Waystar Alternatives: 6 Picks for 2026

TL;DR: If you are leaving Waystar, first decide whether you need another claims network or a new practice operating system. Availity and Change Healthcare replace eligibility, authorizations, claims, and remits without taking over the chart. Tebra, AdvancedMD, and Drchrono collapse EHR, practice management, and billing into one login. CollaborateMD sits in the middle: a billing-first platform with a built-in clearinghouse that imports encounters from the EHR you already run. None of the six publish a list price you can defend to a partner, so the shortlist is about stack shape, payer connectivity, and cutover work, then a written quote for seats, modules, and migration.

How we evaluated

We scored each option the way a partner would score it in a meeting: does it replace the Waystar work your billers actually touch, or does it force a second project to replace the chart, the schedule, and the patient portal at the same time.

Waystar sells financial clearance, patient payments, charge capture, claims, denial recovery, and analytics. Leaving it means leaving the path from visit to a clean 837, a posted 835, and a patient statement.

The six names below already sit next to Waystar on live healthcare pages. We did not add a seventh. We opened each vendor’s public product home once. Availity, Tebra, AdvancedMD, Change Healthcare, CollaborateMD, and Drchrono do not put a defendable figure in a public store, so this page prints no vendor price, seat fee, or claimed savings next to those names. Where a cell would have been a number, it reads “not published.” What usually drives the quote is claim volume, clearinghouse-only versus EHR-plus-PM, eligibility and attachment modules, historical A/R migration, and training seats.

Industry context is separate from vendor marketing. According to CMS, national health spending grew 7.2% to $5.3 trillion in 2024, or 18.0% of GDP.

We weighted the shortlist like this:

Source: evaluation rubric for this comparison; not a vendor scorecard and not a purchased ranking.

According to the AMA 2025 prior authorization physician survey, 95% of the 1,000 surveyed physicians report that prior authorization delays care. If your next platform cannot carry eligibility and auth with claims, you will recreate that delay in a new login.

According to ONC, 95% of U.S. office-based physicians had adopted any EHR as of 2024, and 91% had adopted a certified EHR. Most medical practices already have a chart. The Waystar question is whether you keep that chart and swap the claims pipe, or you replace chart and pipe together.

Physician and clinical spending reached $1,109.7 billion in 2024. According to CMS, that line grew 8.1% in 2024. A switch that stalls posting for a billing month hits that stream directly.

US Tech Automations used those weights to keep this page honest: stack fit first, then a quote, never a guessed sticker.

Who each product is actually for

1. Availity

Availity is for a practice that wants a national payer-provider network and a clearinghouse, not a new EHR.

The public product home describes eligibility, authorizations, claims, remittances, a multi-payer portal, and a trading-partner network. If Waystar is your claims pipe and the chart stays, Availity leaves scheduling, notes, and the patient portal alone.

Skip it if partners want one vendor for documentation, superbill, and deposit. You will still need an EHR and a practice-management layer for appointments and charge entry.

Ask the quote for: payer enrollment versus network reach, attachments, prior-auth workflow, ERA/EFT, and who holds the trading-partner agreement.

2. Tebra

Tebra is for an independent medical practice that wants the chart, the claim, the patient message, and the marketing site in one platform.

The product home lists a cloud EHR (notes, e-prescribe, labs, telehealth, MACRA/MIPS), billing and payments, patient experience (scheduling, digital intake, messaging), and practice marketing. That is a full practice operating system, not a clearinghouse with a thin portal on top.

Choose Tebra when partners will move clinical and billing together. Do not choose it if physicians refuse another EHR conversion.

Ask the quote for: provider versus biller seats, whether marketing and patient-pay are in the same agreement, EHR data migration, and who scrubs claims during the dual-run month.

3. AdvancedMD

AdvancedMD is for independent practices, including multi-location groups and billing companies, that want EHR, practice management, patient engagement, and optional outsourced RCM on one cloud suite.

The public home states ONC-certified EHR, AWS hosting, HIPAA support, and MACRA/MIPS readiness. It also calls out specialty-configurable documentation, ambient note drafting, real-time eligibility, claim scrubbing, patient portal and intake, and managed billing.

It sits close to Tebra: both replace the practice OS. AdvancedMD is the conversation when locations, provider templates, or a billing company on the same database dominate. Tebra is the conversation when marketing and reputation sit in the same meeting as claims.

