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Turn payer policies into predictable revenue.
Your team spends hours researching payer rules manually.
We automate that intelligence.
Covering the majority of insured Americans
Struggling to understand payer behavior?
Turn confusion into clarity, today.
Book a call. We'll show you how Penelope fits your workflow and audit your existing AI setup at no cost.
Struggling to understand payer behavior?
Turn confusion into clarity, today.
Book a call. We'll show you how Penelope fits your workflow and audit your existing AI setup at no cost.
Covering the majority of insured Americans
Struggling to understand payer behavior?
Turn confusion into clarity, today.
Book a call. We'll show you how Penelope fits your workflow and audit your existing AI setup at no cost.
FAQ
Your questions answered.
Still have questions? Book a call and we'll talk things through.
How quickly can we integrate Penelope's policy network?
You can use our web-app straight after signing up. Our API is designed for straightforward integration into existing workflows. Most organizations are querying policies within days, not weeks. We provide documentation, testing environments, and technical support throughout the process.
How do you ensure policy accuracy?
You can automate policy retrieval using the Penelope Health API. It takes in payer, plan and (optionally) state, and returns the policy link and structured JSON for CPT and ICD-10 coverage rules, replacing manual portal searches. We ensure accuracy by using intelligent extraction methods that understand policy context, not just keyword matches. We understand how codes are referenced, whether they're approved, excluded or experimental.
But how do I actually use policies?
Great question! After you use our API or web-app to find policies (e.g. by payer, plan CPT code, ICD code or a 'fuzzy' text search), you can use our policies for a few pretty important things. - Checking code coverage - Checking medical necessity criteria - Auto-generating prior auth requests and appeal letters
Why don't I just Google the policies?
You definitely can! In fact, that's what most of our clients were doing before they used Penelope. But once you do this, you'll probably start facing some challenges. - There are a lot of payers, like, a lot (trust us, we know). - Their policies aren't always the easiest to find (we've scoured enough arcane web portals for a lifetime). - They can randomly update on a Wednesday, and completely change code coverage. - And then, once you find them, you're faced with a 50-page quasi-legal text, with some of the most important info being hidden away in footnotes and appendices. You can't integrate the info into your current workflows - be it to create dynamically updating coding rules, or to automatically generate appeal letters. So yes, you can Google things. But maybe give Penelope a try when you're ready to turbocharge your workflows.
How much does it cost?
Pricing depends on your needs, claims volume and scope. After our free assessment, we'll provide a clear proposal with transparent pricing and no hidden fees.
Keeping your data safe
Security & Governance
How do you secure our information?
We take a privacy-first approach. All data is processed within isolated execution environments and stored using AES-256 encryption at rest. For data in motion, we use TLS-encrypted connections to ensure that your information is never exposed during transit.
How do you manage data access?
We enforce a strict Role-Based Access Control (RBAC) model. This means that every authenticated use is limited to the specific data and operations authorized for their role. We use project and resource scoping to ensure that users never see data from projects they aren't explicitly assigned to.
What infrastructure do you use?
Our platform is built on enterprise-grade infrastructure that maintains SOC 2 Type 2 and HIPAA-aligned security standards.
How do you handle AI governance?
We don't treat AI as a 'black box'. We implement a rigorous AI governance framework that includes systematic model validation against strict internal benchmarks, with a human-in-the-loop. A key part of our governance strategy is a focus on explainability and auditability. AI-generated outputs are traceable to their underlying source data.
Is my data used for model training?
No. We do not use customer data- including prompts, uploads, or outputs- to train our underlying models, unless we have explicit, written consent.
FAQ
Your questions answered.
Still have questions? Book a call and we'll talk things through.
How quickly can we integrate Penelope's policy network?
You can use our web-app straight after signing up. Our API is designed for straightforward integration into existing workflows. Most organizations are querying policies within days, not weeks. We provide documentation, testing environments, and technical support throughout the process.
How do you ensure policy accuracy?
You can automate policy retrieval using the Penelope Health API. It takes in payer, plan and (optionally) state, and returns the policy link and structured JSON for CPT and ICD-10 coverage rules, replacing manual portal searches. We ensure accuracy by using intelligent extraction methods that understand policy context, not just keyword matches. We understand how codes are referenced, whether they're approved, excluded or experimental.
But how do I actually use policies?
Great question! After you use our API or web-app to find policies (e.g. by payer, plan CPT code, ICD code or a 'fuzzy' text search), you can use our policies for a few pretty important things. - Checking code coverage - Checking medical necessity criteria - Auto-generating prior auth requests and appeal letters
Why don't I just Google the policies?
