<SEC-DOCUMENT>0001104659-23-103547.txt : 20240708
<SEC-HEADER>0001104659-23-103547.hdr.sgml : 20240708
<ACCEPTANCE-DATETIME>20230925165904
<PRIVATE-TO-PUBLIC>
ACCESSION NUMBER:		0001104659-23-103547
CONFORMED SUBMISSION TYPE:	DRSLTR
PUBLIC DOCUMENT COUNT:		1
FILED AS OF DATE:		20230925

FILER:

	COMPANY DATA:	
		COMPANY CONFORMED NAME:			Waystar Holding Corp.
		CENTRAL INDEX KEY:			0001990354
		STANDARD INDUSTRIAL CLASSIFICATION:	SERVICES-COMPUTER INTEGRATED SYSTEMS DESIGN [7373]
		ORGANIZATION NAME:           	06 Technology
		IRS NUMBER:				000000000
		STATE OF INCORPORATION:			DE
		FISCAL YEAR END:			1231

	FILING VALUES:
		FORM TYPE:		DRSLTR

	BUSINESS ADDRESS:	
		STREET 1:		1550 DIGITAL DRIVE, #300
		CITY:			LEHI
		STATE:			UT
		ZIP:			84043
		BUSINESS PHONE:		844-492-9782

	MAIL ADDRESS:	
		STREET 1:		1550 DIGITAL DRIVE, #300
		CITY:			LEHI
		STATE:			UT
		ZIP:			84043
</SEC-HEADER>
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hanover street</FONT></P>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; text-align: center; margin-top: 0pt; margin-bottom: 0pt"><FONT STYLE="font-size: 10pt; font-variant: small-caps"></FONT> <FONT STYLE="text-transform: uppercase; font-size: 10pt; font-variant: small-caps">facsimile: +1-650-251-5002</FONT></P>



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    <TD STYLE="font: 10pt Times New Roman, Times, Serif; text-align: right; width: 50%"> E-mail Address</TD></TR>
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    <TD STYLE="font: 10pt Times New Roman, Times, Serif">(650) 251-5110</TD>
    <TD STYLE="font: 10pt Times New Roman, Times, Serif; text-align: right">wbrentani@stblaw.com</TD></TR>
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    <TD STYLE="font: 10pt Times New Roman, Times, Serif">(212) 455-7862</TD>
    <TD STYLE="font: 10pt Times New Roman, Times, Serif; text-align: right"> hui.lin@stblaw.com</TD></TR>
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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; text-align: right; margin: 0pt 1in 0pt 0; text-indent: 5in">September&nbsp;25, 2023</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">Robert Littlepage</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">Inessa Kessman</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">Matthew Derby</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">Edwin Kim<BR>
Division of Corporation Finance<BR>
Securities and Exchange Commission<BR>
100 F Street, N.E.<BR>
Washington, D.C. 20549</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<TABLE CELLPADDING="0" CELLSPACING="0" STYLE="width: 100%; font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0.5in"></TD><TD STYLE="width: 0.5in"><FONT STYLE="font-size: 10pt"><B>Re:</B></FONT></TD><TD><FONT STYLE="font-size: 10pt"><B>Waystar Holding Corp. - Draft
                                            Registration Statement on Form&nbsp;S-1</B></FONT></TD></TR></TABLE>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">Ladies and Gentlemen:</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in; background-color: white"><FONT STYLE="font-size: 10pt">On
behalf of Waystar Holding Corp. (the &ldquo;<U>Company</U>&rdquo;), we hereby confidentially submit for&nbsp;non-public&nbsp;review by
the staff of the Securities and Exchange Commission (the &ldquo;<U>Staff</U>&rdquo;) an amendment to the above-referenced draft registration
statement on Form&nbsp;S-1&nbsp;(the &ldquo;<U>Draft Registration Statement</U>&rdquo;) confidentially submitted to the Staff on August&nbsp;24,
2023. The Company has revised the Draft Registration Statement in response to the Staff&rsquo;s comments in its letter, dated September&nbsp;20,
2023, relating to the Draft Registration Statement (the &ldquo;<U>comment letter</U>&rdquo;), and to otherwise update its disclosure.</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.25in; background-color: white"><FONT STYLE="font-family: Times New Roman, Times, Serif; font-size: 10pt">In
addition, we are providing the following responses to the comment letter. To assist your review, we have retyped the text of the Staff&rsquo;s
comments in italics below. Page&nbsp;references in the text of this letter correspond to the pages&nbsp;of the revised Draft Registration
Statement. Unless otherwise defined below, terms defined in the revised Draft Registration Statement and used below shall have the meanings
