Ensemble has partnered with Penelope Health to bring real-time payer clinical policy intelligence into healthcare revenue cycle operations. Under the partnership, Ensemble will integrate Penelope’s structured and continuously updated view of payer policies into its intelligence engine, while Penelope will use Ensemble’s revenue cycle expertise and operating scale to further develop its platform for health systems. Penelope’s technology converts payer policies, clinical criteria, regulatory guidance, and provider manuals into structured data, with coverage spanning more than 200 million Americans and over 15,000 procedure and drug codes.
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The companies aim to help healthcare organizations identify coverage requirements earlier, supporting denial prevention, prior authorization, appeals, and claims resolution before issues emerge downstream.”Providers want to follow payer guidelines, but transparency and access to those guidelines have never been part of the system,” said Judson Ivy, Founder and Chief Executive Officer of Ensemble. “Penelope has built out a critical layer, a dependable, real-time view of clinical policy that will be additive to our proprietary end-to-end intelligence layer. Embedding that intelligence into the work our teams do every day means fewer denials, faster authorizations and stronger appeals for the health systems we serve, and more time returned to clinicians and patients.”
