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- **Revenue Growth**: Q3 revenue up 12% YoY to $269 million, driven by client retention and Iodine acquisition.
- **Iodine Impact**: Expanded TAM by 15% and accelerated product roadmap by 2 years, with $12 million EBITDA contribution in Q4.
- **AI Innovation**: AI-powered solutions reduce denials by 95% and enable 90% faster appeal processing, with 98.5% first-pass clean claims.
- **Financial Strength**: EBITDA margin 42%, free cash flow conversion 85%, and leverage ratio reduced to 1.9x.
- **Guidance Update**: 2025 revenue raised to $1.085–$1.093 billion (+15% YoY), with $30 million Iodine contribution in Q4.
- **Client Confidence**: 93% client confidence and NRR of 113%, reflecting strong retention and expansion.


**【CEO Summary Section】**
- **Revenue Growth and Profitability**: Q3 revenue reached $269 million, up 12% YoY, with adjusted EBITDA margin of 42%. The company outperformed guidance on both metrics.
- **Iodine Acquisition**: Completed acquisition of Iodine Software, expanding total addressable market (TAM) by 15% and adding 150 health systems. Iodine's AI capabilities accelerate Waystar's product roadmap by nearly 2 years.
- **Innovation Highlights**: Introduced AI-powered solutions like Waystar AltitudeAI for denial prevention (reducing time by 95%) and patient cost estimation tools to reduce uncompensated care. Client satisfaction metrics remain strong, with NRR at 113%.
- **Market Recognition**: Named Fast Company's Best Workplaces for Innovators and awarded 2025 Healthcare Company of the Year.

**【CFO Financial Commentary】**
- **Financial Performance**: GAAP revenue $269 million (+12% YoY), adjusted EBITDA $113 million (+17% YoY). Unlevered free cash flow $96 million (85% of EBITDA).
- **Guidance Update**: Raised 2025 full-year revenue to $1.085–$1.093 billion (+15% YoY) and EBITDA to $451–$455 million. Includes $30 million contribution from Iodine in Q4.
- **Leverage and Synergies**: Leverage ratio reduced to 1.9x (from 2.9x at year-start). On track to achieve $15 million cost synergies from Iodine within 18–24 months.
- **Cash Position**: $421 million in cash, with $1.2 billion gross debt post-acquisition.

**【Q&A Highlights】**
- **Iodine Integration**: Cross-sell opportunities with 35–40% client overlap. Iodine's clinical data enhances Waystar's AI for prior authorization and denial recovery (e.g., 90% faster appeal package creation).
- **Patient Utilization Trends**: Third-quarter patient utilization reverted to historical growth rates, impacting volume-based revenue (-4% sequentially).
- **AI Monetization**: Pricing AI solutions to value, with annual price uplift and new SKUs. Internal AI use (e.g., Copilot) improves operational efficiency and developer productivity.
- **Competitive Position**: Differentiated by cloud-native platform, data richness, and 98.5% first-pass clean claim rate. Go-to-market strategy focuses on ROI-driven conversations and long-term client relationships.
- **Cybersecurity and Trust**: Ranked #1 trusted vendor, with 93% client confidence in Waystar as a partner.


Waystar Holding Corp. (WAY) Q3 2025 Earnings Call Transcript

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