Ask the quote for: core suite versus RCM-as-a-service, locations and providers in scope, fee-schedule conversion, and whether historical encounters come across as discrete data or PDFs.

4. Change Healthcare

Change Healthcare, now presented through Optum’s business site, is for a practice or billing company that needs payer connectivity, claims, and financial transaction infrastructure — and that is willing to live in a stack owned by a large parent.

The public Optum for Business home is payers, hospitals, employers, government, and financial solutions — not a small-practice EHR catalog. For a practice leaving Waystar, the relevant slice is the claims/EDI/remittance path under the Change Healthcare brand.

Pick this conversation when attachments, payer edits, or the clearinghouse relationship are the pain and the EHR is staying. Skip it when partners want one login for the front desk, or when the risk committee will not accept another concentrated claims utility without a downtime plan. HHS treats health-care clearinghouses as covered entities under the HIPAA Security Rule, so the BAA is not optional.

Ask the quote for: which Optum/Change products you are buying, enrollment timelines, how 277 and 835 land in your PM, and who answers when a payer rejects a batch.

5. CollaborateMD

CollaborateMD is for medical practices and billing companies that want a billing-first practice-management system with a built-in clearinghouse, and that intend to keep (or swap later) a separate EHR.

The product home, branded CollaborateMD by EverHealth, lists electronic claims, claim scrubbing, denial management, ERA auto-posting, real-time eligibility, patient payments, lab interfaces, and AI-assisted import of encounter data from other EHRs. That import is why it belongs here: you can leave claims and PM without ripping out the chart on day one.

It is not Availity (you get a billing workstation, not only a network) and it is not Tebra (documentation can stay put).

Ask the quote for: unpublished commercial terms, how the EHR import is licensed, whether the built-in clearinghouse is mandatory for every payer, and how client databases are separated if you are a billing company.

6. Drchrono

Drchrono is for independent practices that want an all-in-one EHR with scheduling, documentation, a patient portal, and a proprietary clearinghouse in the same cloud database.

The public home, branded DrChrono by EverHealth, lists speech-to-text, labs and immunization registries, scheduling and reminders, eligibility, claims, denial workflows, integrated payments, and a HIPAA-compliant portal (OnPatient). That is a practice OS in the same family as Tebra and AdvancedMD.

CollaborateMD and Drchrono share a parent and are not the same product: billing-first with EHR import versus EHR-first with a clearinghouse inside. A partner who already “looked at EverHealth” still has to pick a shape.

Ask the quote for: provider seats, built-in versus external clearinghouse, portal and telehealth modules, data migration, and specialty templates.

Side-by-side comparison

Use this table to kill the wrong conversations before anyone books a demo. Every commercial cell is unpublished on purpose.

Source: vendor public homepages retrieved for this page (Availity, Tebra, AdvancedMD, Optum/Change Healthcare, CollaborateMD, Drchrono). Commercial terms: not published.

The administrative burden you are trying to shrink is not imaginary. 95% of surveyed physicians report prior-auth care delays. According to the AMA, 79% also report that prior authorization can at least sometimes lead to treatment abandonment, and 26% report a serious adverse event tied to the process.

Source: AMA 2025 Prior Authorization Physician Survey (PDF), fielded December 2025 among 1,000 U.S. physicians who complete prior authorizations in a typical week.

National spending context for the same conversation:

Source: CMS National Health Expenditure Fact Sheet, historical NHE 2024 (page last modified June 24, 2026).

If sliding-fee or safety-net timing is part of why claims stall in the current stack, read athenahealth vs CureMD: Sliding-Fee Timing, 2026 next; that page is about fee-schedule timing, not a seventh Waystar alternative.

Pros and cons

Availity

Pros: Leaves the EHR in place. Matches how many front desks already check eligibility. Covers the transaction set Waystar users miss on Monday morning: eligibility, auth, claims, remits.

Cons: Does not retire extra logins for notes and scheduling. You still need a PM or EHR to create the charge. Payer-portal habits can hide whether the work is the network or a specific payer’s skin.

Tebra

Pros: One platform for chart, claim, intake, and reputation. Independent-practice packaging is explicit on the public site. Billing and eligibility live next to the note, which cuts the “who entered this CPT” hunt.