given to them in the revised Draft Registration Statement</FONT><FONT STYLE="font-size: 10pt">.</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify"><FONT STYLE="font-size: 10pt"><U>Summary, page&nbsp;1</U></FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<TABLE CELLPADDING="0" CELLSPACING="0" STYLE="width: 100%; font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0.25in"></TD><TD STYLE="width: 0.25in"><FONT STYLE="font-size: 10pt"><I>1.</I></FONT></TD><TD STYLE="text-align: justify"><FONT STYLE="font-size: 10pt"><I>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.</I></FONT></TD></TR></TABLE>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt"></FONT></P>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.5in; text-align: justify"><FONT STYLE="font-size: 10pt">The Company
has revised its disclosure on pages&nbsp;2, 5, 59, and 77 in response to the Staff&rsquo;s comment. The Company advises the Staff that
its artificial intelligence products are internally developed and it does not currently use third-party artificial intelligence products
in its platform.</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<TABLE CELLPADDING="0" CELLSPACING="0" WIDTH="100%" STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0.25in"></TD><TD STYLE="width: 0.25in"><FONT STYLE="font-size: 10pt"><I>2.</I></FONT></TD><TD STYLE="text-align: justify"><FONT STYLE="font-size: 10pt"><I>Please
                                            clarify what you mean by the &ldquo;flywheel effect&rdquo; on page&nbsp;2 and how it relates
                                            to your use and capture of data as part of your AI-related systems.</I></FONT></TD></TR></TABLE>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.5in; text-align: justify"><FONT STYLE="font-size: 10pt">The Company
has revised its disclosure on pages&nbsp;2, 59, and 77 in response to the Staff&rsquo;s comment.</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<TABLE CELLPADDING="0" CELLSPACING="0" WIDTH="100%" STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0.25in"></TD><TD STYLE="width: 0.25in"><FONT STYLE="font-size: 10pt"><I>3.</I></FONT></TD><TD STYLE="text-align: justify"><FONT STYLE="font-size: 10pt"><I>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.</I></FONT></TD></TR></TABLE>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.5in; text-align: justify"><FONT STYLE="font-size: 10pt">The Company
has revised its disclosure on page&nbsp;11 in response to the Staff&rsquo;s comment.</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify"><FONT STYLE="font-size: 10pt"><U>Our Market Opportunity,
page&nbsp;3</U></FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<TABLE CELLPADDING="0" CELLSPACING="0" WIDTH="100%" STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0.25in"></TD><TD STYLE="width: 0.25in"><FONT STYLE="font-size: 10pt"><I>4.</I></FONT></TD><TD STYLE="text-align: justify"><FONT STYLE="font-size: 10pt"><I>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.</I></FONT></TD></TR></TABLE>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.5in; text-align: justify"><FONT STYLE="font-size: 10pt">The Company
has revised its disclosure on pages 4, 79, and 80 in response to the Staff&rsquo;s comment.</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<TABLE CELLPADDING="0" CELLSPACING="0" WIDTH="100%" STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0.25in"></TD><TD STYLE="width: 0.25in"><FONT STYLE="font-size: 10pt"><I>5.</I></FONT></TD><TD STYLE="text-align: justify"><FONT STYLE="font-size: 10pt"><I>We
                                            note your disclosure that &ldquo;we estimate that our TAM with respect to our current software
                                            solution set, is approximately $15 billion today....&rdquo; 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.</I></FONT></TD></TR></TABLE>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.5in; text-align: justify"><FONT STYLE="font-size: 10pt">The Company
advises the Staff that the $15 billion TAM is indicative of the market opportunity for solutions the Company actively sells in the market
today, which excludes any adjacent market opportunities or solutions offered by other market participants. Further, the Company has revised
