Pelica Health

What are the copilots?

The vendor's architecture has three layers: data, an intelligence layer of copilots and an action layer of voice, EMR overlays, a provider portal and a coder workspace.

• Risk Adjustment Copilot: "Real-time HCC capture," trumping logic, V24 and V28 mapping, RADV-defensible documentation, an EMR overlay and a coder workspace.
• Quality & Stars Copilot: gap closure across payers and Stars glide-path forecasting.
• Pharmacy & Part D Copilot: adherence on the three triple-weighted measures.
• Provider Network Copilot: auto-generated practice agendas, "90 min to 15 min meeting prep."
• Care Management Copilot: ADT-driven transitions-of-care worklists, five-day follow-up tracking and AI call recording that writes the note.
• AI Data Analyst, which promises plain-English answers in place of the BI ticket queue.

Inputs include "Claims (277CA, MAO-004, MMR, MOR), EHR (FHIR/HL7), charts, labs, and payer SFTP drops." Epic appears on a demo mock as a source label. Pelica positions itself against "8 to 15 point vendors" for risk adjustment, quality and pharmacy.

What does the customer story show?

The vendor's customer page describes HealthCare Partners, part of Heritage Provider Network, as roughly 1,000 providers and 200,000 lives across the five boroughs and Long Island. The vendor-written story reports weekly admin falling from 8 hours to 15 minutes, 2,500 or more hours saved in a year, two weeks from signing to live and 100% adoption across the risk and coding teams. The About page puts kickoff to live copilot at 2 to 4 weeks. The vendor's risk-adjustment page carries a HealthCare Partners pharmacist's praise: "My favorite feature is the AI call recording."

Who started Pelica?

Pelica's terms send disputes to San Francisco County courts, and no street address is published. Lalit Kundu is co-founder and CEO and Catherine Zhao is co-founder and COO. The About page calls Pelica a Y Combinator company and lists Y Combinator, SurgePoint Capital, Upside Partnership and ISE among its backers, without round sizes or dates. The founding year is not stated.

What does the trust center say about security and models?

The trust center says "HIPAA-compliant, SOC 2 Type I & II certified," names MJD Advisors as auditor, offers the report on request and says a BAA is available. It states AES256 at rest, TLS in transit, SAML SSO and United States-only hosting, with data deleted 15 days after the contract ends. HITRUST is "in progress." Pelica discloses that its subprocessors Google Cloud, Anthropic and OpenAI supply the language models used to synthesize customer data.

The verdict

An IPA or risk-bearing group with coders, quality staff and a pharmacy team to equip will find each role covered by a named copilot. Every outcome figure on the site comes from HealthCare Partners.