Pelica Health
AI operating system for value-based care: one canonical record per member unifying claims, EHR, pharmacy, lab, and ADT data with six role-specific AI copilots and an action layer.
Where Pelica Health ranks
Current edition · updated Oct 20, 2026About Pelica Health
Pelica is the AI-native operating system for value-based care organizations. We unify claims, EHR, pharmacy, lab, and ADT data into one live record and put an AI copilot next to every team that depends on it: quality/Stars, pharmacy, care management, provider network, and risk adjustment. The copilots don't just surface insights. They do the work, from engaging members for preventative care using multi-channel communications to preparing provider field reps with everything they need before they walk in the door. So teams spend time on relationships, not admin.
Products
One canonical record per member, six role-specific AI copilots, and an action layer that closes the loop with members and providers for value-based care operations.
Real-time HCC capture with V28-aware trumping logic and RADV-defensible chain-of-custody.
Unified gap closure across every payer contract.
PDC lift on the three triple-weighted adherence measures (diabetes, RAS, statins).
Auto-generated practice agendas with EMR overlay.
ADT-driven transitions of care worklists with 5-day follow-up tracking.
Plain-English answers from the canonical record.
What customers say
“Pelica felt like an extension of our team. You don't just get software, you get partners. Working with Pelica, manual work that took about eight hours a week takes fifteen minutes today, and we were live within two weeks of signing.”
“You get Excels coming from left, right, and center on different cadences, some regular, some irregular, different columns, different values. Taking all of that and turning it into something actionable and usable is really difficult.”
“My favorite feature is the AI call recording. My team used to take notes during every call. Now they can be fully present with the member, and the AI writes the perfect note for them.”
HealthCare Partners uses Pelica to consolidate payer data, prioritize member worklists, and automate routine outreach and documentation across quality, pharmacy, nursing, and risk teams. Pelica reports weekly…
Case study
Security and compliance
As reported by Pelica Health. Ask for audit reports before you buy.
- SOC 2 Type ICertified
- SOC 2 Type IICertified
- HIPAACompliant
- HITRUST CSFIn progress
- AES256 encryption at rest
- TLS1.2 encryption in transit
- Tenant isolation
- Per-customer data plane
- Customer-managed keys
- Role-Based Access Control (RBAC)
- Audit logging
- Daily database backups
- Zero-data retention agreements with LLM providers
- SAML SSO via Identity Platform
- Data Loss Prevention (DLP)
- Security Information & Event Management (SIEM)
- Full disk encryption on endpoint assets
- Static application security testing (SAST)
- Dependency monitoring
- Secure code reviews
- Quarterly access recertification
- Responsible vulnerability disclosure program
- Phishing training
- Security awareness training
- Cybersecurity training
- Recovery Time Objective: 24 hours
- Recovery Point Objective: 24 hours
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