its disclosure on pages 4, 79, and 80 in response to the Staff&rsquo;s comment.</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<TABLE CELLPADDING="0" CELLSPACING="0" WIDTH="100%" STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0.25in"></TD><TD STYLE="width: 0.25in"><FONT STYLE="font-size: 10pt"><I>6.</I></FONT></TD><TD STYLE="text-align: justify"><FONT STYLE="font-size: 10pt"><I>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.</I></FONT></TD></TR></TABLE>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.5in; text-align: justify"><FONT STYLE="font-size: 10pt">The Company
has revised its disclosure on pages&nbsp;4 and 80 in response to the Staff&rsquo;s comment.</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt"><U>Risk Factors<BR>
We are subject to health care laws and data privacy and security laws and regulations<BR>
governing&hellip;, page&nbsp;32</U></FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<TABLE CELLPADDING="0" CELLSPACING="0" WIDTH="100%" STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0.25in"></TD><TD STYLE="width: 0.25in"><FONT STYLE="font-size: 10pt"><I>7.</I></FONT></TD><TD STYLE="text-align: justify"><FONT STYLE="font-size: 10pt"><I>On
                                            page&nbsp;33 of this risk factor, you reference that your AI platform and data it uses may
                                            subject you to additional risks under HIPAA 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.</I></FONT></TD></TR></TABLE>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt"></FONT></P>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.5in; text-align: justify"><FONT STYLE="font-size: 10pt">The
Company advises the Staff that, at present, its AI platform and the data it uses may subject the Company to additional risks under HIPAA and other health privacy laws, specifically risks related to the failure to properly de-identify PHI before using it to train the
Company&rsquo;s AI. The Company believes that the AI functionality at present does not present any heightened risk of the
Company&rsquo;s controls and procedures related to privacy protection to be avoided or overwritten. The Company has revised its
disclosure on page&nbsp;35 in response to the Staff&rsquo;s comment, and will further revise its risk factor disclosure to the
extent there is a change in the Company&rsquo;s practices with respect to its AI platform that subjects it to additional risks under
HIPAA and other health privacy laws.</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify"><FONT STYLE="font-size: 10pt"><U>Restrictive
covenants in the agreements governing our Credit Facilities may restrict our ability to pursue our business strategies,
page&nbsp;39</U></FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<TABLE CELLPADDING="0" CELLSPACING="0" WIDTH="100%" STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0.25in"></TD><TD STYLE="width: 0.25in"><FONT STYLE="font-size: 10pt"><I>8.</I></FONT></TD><TD STYLE="text-align: justify"><FONT STYLE="font-size: 10pt"><I>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 transactions with affiliates,
                                            and transfer or disposal of assets. You should specify the existing restrictions and explain
                                            how it limits your ability to do certain activities and transactions.</I></FONT></TD></TR></TABLE>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.5in; text-align: justify"><FONT STYLE="font-size: 10pt">The Company
has revised its disclosure on page&nbsp;41 in response to the Staff&rsquo;s comment.</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify"><FONT STYLE="font-size: 10pt"><U>Management&rsquo;s
discussion and analysis of financial condition and results of operations</U></FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify"><FONT STYLE="font-size: 10pt"><U>Results of operations
for the six months ended June&nbsp;30, 2023 and 2022, page&nbsp;60</U></FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<TABLE CELLPADDING="0" CELLSPACING="0" WIDTH="100%" STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0.25in"></TD><TD STYLE="width: 0.25in"><FONT STYLE="font-size: 10pt"><I>9.</I></FONT></TD><TD STYLE="text-align: justify"><FONT STYLE="font-size: 10pt"><I>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.</I></FONT></TD></TR></TABLE>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.5in; text-align: justify"><FONT STYLE="font-size: 10pt">The Company
has revised its disclosure on pages 62, 63, 64, and 65 in response to the Staff&rsquo;s comment.</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify"><FONT STYLE="font-size: 10pt"><U>Key performance
