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                              September 20, 2023

       Matthew J. Hawkins
       Chief Executive Officer
       Waystar Holding Corp.
       1550 Digital Drive, #300
       Lehi, UT 84043

                                                        Re: Waystar Holding
Corp.
                                                            Draft Registration
Statement on Form S-1
                                                            Submitted August
24, 2023
                                                            CIK No. 0001990354

       Dear Matthew J. Hawkins:

              We have reviewed your draft registration statement and have the
following comments. In
       some of our comments, we may ask you to provide us with information so
we may better
       understand your disclosure.

              Please respond to this letter by providing the requested
information and either submitting
       an amended draft registration statement or publicly filing your
registration statement on
       EDGAR. If you do not believe our comments apply to your facts and
circumstances or do not
       believe an amendment is appropriate, please tell us why in your
response.

             After reviewing the information you provide in response to these
comments and your
       amended draft registration statement or filed registration statement, we
may have additional
       comments.

       Draft Registration Statement submitted August 24, 2023

       Summary, page 1

   1.                                                   You reference that your
platform leverages artificial intelligence, as well as proprietary,
                                                        advanced algorithms to
automate payment-related workflow tasks. Please clarify what
                                                        you mean by artificial
intelligence and explain how it is used in your platform and differs
                                                        from simple algorithmic
code that automates processes in your platform. In addition,
                                                        clarify whether your
platform utilizes third-party artificial intelligence products or
                                                        internally developed
artificial intelligence processes.
   2.                                                   Please clarify what you
mean by the    flywheel effect    on page 2 and how it relates to your
                                                        use and capture of data
as part of your AI-related systems.
 Matthew J. Hawkins
Waystar Holding Corp.
September 20, 2023
Page 2
3.       We note that the Institutional Investors have certain corporate
governance rights if they
         collectively own 40% of more of the voting power of the total
outstanding common stock,
         such as a lower voting threshold to change your articles or bylaws.
Please briefly disclose
         these rights in the summary.
Our Market Opportunity, page 3

4.       Please provide the basis for your belief that your total addressable
market is $15 billion
         and why you believe it will grow on a compounded annual basis of 5%.
Clarify how you
         calculated these figures.
5.       We note your disclosure that    we estimate that our TAM with respect
to our current
         software solution set, is approximately $15 billion today....
Please clarify if this means
         your market healthcare payment system providers and software-related
products and
         services, or if it is a narrower term meaning a subset of the
healthcare payment systems
         that only have the functions that you currently offer. If you are
referring to a broader
         market of healthcare-related software beyond payments, provide a more
complete
         description of the market you are referencing.
6.       Please clarify how you determined your market share was between 3% and
7% for
         hospitals and ambulatory practices, respectively, and define the
market these market
         share percentages measure.
Risk Factors
We are subject to health care laws and data privacy and security laws and
regulations
governing..., page 32

7.       On page 33 of this risk factor, you reference that your AI platform
and data it uses may
         subject you to additional risks under HIPPA and other health privacy
laws. Please clarify
         whether are referring specifically to the use of AI in the operation
of your platform and
         whether such use may expose you to risks of non-compliance with such
health privacy
         laws. For example, whether the AI functionality may cause your
controls and procedures
         related to privacy protection to be avoided or overwritten without
proper authorization or
         oversight.
Restrictive covenants in the agreements governing our Credit Facilities may
restrict our ability to
pursue our business strategies, page 39

8.     Please provide more detail regarding the restrictive covenants in your
existing Credit
       Facilities and how they may limit your current business operations,
including, for
       example, acquiring other companies, engaging in new lines of business,
entering into
FirstName LastNameMatthew J. Hawkins
       transactions with affiliates, and transfer or disposal of assets. You
should specify the
Comapany    NameWaystar
       existing restrictionsHolding  Corp.
                             and explain  how it limits your ability to do
certain activities and
       transactions.
September  20, 2023 Page 2
FirstName LastName
 Matthew J. Hawkins
FirstName LastNameMatthew   J. Hawkins
Waystar Holding Corp.
Comapany 20,
September NameWaystar
              2023      Holding Corp.
September
Page 3    20, 2023 Page 3
FirstName LastName
Management   s discussion and analysis of financial condition and results of
operations
Results of operations for the six months ended June 30, 2023 and 2022, page 60

