Change Healthcare (Optum) vs Waystar
Two Claims & Clearinghouses vendors, side by side. Facts from public sources; judgments are ours.
At a glance
Derived from public facts · a rough scale, not a ranking
| Change Healthcare (Optum) | Waystar | |
|---|---|---|
| Pricing model | Per-transaction / per-chart · Clearinghouse per-transaction fees | Per-transaction / per-chart · per-claim fees plus subscription, quote based |
| Speed to go live | Payer enrollment and testing cycles | standard EHR/PM integration project |
| Automation model | Data / network utility · Largest claims clearinghouse network | Software platform · AI-assisted RCM and clearinghouse suite |
| Built for | Enterprise systems, Payers, Billing companies, Mid-size groups | Small practices, Mid-size groups, Enterprise systems, Billing companies |
| Security posture | HITRUST, HIPAA | HITRUST, SOC 2 Type II, PCI DSS |
| Company maturity | 9 yrs (est. 2017) | 9 yrs (est. 2017) |
| Financial backing | Subsidiary of UnitedHealth Group (Optum) | Public (Nasdaq: WAY) |
| Named customers | None public | 5 named |
| Published results | No public numbers | Specific numbers public |
| Documented integrations | 5 listed | 5 listed |
| Third-party validation | None found | None found |
Bottom line
- Pick Change Healthcare if you need the broadest payer connectivity for claims, eligibility, and remits and can accept post-breach vendor concentration risk inside Optum.
- Pick Waystar if you want one proven clearinghouse and claims platform covering eligibility through payments across any practice size.
Change Healthcare (Optum)
The largest US medical claims clearinghouse, now part of Optum
- Founded
- 2017
- HQ
- Nashville, TN
- Stage
- Subsidiary of UnitedHealth Group (Optum)
- Raised
- n/a
What it does
- Medical, dental, and pharmacy claims clearinghouse
- Eligibility and benefits verification at scale
- Electronic remittance and payment services
- Claims editing and payment accuracy tools
- Clinical data exchange and attachments
- Patient billing and payment products
Where it's strong
- Unmatched payer connectivity: it remains the default clearinghouse route for a huge share of US claims volume.
- Breadth across medical, dental, and pharmacy transactions plus payments means one vendor can cover most exchange needs.
- Optum ownership gives it deep resources and long-term viability.
What buyers should weigh
- The February 2024 ransomware attack took its clearinghouse down for months, exposed data on roughly 192.7 million people, and cost UnitedHealth over $2B; restoration was not complete until late 2024 and litigation continues into 2026.
- Many providers now run a second clearinghouse for redundancy after the outage, and buyers should plan for the same.
- Being owned by UnitedHealth raises conflict-of-interest questions for providers and competing payers, and post-attack loan clawbacks strained provider trust.
Integrations
Waystar
Public RCM platform spanning claims to patient payments
- Founded
- 2017
- HQ
- Lehi, UT
- Stage
- Public (Nasdaq: WAY)
- Raised
- $968M IPO (June 2024)
What it does
- Claims clearinghouse connected to 5,000+ payer endpoints
- Eligibility verification and prior authorization automation
- Denial prevention, appeals, and recovery workflows
- Patient estimates, billing, and payment collection
- Remit and payer payment management with analytics
- AI clinical documentation integrity via Iodine Software
Where it's strong
- True end-to-end RCM platform, so one vendor can replace several point solutions across the revenue cycle.
- Deep, certified EHR integrations (Epic, Cerner, MEDITECH) mean staff work claims inside existing workflows rather than a separate portal.
- Named client results are strong and public: Cincinnati Children's cut clearinghouse costs in half and BAYADA reduced denials 72%.
What buyers should weigh
- Pricing is modular and not published, and total cost climbs quickly as you add suites beyond the base clearinghouse.
- The $1.25B Iodine acquisition closed October 2025, so clinical intelligence products are still being integrated and roadmaps may shift.
- Enterprise contracts are multi-year, and switching clearinghouses later means re-doing payer enrollments, a real lock-in cost.
Named customers
Piedmont · Baptist Health (Kentucky) · Cincinnati Children's · Renown Health · BAYADA Home Health Care
Integrations
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