metrics and non-GAAP financial measures, page&nbsp;64</U></FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<TABLE CELLPADDING="0" CELLSPACING="0" WIDTH="100%" STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0.25in"></TD><TD STYLE="width: 0.25in"><FONT STYLE="font-size: 10pt"><I>10.</I></FONT></TD><TD STYLE="text-align: justify"><FONT STYLE="font-size: 10pt"><I>You
                                            state on pages&nbsp;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)&nbsp;of Regulation S-K.</I></FONT></TD></TR></TABLE>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.5in; text-align: justify"><FONT STYLE="font-size: 10pt">The Company
acknowledges the Staff's comment and advises the Staff that while customer count&nbsp;is a factor in the Company&rsquo;s growth trends,
it is not a primary driver. As not all customers are equal contributors to the Company&rsquo;s growth, disclosing customers by quarter
could disproportionately impact the perceived importance of the growth of one customer versus another, particularly customers with lower-dollar
contributions. As such, the Company does not believe that it is appropriate to report and track total customer count because the Company&rsquo;s
smaller customer count can fluctuate and does not indicate the true growth of the business. The Company respectfully submits that the
number of customers that generate over $100,000 in revenue is a more relevant statistic as these customers represented the majority of
the Company&rsquo;s total revenue. The Company has disclosed such statistic on pages&nbsp;1, 59, 76, and 85.</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt"></FONT></P>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify"><FONT STYLE="font-size: 10pt"><U>Liquidity and
Capital Resources, page&nbsp;65</U></FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<TABLE CELLPADDING="0" CELLSPACING="0" WIDTH="100%" STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0.25in"></TD><TD STYLE="width: 0.25in"><FONT STYLE="font-size: 10pt"><I>11.</I></FONT></TD><TD STYLE="text-align: justify"><FONT STYLE="font-size: 10pt"><I>You
                                            state that you believe your &quot;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.&quot; 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)&nbsp;of Regulation S-K.</I></FONT></TD></TR></TABLE>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.5in; text-align: justify"><FONT STYLE="font-size: 10pt">The Company
has revised its disclosure on page&nbsp;68 in response to the Staff&rsquo;s comment.</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt"><U>Critical accounting policies and
use of estimates<BR>
Goodwill and long-lived assets, page&nbsp;72</U></FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<TABLE CELLPADDING="0" CELLSPACING="0" WIDTH="100%" STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0.25in"></TD><TD STYLE="width: 0.25in"><FONT STYLE="font-size: 10pt"><I>12.</I></FONT></TD><TD STYLE="text-align: justify"><FONT STYLE="font-size: 10pt"><I>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.</I></FONT></TD></TR></TABLE>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.5in; text-align: justify"><FONT STYLE="font-size: 10pt">The Company
has revised its disclosure on page&nbsp;74 in response to the Staff&rsquo;s comment.</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify"><FONT STYLE="font-size: 10pt"><U>Business<BR>
Our go-to-market strategy, page&nbsp;79</U></FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<TABLE CELLPADDING="0" CELLSPACING="0" WIDTH="100%" STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0.25in"></TD><TD STYLE="width: 0.25in"><FONT STYLE="font-size: 10pt"><I>13.</I></FONT></TD><TD STYLE="text-align: justify"><FONT STYLE="font-size: 10pt"><I>On
                                            pages&nbsp;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.</I></FONT></TD></TR></TABLE>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.5in; text-align: justify"><FONT STYLE="font-family: Times New Roman, Times, Serif; font-size: 10pt">The
Company has revised its disclosure on pages&nbsp;84 and 85 in response to the Staff&rsquo;s comment. The Company advises the Staff
that it does not believe it is materially dependent on </FONT><FONT STYLE="font-size: 10pt">any of these ERP, EHR, PM or other strategic
partners. While the Company partners with ERP, EHR, and PM systems for integration and joint marketing efforts, as described on page&nbsp;85,
