Penelope Health
Penelope Health provides API infrastructure for real-time payer medical policy intelligence. The company's knowledge graph structures medical coverage policies from major payers into programmable data, making policy information instantly accessible through a unified API. The platform delivers contextual code coverage across >500,000 extracted CPT, HCPCS, and ICD codes, with daily policy updates that track changes as they happen. Penelope's API allows organizations to query specific code coverage, compare payer policies, and understand medical necessity requirements without manual document review. Use cases span revenue cycle management (claim scrubbing, prior authorization, appeals automation), payer competitive intelligence, medical device field sales coverage verification, and healthtech companies building billing capabilities. The platform serves as neutral policy infrastructure, aggregating coverage criteria from UnitedHealthcare, Cigna, Aetna, Humana, and other major payers. Founded by a Cambridge-trained physician and ML engineer, Penelope Health operates as the policy intelligence layer for healthcare, turning scattered PDF documents into structured, real-time data.