Cons: You are converting an EHR, not only a clearinghouse. Marketing modules can expand the quote and the training list. Unpublished pricing means two similar practices can be offered different bundles; get the module list in writing.

AdvancedMD

Pros: EHR, PM, patient engagement, and managed RCM are designed as one suite. Multi-location reporting is part of the public story. ONC certification and MACRA/MIPS readiness are stated in public, which matters if you still attest.

Cons: Close enough to Tebra that a partner will ask why you are in both demos — have an answer (locations, RCM outsourcing, specialty templates) or drop one. A managed-billing add-on changes who your staff reports to; that is an employment conversation, not a software toggle.

Change Healthcare

Pros: Stays in the claims and financial lane. Fits a billing company that already thinks in batches, edits, and enrollments. You can keep the current EHR.

Cons: The public face is now an Optum business catalog, so the practice has to name the actual product on the order form. It will not give physicians a new chart. Concentration risk belongs in the same memo as the BAA.

CollaborateMD

Pros: Billing-first without an EHR conversion on day one. Built-in clearinghouse plus ERA posting is the Waystar-shaped work. EHR import is the escape hatch if physicians will not move notes yet.

Cons: Two systems still exist until you later collapse them. Front-desk scheduling and clinical quality reporting may still live elsewhere. Same parent as Drchrono, so a confused partner may think you already “picked EverHealth” when you only picked the billing cousin.

Drchrono

Pros: Chart, schedule, portal, and clearinghouse in one database. Mobile documentation is a real reason physicians agree to move. Denial workflows sit next to the encounter that caused them.

Cons: EHR conversion. Proprietary clearinghouse means you must test payer-list coverage, not assume the Waystar payer list follows you. Same parent as CollaborateMD; pick one shape so staff are not trained on both.

Patient messaging and reminders show up on Tebra and Drchrono. If SMS is in scope, keep consent review on a separate rail; Medical Practices Keep 1 Consent Review Before SMS in 2026 is the live companion, not a product on this shortlist.

What switching actually costs

The invoice is unpublished. The work is not.

Data. You need a map of what leaves Waystar: open claims, denial queues, eligibility logs, patient balances, ERA history, and attachment templates. Clinical data only moves if you also change EHR (Tebra, AdvancedMD, Drchrono). If you keep the chart (Availity, Change Healthcare, CollaborateMD), you still have to map charge codes, providers, and locations so the new 837 carries the same NPI, taxonomy, and payer quirks you already fought once. Historical A/R often stays in the old system through run-out; decide in writing who works those balances.

Payer enrollment. ERA, EFT, and trading-partner IDs do not travel because you signed a new BAA. Budget a dual-run that covers one full billing month: submit a slice of 837s through the new pipe while Waystar still submits the rest, then compare 277CA rejects and 835 postings side by side. US Tech Automations can watch those 277CA and 835 files during the dual-run so billers are not grepping portals by hand; that is a file-watch step, not a new clearinghouse.

Retraining. Front desk learns eligibility and auth in the new UI. Billers learn claim status, denial worklists, and payment posting. Physicians only sit in class if the chart moves. A clearinghouse-only swap is a billing-team project. An EHR swap is an all-hands project and will collide with the appointment book. If online booking is in the new suite, do not assume it behaves like a generic calendar; Why 7 Calendly Alternatives Fit Medical Practices 2026 is the scheduling companion for that fight.

The month it takes. Plan for a billing month of parallel operations, not an overnight cut. Calendar time after that month depends on payer enrollment, not on a blog. Ask each vendor who submits the first production batch, who owns rejects after go-live, and what happens to claims still sitting in Waystar.

HIPAA. Clearinghouses and EHR vendors are in scope. According to HHS, the Security Rule has applied to clearinghouses and to providers who transmit standard transactions since the 2003 final rule, and it requires an accurate risk analysis of ePHI. Execute a BAA before the first test file. According to HHS OCR, OCR had received over 374,321 HIPAA complaints as of October 31, 2024, and had settled or imposed penalties totaling $144,878,972 across 152 cases. Private practices sit on that complaint list. A sloppy cutover is a disclosure risk, not only a cash-flow risk.

