Patient Notebook

Waystar, Inc.

1-844-492-9782 - Option 3

888 W. Market Street

ATTN: Finance

Louisville, KY 40202

Email: billinginquiry@waystar.com

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Error Summary

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1. Account Information

First Name *

M.I.

Last Name *

Account Name

Account Number *

Invoice Number *

NOTE: For any credit card payments that exceed $5,000/month you will be billed a 3% convenience fee.

Email Address

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2. Payment Amount

Amount

3. Payment Method

Credit/Debit Card

Bank Account

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Expiration Date *

Security Code *

Zip Code *

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1-844-492-9782 - Option 3

888 W. Market Street ATTN: Finance

Louisville, KY 40202