a substantial majority of new business is generated through the Company&rsquo;s direct sales force. Although strategic partners provide
us with referrals to their client base, we are generally responsible for the marketing and sales into the end provider client. We generally
directly contract with, and fulfill our contractual obligations to, the end provider, and are responsible for implementing and servicing
the client on an ongoing basis. Therefore, we do not believe that we are materially dependent on our strategic partners.</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<TABLE CELLPADDING="0" CELLSPACING="0" WIDTH="100%" STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0.25in"></TD><TD STYLE="width: 0.25in"><FONT STYLE="font-size: 10pt"><I>14.</I></FONT></TD><TD STYLE="text-align: justify"><FONT STYLE="font-size: 10pt"><I>On
                                            pages&nbsp;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.</I></FONT></TD></TR></TABLE>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt"></FONT></P>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.5in; text-align: justify"><FONT STYLE="font-family: Times New Roman, Times, Serif; font-size: 10pt">The
Company has revised its disclosure on pages&nbsp;23 and 24
in response to the Staff&rsquo;s comment. The Company advises the Staff that while it relies on such third-party vendors to provide certain
services, it does not believe any of such relationships are material as the Company could replace the services of such third-party vendors
with alternative vendors.</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<TABLE CELLPADDING="0" CELLSPACING="0" WIDTH="100%" STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0.25in"></TD><TD STYLE="width: 0.25in"><FONT STYLE="font-size: 10pt"><I>15.</I></FONT></TD><TD STYLE="text-align: justify"><FONT STYLE="font-size: 10pt"><I>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.</I></FONT></TD></TR></TABLE>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.5in; text-align: justify"><FONT STYLE="font-size: 10pt">The
Company has revised its disclosure on page 76 in response to the Staff&rsquo;s comment. In addition, the Company notes that the
description of its solutions set forth in &ldquo;Business&mdash;Our Solutions&rdquo; starting on page&nbsp;83 provides incremental
detail on how its platform can avoid or reduce billing errors.</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify"><FONT STYLE="font-size: 10pt"><U>Client Case
Studies, page&nbsp;80</U></FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<TABLE CELLPADDING="0" CELLSPACING="0" WIDTH="100%" STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0.25in"></TD><TD STYLE="width: 0.25in"><FONT STYLE="font-size: 10pt"><I>16.</I></FONT></TD><TD STYLE="text-align: justify"><FONT STYLE="font-size: 10pt"><I>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.</I></FONT></TD></TR></TABLE>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.5in; text-align: justify"><FONT STYLE="font-size: 10pt">The Company
has revised its disclosure on pages 86, 87, and 88 in response to the Staff&rsquo;s comment.</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify"><FONT STYLE="font-size: 10pt"><U>Our Clients,
page&nbsp;80</U></FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<TABLE CELLPADDING="0" CELLSPACING="0" WIDTH="100%" STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0.25in"></TD><TD STYLE="width: 0.25in"><FONT STYLE="font-size: 10pt"><I>17.</I></FONT></TD><TD STYLE="text-align: justify"><FONT STYLE="font-size: 10pt"><I>On
                                            page&nbsp;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.</I></FONT></TD></TR></TABLE>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.5in; text-align: justify"><FONT STYLE="font-size: 10pt">The
Company has revised its disclosure on pages 85 and 86 in response to the Staff&rsquo;s comment. The Company advises the Staff
that its client agreements typically do not allow for early termination without significant penalty in the initial contract term,
but allow for termination in subsequent renewal periods upon 30-60 days&rsquo; advanced written notice. In addition, the Company
advises the Staff that management does not evaluate renewal rates as a key metric, but does calculate and evaluate Net Revenue
Retention Rate, which it has disclosed on pages&nbsp;2, 6, 59, 67, 77, 81, and 86.</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify"><FONT STYLE="font-size: 10pt"><U>Competition,