What to ask when no figure is printed. Seats (providers, billers, front desk). Modules (eligibility, auth, attachments, patient pay, marketing, telehealth, managed RCM). Migration (discrete data vs. documents, who maps CPT and modifiers). Transaction path (must you use the built-in clearinghouse). Training hours and whether they are in the agreement. Run-out of old A/R. Downtime and batch-fail procedures. Those answers usually drive the number more than a headline package name.

If denial codes and patient-balance files are the part your staff dreads, US Tech Automations can extract CARC/RARC text from remits onto a worklist while the new vendor’s posting rules are still being tuned. That is the data extraction step next to finance posting, not a replacement for the clearinghouse itself.

Verdict: who should pick which

There is no single winner, and two pairs on this list are close.

Clearinghouse / network swap, keep the EHR: Availity or Change Healthcare. They are close on job-to-be-done. Pick Availity if the office already lives in a multi-payer portal and you want a provider-network conversation. Pick Change Healthcare if your billing company already speaks EDI catalogs and can name the Optum product on the order form. If you cannot name the product, you are not ready to sign.

Billing workstation, keep the EHR for now: CollaborateMD. It is the only one of the six that is explicitly billing-first with EHR import. Use it when physicians veto a chart conversion this year but billers cannot stay on Waystar.

Replace the practice OS: Tebra, AdvancedMD, or Drchrono. They are close. Pick Tebra when marketing, intake, and claims are one budget. Pick AdvancedMD when locations, specialty templates, or outsourced RCM dominate the memo. Pick Drchrono when the charting surface (including mobile) is the reason physicians will agree to move at all.

Do not run all six demos. Run one network option and one practice-OS option, unless CollaborateMD’s import story is the only politically possible path. Bring the dual-run plan to the demo and make the vendor walk a real 837 from your fee schedule, not a canned clinic.

Then open pricing on US Tech Automations if you want the dual-run watchers and remit extraction sitting beside whichever vendor you sign — not instead of that vendor.

FAQs

What is the closest Waystar alternative if we only need a clearinghouse?

Availity or Change Healthcare. Both keep your EHR in place and take the eligibility, claims, and remit path. They will not give you a new schedule or a new note.

Can we leave Waystar without converting the EHR?

Yes. Availity, Change Healthcare, and CollaborateMD are the three on this list that do not require a new chart on day one. CollaborateMD still replaces practice-management and billing workstations.

How long does a clearinghouse cutover take?

Plan a dual-run that covers one full billing month, then add whatever payer enrollment the vendor quotes in writing. This page does not invent a go-live date. The month is for comparing 277CA and 835 results, not for hoping the old pipe fails quietly.

Which of the six include an EHR?

Tebra, AdvancedMD, and Drchrono. CollaborateMD imports from an EHR. Availity and Change Healthcare do not replace the chart.

How do we compare quotes when no list price is published?

Ask every vendor the same written list: seats, modules, migration scope, clearinghouse rules, training, A/R run-out, and batch-fail support. Compare those line items, not a verbal “it depends.” If a number is not on paper, it is not a number you can defend to a partner.

Do CollaborateMD and Drchrono count as two independent choices?

They are two products with different shapes under the same EverHealth parent. Treat them as separate demos. Do not assume a contract for one covers the other.

Should prior authorization sit in the new stack or in a side tool?

In the stack you pick, if that stack offers it. The AMA survey’s 95% delay figure is why auth cannot live in a personal inbox. If the vendor’s auth module is an add-on, put it on the quote now so it is not a surprise in month two.

Key Takeaways

• Leaving Waystar is either a claims-network swap or a practice-OS conversion; do not demo those as if they were the same project.

• The six picks are Availity, Tebra, AdvancedMD, Change Healthcare, CollaborateMD, and Drchrono — no seventh name.

• Availity and Change Healthcare are close as network replacements; Tebra, AdvancedMD, and Drchrono are close as EHR-plus-billing suites; CollaborateMD is the billing-first middle path.

• National health spending hit $5.3 trillion in 2024. Claims still have to post through whatever you sign.

• 91% of office-based physicians used a certified EHR as of 2024, so most offices already have a chart to keep or convert.

• No figure in this article is a vendor price. Ask for seats, modules, and migration in writing.

• Budget a billing month of dual-run, new BAAs, and a named owner for Waystar A/R run-out.

• Use US Tech Automations only for the watchers and extraction around that dual-run, then compare the vendor quote against pricing.