Adonis vs Waystar (2026)
A denials specialist against the clearinghouse network. Adonis, founded in 2022, is built around the payer relationship: it predicts and clusters denials, and sends agents into payer portals to check authorizations and to draft and file appeals, as an overlay on the systems a provider already runs. Waystar is a publicly traded revenue cycle platform clearing claims, eligibility and payment transactions for about one million providers. Its AltitudeAI layer adds denial prioritization, drafted appeal packages from payer specific templates and, since 2026, agentic features. If you want an overlay built only for denials and receivables, start with Adonis, and pin down what files without review. If you want AI inside the clearinghouse you already run, start with Waystar.
- Denials and aged receivables are the specific job: denial prediction and clustering, then agents in payer portals for authorization checks and appeals.
- A founder background inside health insurers, with named references at Mount Sinai and Fox Valley Orthopedics.
- An overlay rather than a new system of record, available through Epic's Connection Hub.
- Network scale: claims, eligibility and payment transactions for about one million providers, with integrations to more than 500 record and practice management systems.
- AI inside the platform: appeal packages from payer specific templates, denials prioritized by expected value and medical necessity summaries for authorizations.
- Attestations stated in a public filing: HITRUST, SOC 2 Type II and PCI DSS Level 1, and a HIPAA covered entity for its clearinghouse services.
This comparison is published by AI Health Index, an independent research platform that compares healthcare AI vendors objectively. Adonis and Waystar are each graded against the same capability taxonomy, from each vendor's own public materials and the regulatory record, under the AI Health Index verification standard. No vendor pays for placement, and no vendor has reviewed this page. How this evidence is graded
Plain facts
| Fact | Adonis | Waystar |
|---|---|---|
| Primary category | RCM & Prior Auth AI | RCM & Prior Auth AI |
| Founded | 2022 | 2017 |
| Headquarters | New York, New York | Lehi, Utah and Louisville, Kentucky |
| Website | adonis.io | waystar.com |
Side by Side
Select any grade to read the note behind it.
Product updates
The latest logged changes from each vendor, newest first, each linked to its source.
Waystar
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Product / capability
Waystar launched agentic AI capabilities inside its AltitudeAI platform, moving from software that scores and routes work to agents that carry the work out.
Source
Each vendor in one paragraph
Written to be quoted whole. Each paragraph opens the AI Health Index profile of the vendor: what the product is, who buys it and what it does.
AI orchestration platform for provider side revenue cycle, founded 2022, positioned as an overlay on the systems of record rather than a replacement. Adonis Intelligence monitors denials, aged receivables and payer behavior, clusters denials and builds smart worklists and dashboards; AI Agents work appeal status, prior authorization, documentation requests, timely filing, coverage checks and unknown denial reasons on payer portals and write updates back into the practice management system; Orchestration ties the two together and, the company says, improves with every resolved denial.
Source: AI Health Index, July 2026
Waystar's AltitudeAI capabilities on its healthcare revenue cycle platform, which clears claims, eligibility and payment transactions for about one million providers and roughly 60 percent of US patients.
Source: AI Health Index, July 2026
Questions buyers ask
How do Adonis and Waystar work with the EHR?
Adonis's partners page names AdvancedMD, athenahealth, Epic, ModMed, NextGen, Availity, Canvas, Change Healthcare and Office Ally, and its AI Agents write updates back into the practice management system after reading claims and denials. Since June 2026 Adonis is listed in Epic's Connection Hub, which lists integrations live at an Epic customer, as an intelligence and orchestration layer on a health system's Epic environment.
With Waystar, the Innovation Lab adds FHIR-based prior authorization connectivity for CMS-0057-F. A 2023 third-party survey reports 94 percent of clients satisfied with its EHR integrations. From the AI Health Index, drawn from each vendor's own published materials and the regulatory record, verified July 22, 2026. No vendor pays for placement.
How are Adonis and Waystar priced and sold?
Adonis sells enterprise agreements to physician groups, hospitals and health systems, digital health organizations and revenue cycle services organizations, across three modules (Intelligence, AI Agents, Orchestration), and sells through Epic's Connection Hub to health systems on Epic.
Waystar's annual report on Form 10-K says contracts generally combine a subscription fee with a volume-based component, sometimes only one; initial terms run two or three years and renew automatically for one-year terms with standard price escalators; billing is monthly; and more than 99 percent of revenue is recurring subscription or predictable volume. From the AI Health Index, drawn from each vendor's own published materials and the regulatory record, verified July 22, 2026. No vendor pays for placement.
How do Adonis and Waystar handle patient data?
With Adonis, the privacy and security page states encryption in transit and at rest, role based access limited to authorized personnel, regular audits, vulnerability assessments and penetration tests, and mandatory security and HIPAA training covering PHI; infrastructure runs in AWS. Agents work claims, denials and documentation requests, so clinical records reach the platform.
In Waystar's case, the website privacy policy covers site visitors, keeping web analytics data 24 months and no longer than five years, and says support staff are trained and bound by confidentiality. From the AI Health Index, drawn from each vendor's own published materials and the regulatory record, verified July 22, 2026. No vendor pays for placement.
Which settings and specialties do Adonis and Waystar cover?
Adonis names physician groups, hospitals and health systems, digital health organizations and revenue cycle services organizations, and specialties including orthopedics, gastroenterology, emergency medicine and behavioral health.
With Waystar, the company's filing reports more than 30,000 client organizations and about one million providers, with revenue split roughly 30 percent hospitals and health systems to 70 percent ambulatory and alternate sites. The AI features run across that platform; results specific to them are not broken out by setting. From the AI Health Index, drawn from each vendor's own published materials and the regulatory record, verified July 22, 2026. No vendor pays for placement.
Related comparisons
Other published head to head assessments involving these vendors or their closest peers.
Adonis's record has not yet been reviewed on this site, so its side of this page rests on the build record. Both draft appeal letters, which are formal representations of medical necessity to a payer. Adonis describes no review step before filing; ask both what goes out without a person signing off.
Waystar bought Iodine Software in October 2025, adding clinical documentation integrity and utilization management. Outcome figures on both sides are the companies' own.