page&nbsp;84</U></FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<TABLE CELLPADDING="0" CELLSPACING="0" WIDTH="100%" STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0.25in"></TD><TD STYLE="width: 0.25in"><FONT STYLE="font-family: Times New Roman, Times, Serif; font-size: 10pt"><I>18.</I></FONT></TD><TD STYLE="text-align: justify"><FONT STYLE="font-size: 10pt"><I>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, EHR, PM or other strategic partners also provide
                                            potentially competing payments or payments workflow-related solutions.</I></FONT></TD></TR></TABLE>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt"></FONT></P>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.5in; text-align: justify"><FONT STYLE="font-size: 10pt">The Company
has revised its disclosure on page 90 in response to the Staff&rsquo;s comment.</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify"><FONT STYLE="font-size: 10pt"><U>Management,
page&nbsp;92</U></FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<TABLE CELLPADDING="0" CELLSPACING="0" WIDTH="100%" STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0.25in"></TD><TD STYLE="width: 0.25in"><FONT STYLE="font-size: 10pt"><I>19.</I></FONT></TD><TD STYLE="text-align: justify"><FONT STYLE="font-size: 10pt"><I>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.</I></FONT></TD></TR></TABLE>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.5in; text-align: justify"><FONT STYLE="font-size: 10pt">The Company
has revised its disclosure on pages 101 and 102 in response to the Staff&rsquo;s comment.</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify"><FONT STYLE="font-size: 10pt"><U>Certain Relationships
and Related Party Transactions, page&nbsp;107</U></FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<TABLE CELLPADDING="0" CELLSPACING="0" WIDTH="100%" STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0.25in"></TD><TD STYLE="width: 0.25in"><FONT STYLE="font-size: 10pt"><I>20.</I></FONT></TD><TD STYLE="text-align: justify"><FONT STYLE="font-size: 10pt"><I>Please
                                            explain further what you mean by the &ldquo;highest level of support&rdquo; 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&rsquo;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.</I></FONT></TD></TR></TABLE>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.5in; text-align: justify"><FONT STYLE="font-size: 10pt">The
Company has revised its disclosure on page&nbsp;115 in response to the Staff&rsquo;s comment. The Company advises the Staff that
none of EQT, CPPIB, or Bain are obligated to each other to vote their shares to elect the other&rsquo;s nominees, but are obligated
to vote in favor of the slate of directors proposed by the Company.</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify"><FONT STYLE="font-size: 10pt"><U>Principal stockholders,
page&nbsp;110</U></FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<TABLE CELLPADDING="0" CELLSPACING="0" WIDTH="100%" STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0.25in"></TD><TD STYLE="width: 0.25in"><FONT STYLE="font-size: 10pt"><I>21.</I></FONT></TD><TD STYLE="text-align: justify"><FONT STYLE="font-size: 10pt"><I>Please
                                            disclose the natural person(s)&nbsp;that hold investment and/or voting power over the shares
                                            held by the Institutional Investors, other than the funds affiliated with EQT Investor.</I></FONT></TD></TR></TABLE>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.5in; text-align: justify"><FONT STYLE="font-size: 10pt">The Company
has revised its disclosure on page&nbsp;119 in response to the Staff&rsquo;s comment.</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify"><FONT STYLE="font-size: 10pt"><U>Description
of Capital Stock, page&nbsp;112</U></FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<TABLE CELLPADDING="0" CELLSPACING="0" WIDTH="100%" STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0.25in"></TD><TD STYLE="width: 0.25in"><FONT STYLE="font-size: 10pt"><I>22.</I></FONT></TD><TD STYLE="text-align: justify"><FONT STYLE="font-size: 10pt"><I>You
                                            indicate in this section there is a single class of common stock, but you refer to issued
                                            and outstanding Class&nbsp;A Common Stock with no voting rights on page&nbsp;F-28. Please
