Pelica Reviews & Product Details

Pelica is the AI operating system for value-based care. It unifies claims, EHR, pharmacy, lab, and ADT data into one live record and deploys AI agents across quality and Stars, risk adjustment, pharmacy and Part D, care management, and provider network. Unlike analytics tools and dashboards that only surface what needs to happen, Pelica's agents do the work end to end: multi-channel member outreach (voice AI, SMS, email), HEDIS care gap closure, suspect-and-documentation chase, ADT-triggered transitions of care, provider directory verification, and follow-up, escalating to a human only when clinical judgment is needed. Built for health plans and the risk-bearing groups they delegate to (IPAs, ACOs, MSOs, CINs), Pelica lets lean teams cover 2-3x more members without adding headcount. SOC 2 Type II certified, HIPAA compliant, with BAA available. Y Combinator-backed and built by former Google AI and engineering leaders.