9.       For revenue, cost of revenue, and other line items where there is a
material changes from
         period-to-period, please expand your discussion to describe the
underlying reasons for the
         material changes in both quantitative and qualitative terms. If more
than one factor
         contributed to the change, quantify each factor. We refer to guidance
in Item 303 of
         Regulation S-K.
Key performance metrics and non-GAAP financial measures, page 64

10.      You state on pages 58 and 62 that increases in revenue were driven by
expansion of
         existing and new clients. Please disclose statistical data regarding
client numbers for each
         period presented in your key performance metrics or tell us why such a
metric is not
         provided. We refer to guidance in Item 303(a) of Regulation S-K.
Liquidity and Capital Resources, page 65

11.      You state that you believe your "existing unrestricted cash on hand,
expected future cash
         flows from operations, and additional borrowings will provide
sufficient resources to fund
         our operating requirements, as well as future capital expenditures,
debt service
         requirements, and investments in future growth for at least the next
twelve months."
         Please expand your discussion to also analyze your ability to generate
and obtain adequate
         amounts of cash to meet your requirements in the long-term (i.e.,
beyond the next 12
         months). We refer to guidance in Item 303(b)(1) of Regulation S-K.
Critical accounting policies and use of estimates
Goodwill and long-lived assets, page 72

12.      Please expand your discussion of goodwill impairment to explain how
goodwill was
         tested, significant judgements and assumptions made during testing,
and the sensitivity of
         goodwill to future impairment.
Business
Our go-to-market strategy, page 79

13.      On pages 3 and 16, you reference that your platform is integrated with
over 200 vendors,
         including ERP, EHR and PM systems. You further indicate that you have
entered
         strategic relationships with channel partners to sell your solutions.
Please described these
         relationships in more detail and clarify if you are materially
dependent on any of these
         ERP, EHR, PM or strategic partners or types of strategic partners. For
example, clarify, if
         true, whether you are dependent on a small number of ERPs to sell your
platform through
         their systems for your larger enterprise clients or clients where you
generate more than
         $100,000 in revenue per client.
 Matthew J. Hawkins
FirstName LastNameMatthew   J. Hawkins
Waystar Holding Corp.
Comapany 20,
September NameWaystar
              2023      Holding Corp.
September
Page 4    20, 2023 Page 4
FirstName LastName
14.      On pages 21-22, you reference that you are reliant on third-party
vendors for critical
         services such as clearinghouse systems, payment processing services,
software
         development, and eligibility verification. Please clarify whether any
of these relationships
         are material, and if so, please describe the respective agreements.
Further, please expand
         your Business section to discuss how these critical services operate
through your
         platform. For example, your Research and Development discussion
appears to imply that
         the development and improvement of your platform is handled in-house.
If you are reliant
         on outside software developers for this work, please clarify so.
15.      We note that billing errors and mistakes related to billing may have a
significant effect on
         your clients, the end users, and your business. Please clarify how
your system can avoid
         or reduce billing errors.
Client Case Studies, page 80

16.      We note that you provide several examples of how your clients use your
platform to
         address their payment and business challenges, which include
references to various
         statistics and financial measures. When using such information, please
reference the
         periods, timeframes, and/or dates being measured to provide context of
what is being
         measured.
Our Clients, page 80

17.      On page 15, you briefly describe your client agreements are typically
are 2-3 years in
         duration, renew automatically in 1-year increments, and allow the
client to terminate the
         agreement early. Please clarify whether your typical client agreement
allows for early
         termination without significant penalty and the ease, or lack thereof,
to switch to a
         competitor from a financial or technological point of view. Further,
clarify whether
         management calculates and evaluates renewal rates as part of this
oversight and
         management of your business and if they are a key metric.
Competition, page 84