                                            clarify.</I></FONT></TD></TR></TABLE>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.5in; text-align: justify"><FONT STYLE="font-size: 10pt">The Company
advises the Staff that in connection with amending and restating its existing certificate of incorporation, all issued and outstanding
Class&nbsp;A Common Stock of the Company will be reclassified as common stock, $0.01 par value per share, of the Company. The Company
has revised its disclosure on page&nbsp;120 in response to the Staff&rsquo;s comment.</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify"><FONT STYLE="font-size: 10pt"><U>Notes to Consolidated
Financial Statements</U></FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify"><FONT STYLE="font-size: 10pt"><U>16. Stock-based
compensation, page&nbsp;F-28</U></FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></P>

<TABLE CELLPADDING="0" CELLSPACING="0" WIDTH="100%" STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0.25in"></TD><TD STYLE="width: 0.25in"><FONT STYLE="font-size: 10pt"><I>23.</I></FONT></TD><TD STYLE="text-align: justify"><FONT STYLE="font-size: 10pt"><I>We
                                            note your statement on page&nbsp;F-29 that, &quot;At December&nbsp;31, 2022, we did not believe
                                            the vesting of performance condition options criteria was probable and, therefore, no stock-based
                                            compensation has been recorded.&quot; That statement appears to contradict disclosure regarding
                                            stock-based compensation expense recorded on page&nbsp;F-28. Please clarify your disclosure
                                            to distinguish between various types of stock options.</I></FONT></TD></TR></TABLE>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.5in; text-align: justify"><FONT STYLE="font-size: 10pt">The Company
has revised its disclosure on pages&nbsp;F-29 and F-48 in response to the Staff&rsquo;s comment.</FONT></P>

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<TD STYLE="width: 0.25in"></TD><TD STYLE="width: 0.25in"><FONT STYLE="font-size: 10pt"><I>24.</I></FONT></TD><TD STYLE="text-align: justify"><FONT STYLE="font-size: 10pt"><I>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.</I></FONT></TD></TR></TABLE>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.5in; text-align: justify"><FONT STYLE="font-size: 10pt">The
Company has revised its disclosure on pages&nbsp;F-28, F-29, F-30, F-47, F-48, and F-49 in response to the Staff&rsquo;s
comment.</FONT></P>

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<TD STYLE="width: 0.25in"></TD><TD STYLE="width: 0.25in"><FONT STYLE="font-size: 10pt"><I>25.</I></FONT></TD><TD STYLE="text-align: justify"><FONT STYLE="font-size: 10pt"><I>Please
                                            provide a summary of stock options granted since January&nbsp;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.</I></FONT></TD></TR></TABLE>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.5in; text-align: justify"><FONT STYLE="font-size: 10pt">The Company
acknowledges the Staff&rsquo;s comment and will comply with the Staff&rsquo;s request once an estimated offering price or range has been
established.</FONT></P>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-size: 10pt"><U>General</U></FONT></P>

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<TD STYLE="width: 0.25in"></TD><TD STYLE="width: 0.25in"><FONT STYLE="font-size: 10pt"><I>26.</I></FONT></TD><TD STYLE="text-align: justify"><FONT STYLE="font-size: 10pt"><I>Please
                                            supplementally provide us with copies of all written communications, as defined in Rule&nbsp;405
                                            under the Securities Act, that you, or anyone authorized to do so on your behalf, present
                                            to potential investors in reliance on Section&nbsp;5(d)&nbsp;of the Securities Act, whether
                                            or not they retain copies of the communications.</I></FONT></TD></TR></TABLE>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.5in; text-align: justify"><FONT STYLE="font-size: 10pt">In response
to the Staff&rsquo;s comment, the Company advises the Staff that it will provide the Staff with a copy of the written communications,
