate into strong commercial results. Iodine bookings exceeded our year-to-date plan by 74%. A key driver has been our go-to-market strategy of bringing together clinical documentation integrity known as CDI and pre-bill anomaly detection to address a broader set of Mid-Cycle Needs. Across these two solutions, we generated nearly $30 million of year-to-date bookings, including approximately $15 million in the third quarter alone, with a combined pipeline of more than $100 million. We're also seeing encouraging cross-sell momentum. Existing Waystar clients adopting iodine capabilities contributed approximately $9 million of bookings in Q3. up 50% sequentially. Taken together, these results demonstrate the opportunity we have to bring more of Waystar's capabilities to our installed base, expand our strategic client relationships, and drive durable growth across the platform. We're also extending our reach through strategic channel relationships, particularly across the ambulatory market. During the quarter, we expanded our partnership with a leading physical therapy practice management system, giving Waystar distribution into an additional segment of its client base. This expansion displaces three incumbent revenue cycle vendors and extends 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. These wins demonstrate how our platform strategy is translating into competitive success. We are winning large new clients, replacing fragmented incumbent solutions and expanding relationships as clients and channel partners select Waystar to tackle more of their revenue cycle challenges. Our trusted, connected and independent platform is built on four and the structural foundations we've discussed before. Mission critical infrastructure, proprietary data, an extensively deployed network and deep domain expertise. Together, these strengths enable us to connect providers, payers and patients across the revenue cycle. Our network continues to grow in both scale and depth. Waystar now processes more than 8.5 billion transactions annually representing more than $3 trillion in gross claims. We connect approximately 1.5 million providers, and our clinical intelligence spans approximately one-third of US hospital discharges. We continue to deepen our payer connectivity. In 2026, we've added more than 100 direct connections to health plans, supporting nearly 50 million transactions annually. These deeper integrations increase the value of our network for clients and further strengthen Waystar's role as the connected financial operating layer for healthcare. And we believe these advantages become even more valuable as AI accelerates across healthcare. We're moving beyond AI that identifies opportunities and recommends actions toward AI agents that can execute increasingly complex work on behalf of our clients. We continue to make meaningful progress advancing AI and innovation across the Waystar platform. As AI accelerates across healthcare, we believe the value of a trusted, connected, and independent platform becomes even greater. The revenue cycle doesn't operate within a single application. It spans providers, payers, patients, and thousands of financial workflows. Waystar is the system of action that sits at the intersection of those workflows. One example is the industry's first autonomous claim resubmission capability, which we launched this quarter and is now in production as part of our premium claims management offering. Powered by Altitude AI, the capability interprets payer responses, applies payer-specific intelligence to determine the next action, and autonomously resubmits eligible rejected claims with minimal human intervention. 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. For clients, that means lower administrative costs Thank you for joining us today. Clients can quickly analyze complex revenue cycle data by simply asking questions in natural language. Early adopters have reported up to a 75% reduction in time spent on data analysis. Mid-cycle is a strategic part of how we're expanding the Waystar platform. 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. As quality becomes an increasingly important component of reimbursement, we'll extend our pre-built anomaly detection capabilities into quality-related workflows, further connecting clinical and financial performance. We're seeing this innovation translate into commercial momentum. Altitude AI powered offerings represented approximately 43% of third quarter bookings. More than 130 clients have joined our early adopter program, helping us test and refine new capabilities as we bring them to market. We also saw strong client engagement at our recent Waystar True North Conference, where a majority of surveyed attendees said they were more likely to expand the number of Waystar products their organizations use following the event. Taken together, these proof points reinforce our long-term opportunity ahead as we bring AI more deeply into the revenue cycle. To help lead this next phase, we recently welcomed Amit Khanna as our Chief Product and Technology Officer. Amit brings more than 25 years of enterprise technology experience Most recently leading healthcare at Salesforce, where he helped bring agent force for health to market. His experience strengthens our ability to accelerate AI innovation and execute against our long-term vision. We're pleased with the progress we're making across our platform, product roadmap, and commercial execution. A key part of our strategy is signing larger, broader platform relationships, and we're seeing strong success here. As we sign more of these larger deals, we are seeing implementation and revenue ramp periods that are longer than we originally anticipated. These relationships represent significant long-term revenue opportunities, with revenue building as clients implement and adopt more of the WayStar platform. Other factors are also affecting our near-term revenue outlook, which Alpana will discuss. We are confident and the underlying business and focused on translating our commercial momentum into low double-digit revenue growth while continuing to invest in the Waystar platform, operate with discipline and deliver adjusted EBITDA margins of 40% or greater. Alpana will walk through our updated outlook, the near-term revenue dynamics and how we're thinking about the business from here. Alpana, over to you.