18.      Please provide more details of your competition and your competitive
environment. We
         note that you indicate that your market share is less than 7% of the
market. Yet you
         believe that no competitor matches the breadth and depth of your
solutions. Clarify, for
         example, if the market is highly fragmented and mostly consists of
similarly sized or
         smaller healthcare payments focused companies. It is unclear whether
the ERP, HER, PM
         or other strategic partners also provide potentially competing
payments or payments
         workflow-related solutions.
Management, page 92

19.      We note that several of your directors are affiliated with principal
stockholders, namely
         your Institutional Investors. Please clarify if these directors were
appointed through any
         nomination or appointment right through any agreement.
 Matthew J. Hawkins
FirstName LastNameMatthew   J. Hawkins
Waystar Holding Corp.
Comapany 20,
September NameWaystar
              2023      Holding Corp.
September
Page 5    20, 2023 Page 5
FirstName LastName
Certain Relationships and Related Party Transactions, page 107

20.      Please explain further what you mean by the    highest level of
support    that will be
         provided to EQT, CPPIB, and Bain director nominees. For example,
clarify whether each
         of EQT, CPPIB, and Bain may nominate a director and whether the
parties to the
         shareholders agreement are obligated to vote their shares to elect
those nominees. Further,
         clarify whether this provision terminates if EQT, CPPIB, and Bain   s
collective beneficial
         ownership falls below a certain voting threshold similar to the
provision that would
         eliminate the classified board structure should they collectively own
less than 15% of the
         voting power of the total outstanding shares entitled to vote in
director elections.
Principal stockholders, page 110

21.      Please disclose the natural person(s) that hold investment and/or
voting power over the
         shares held by the Institutional Investors, other than the funds
affiliated with EQT
         Investor.
Description of Capital Stock, page 112

22.      You indicate in this section there is a single class of common stock,
but you refer to issued
         and outstanding Class A Common Stock with no voting rights on page
F-28. Please
         clarify.
Notes to Consolidated Financial Statements
16. Stock-based compensation, page F-28

23.      We note your statement on page F-29 that, "At December 31, 2022, we
did not believe the
         vesting of performance condition options criteria was probable and,
therefore, no stock-
         based compensation has been recorded." That statement appears to
contradict disclosure
         regarding stock-based compensation expense recorded on page F-28.
Please clarify your
         disclosure to distinguish between various types of stock options.
24.      For performance based stock options, please disclose the specific
performance conditions
         and the amount of expense you will incur once the vesting of
performance criteria
         becomes probable.
25.      Please provide a summary of stock options granted since January 1,
2022. Provide the
         date and amount of each stock option granted along with estimated fair
value of the
         underlying shares of common stock. Reconcile and explain the
differences between the
         fair values determined on each grant date including the difference
between the most recent
         grant date fair value and the midpoint of your offering range. This
reconciliation should
         describe significant intervening events within the company and changes
in assumptions
         with the valuation methodologies employed that explain the changes in
fair value of your
         common stock up to the filing of the registration statement. Continue
to provide us with
         updates to the above analysis for all equity related transactions
through the effectiveness
         date of the registration statement.
 Matthew J. Hawkins
Waystar Holding Corp.
September 20, 2023
Page 6
General

26.   Please supplementally provide us with copies of all written
communications, as defined in
      Rule 405 under the Securities Act, that you, or anyone authorized to do
so on your behalf,
      present to potential investors in reliance on Section 5(d) of the
Securities Act, whether or
      not they retain copies of the communications.
        You may contact Inessa Kessman, Senior Staff Accountant, at (202)
551-3371 or Robert
Littlepage, Accounting Branch Chief, at (202) 551-3361 if you have questions
regarding
comments on the financial statements and related matters. Please contact Edwin
Kim, Staff
Attorney, at (202) 551-3297 or Matthew Derby, Legal Branch Chief, at (202)
551-3334 with any
other questions.



                                                            Sincerely,
FirstName LastNameMatthew J. Hawkins
                                                            Division of
Corporation Finance
Comapany NameWaystar Holding Corp.
                                                            Office of
Technology
September 20, 2023 Page 6
cc:       William Brentani, Esq.
FirstName LastName