as defined in Rule&nbsp;405 under the Securities Act, expected to be used in meetings with qualified institutional buyers or institutional
accredited investors in reliance on Section&nbsp;5(d)&nbsp;of the Securities Act. The Company will supplementally provide copies of any
written communications used after such meetings that differ in any substantive way from those provided to the Staff that the Company,
or anyone authorized to do so on its behalf, presents to potential investors in reliance on Section&nbsp;5(d)&nbsp;of the Securities
Act.</FONT></P>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: center"><FONT STYLE="font-size: 10pt">* * * * * * *</FONT></P>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify; text-indent: 0.5in"><FONT STYLE="font-size: 10pt">Please
do not hesitate to contact William B. Brentani at (650) 251-5110 or Hui Lin at (212) 455-7862 with any questions you may have regarding
our responses to the comment letter.</FONT></P>

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  <TR STYLE="vertical-align: bottom">
    <TD STYLE="font-size: 10pt; width: 50%"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></TD>
    <TD STYLE="font: 10pt Times New Roman, Times, Serif; width: 50%"><FONT STYLE="font-size: 10pt">Very truly yours, &nbsp;</FONT></TD></TR>
  <TR STYLE="font-size: 10pt; vertical-align: bottom">
    <TD STYLE="font-size: 10pt"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></TD>
    <TD STYLE="font: 10pt Times New Roman, Times, Serif"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></TD></TR>
  <TR STYLE="font-size: 10pt; vertical-align: bottom">
    <TD STYLE="font-size: 10pt"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></TD>
    <TD STYLE="border-bottom: Black 1pt solid; font: 10pt Times New Roman, Times, Serif"><FONT STYLE="font-size: 10pt">/s/ William B. Brentani</FONT></TD></TR>
  <TR STYLE="font-size: 10pt; vertical-align: bottom">
    <TD STYLE="font-size: 10pt"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></TD>
    <TD STYLE="font: 10pt Times New Roman, Times, Serif"><FONT STYLE="font-size: 10pt">William B. Brentani &nbsp; </FONT></TD></TR>
  <TR STYLE="font-size: 10pt; vertical-align: bottom">
    <TD STYLE="font-size: 10pt"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></TD>
    <TD STYLE="font: 10pt Times New Roman, Times, Serif"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></TD></TR>
  <TR STYLE="font-size: 10pt; vertical-align: bottom">
    <TD STYLE="font-size: 10pt"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></TD>
    <TD STYLE="border-bottom: Black 1pt solid; font: 10pt Times New Roman, Times, Serif"><FONT STYLE="font-size: 10pt">/s/ Hui Lin</FONT></TD></TR>
  <TR STYLE="font-size: 10pt; vertical-align: bottom">
    <TD STYLE="font-size: 10pt"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></TD>
    <TD STYLE="font: 10pt Times New Roman, Times, Serif"><FONT STYLE="font-size: 10pt">Hui Lin</FONT></TD></TR>
  </TABLE>



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    <TD STYLE="font: 10pt Times New Roman, Times, Serif; width: 0.5in">cc:</TD>
    <TD STYLE="font: 10pt Times New Roman, Times, Serif">Matthew J. Hawkins, Chief Executive Officer</TD></TR>
  <TR STYLE="vertical-align: bottom">
    <TD STYLE="font: 10pt Times New Roman, Times, Serif">&nbsp;</TD>
    <TD STYLE="font: 10pt Times New Roman, Times, Serif">Matthew R. A. Heiman, Chief Legal&nbsp;&amp; Administrative Officer</TD></TR>
  <TR STYLE="vertical-align: bottom">
    <TD STYLE="font: 10pt Times New Roman, Times, Serif">&nbsp;</TD>
    <TD STYLE="font: 10pt Times New Roman, Times, Serif">Waystar Holding Corp.</TD></TR>
  <TR STYLE="vertical-align: bottom">
    <TD STYLE="font: 10pt Times New Roman, Times, Serif">&nbsp;</TD>
    <TD STYLE="font: 10pt Times New Roman, Times, Serif">&nbsp;</TD></TR>
  <TR STYLE="vertical-align: bottom">
    <TD STYLE="font: 10pt Times New Roman, Times, Serif">&nbsp;</TD>
    <TD STYLE="font: 10pt Times New Roman, Times, Serif">Jason M. Licht</TD></TR>
  <TR STYLE="vertical-align: bottom">
    <TD STYLE="font: 10pt Times New Roman, Times, Serif">&nbsp;</TD>
    <TD STYLE="font: 10pt Times New Roman, Times, Serif">Christopher J. Clark</TD></TR>
  <TR STYLE="vertical-align: bottom">
    <TD STYLE="font: 10pt Times New Roman, Times, Serif">&nbsp;</TD>
    <TD STYLE="font: 10pt Times New Roman, Times, Serif">Latham&nbsp;&amp; Watkins LLP</TD></TR>
  </TABLE>


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