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Risk Adjustment Copilot

Healthcare revenue cycle · by Pelica Health

Real-time HCC capture with V28-aware trumping logic and RADV-defensible chain-of-custody.

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What it does

Real-time HCC capture with V28-aware trumping logic and RADV-defensible chain-of-custody. Tracks claims through 277CA, 002, MAO-004, MMR, MOR.

  • Real-time RAF lift
  • Stars glide-path
  • PDC triple-weighted adherence
  • Audit defense
  • Cross-team coordination
  • Care management transitions of care
Category
Healthcare revenue cycle
Built for
Healthcare and life sciences
Users
Health plans (MA, dual-SNP, regional Blues), IPAs and MSOs, Delegated risk-bearing ACOs (MSSP, REACH, CINs), Medical groups (primary care, multi-specialty, DSOs)
Public API
Not offered

Not yet disclosed: deployment options, platforms, languages and support channels.

Pricing

  • CustomCustom
    • Quoted by their sales team

Prices as published by Pelica Health, checked Oct 2026.

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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