You definitely can! In fact, that's what most of our clients were doing before they used Penelope. But once you do this, you'll probably start facing some challenges. - There are a lot of payers, like, a lot (trust us, we know). - Their policies aren't always the easiest to find (we've scoured enough arcane web portals for a lifetime). - They can randomly update on a Wednesday, and completely change code coverage. - And then, once you find them, you're faced with a 50-page quasi-legal text, with some of the most important info being hidden away in footnotes and appendices. You can't integrate the info into your current workflows - be it to create dynamically updating coding rules, or to automatically generate appeal letters. So yes, you can Google things. But maybe give Penelope a try when you're ready to turbocharge your workflows.
How much does it cost?
Pricing depends on your needs, claims volume and scope. After our free assessment, we'll provide a clear proposal with transparent pricing and no hidden fees.
Keeping your data safe
Security & Governance
How do you secure our information?
We take a privacy-first approach. All data is processed within isolated execution environments and stored using AES-256 encryption at rest. For data in motion, we use TLS-encrypted connections to ensure that your information is never exposed during transit.
How do you manage data access?
We enforce a strict Role-Based Access Control (RBAC) model. This means that every authenticated use is limited to the specific data and operations authorized for their role. We use project and resource scoping to ensure that users never see data from projects they aren't explicitly assigned to.
What infrastructure do you use?
Our platform is built on enterprise-grade infrastructure that maintains SOC 2 Type 2 and HIPAA-aligned security standards.
How do you handle AI governance?
We don't treat AI as a 'black box'. We implement a rigorous AI governance framework that includes systematic model validation against strict internal benchmarks, with a human-in-the-loop. A key part of our governance strategy is a focus on explainability and auditability. AI-generated outputs are traceable to their underlying source data.
Is my data used for model training?
No. We do not use customer data- including prompts, uploads, or outputs- to train our underlying models, unless we have explicit, written consent.
FAQ
Your questions answered.
Still have questions? Book a call and we'll talk things through.
How quickly can we integrate Penelope's policy network?
You can use our web-app straight after signing up. Our API is designed for straightforward integration into existing workflows. Most organizations are querying policies within days, not weeks. We provide documentation, testing environments, and technical support throughout the process.
How do you ensure policy accuracy?
You can automate policy retrieval using the Penelope Health API. It takes in payer, plan and (optionally) state, and returns the policy link and structured JSON for CPT and ICD-10 coverage rules, replacing manual portal searches. We ensure accuracy by using intelligent extraction methods that understand policy context, not just keyword matches. We understand how codes are referenced, whether they're approved, excluded or experimental.
But how do I actually use policies?
Great question! After you use our API or web-app to find policies (e.g. by payer, plan CPT code, ICD code or a 'fuzzy' text search), you can use our policies for a few pretty important things. - Checking code coverage - Checking medical necessity criteria - Auto-generating prior auth requests and appeal letters
Why don't I just Google the policies?
You definitely can! In fact, that's what most of our clients were doing before they used Penelope. But once you do this, you'll probably start facing some challenges. - There are a lot of payers, like, a lot (trust us, we know). - Their policies aren't always the easiest to find (we've scoured enough arcane web portals for a lifetime). - They can randomly update on a Wednesday, and completely change code coverage. - And then, once you find them, you're faced with a 50-page quasi-legal text, with some of the most important info being hidden away in footnotes and appendices. You can't integrate the info into your current workflows - be it to create dynamically updating coding rules, or to automatically generate appeal letters. So yes, you can Google things. But maybe give Penelope a try when you're ready to turbocharge your workflows.
How much does it cost?
Pricing depends on your needs, claims volume and scope. After our free assessment, we'll provide a clear proposal with transparent pricing and no hidden fees.
Keeping your data safe
Security & Governance
How do you secure our information?
We take a privacy-first approach. All data is processed within isolated execution environments and stored using AES-256 encryption at rest. For data in motion, we use TLS-encrypted connections to ensure that your information is never exposed during transit.
How do you manage data access?
We enforce a strict Role-Based Access Control (RBAC) model. This means that every authenticated use is limited to the specific data and operations authorized for their role. We use project and resource scoping to ensure that users never see data from projects they aren't explicitly assigned to.
What infrastructure do you use?
Our platform is built on enterprise-grade infrastructure that maintains SOC 2 Type 2 and HIPAA-aligned security standards.
How do you handle AI governance?
We don't treat AI as a 'black box'. We implement a rigorous AI governance framework that includes systematic model validation against strict internal benchmarks, with a human-in-the-loop. A key part of our governance strategy is a focus on explainability and auditability. AI-generated outputs are traceable to their underlying source data.
Is my data used for model training?
No. We do not use customer data- including prompts, uploads, or outputs- to train our underlying models, unless we have explicit, written consent.
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