Put an AI agent on the work behind the gap list.
Pelica handles chart retrieval, member outreach and the follow-up that usually gets buried. Your team steps in when a person needs to make the call. Meet Co‑Founder & COO Catherine Zhao at RISE West, September 2–4.
Start with the metric your team owns.
Pick your function. We’ll start with the work your team owns.
Risk Adjustment & HCC
The number you own
HCC capture, chart throughput and defensible submissions.
Where it slips
Charts sit in provider portals while coders wait, and suspects age out before submission.
What Pelica’s agents do
Agents pull encounters from portals and EHRs, then pair each chart with the claim and linked MEAT evidence. Every diagnosis stays tracked through submission.
Quality & Stars
The number you own
In‑year gap closure, cut-point position and audit‑ready supplemental data.
Where it slips
The calling team cannot keep up, so members who need three touches often get only one.
What Pelica’s agents do
Agents call or text members in their preferred language, book the screening and retry on a schedule. Completed work writes back to the record for review.
Operations & VBC
The number you own
Throughput per employee, queue age and cost per completed workflow.
Where it slips
Separate lists produce duplicate calls and aging queues. The usual fix is more staff.
What Pelica’s agents do
Pelica puts the work in one queue. Each item routes to an agent or person, and completions write back automatically. The same view shows human and agent throughput.
Care & Member Engagement
The number you own
Timely post‑discharge contact, 7‑day follow-up and coordinator capacity.
Where it slips
The ADT alert arrives on time, but calls and scheduling consume the measure window.
What Pelica’s agents do
The discharge signal starts outreach the same day. Agents reach the member, book the PCP visit and arrange transportation. A clinical concern moves straight to a nurse.
A medication gap, from alert to close.
This workflow runs in production at HealthCare Partners.
A member falls behind on a high‑weight adherence measure
Pelica sends the gap straight to an agent.
The agent checks the record and calls the pharmacy
Before dialing, it checks the member’s notes and claims. The pharmacy says the refill needs the prescriber.
The agent calls the prescriber’s office
No answer, so it leaves a voicemail and schedules the retry.
The office calls back to the same agent
The agent handles what it can and flags the decision that needs a person.
A coordinator receives one clear exception
The full call history and transcript arrive with it, ready for a judgment call.
The refill is resolved and the record updates
It documents the completion for audit, then moves to the next member.
of human coordination per member in production
Live with HealthCare Partners in two weeks.
Pelica runs these workflows for a physician‑led IPA serving about 200,000 lives across 1,000 providers.
Read the customer story →
Catherine began as a medical assistant at the San Francisco Free Clinic, then led AI product work at Google. She also conducted clinical AI research at Stanford School of Medicine. Today she runs operations at Pelica. Bring her a workflow in San Diego and she’ll show you where an agent can take over.
20 minutes in San Diego?
Catherine will be at the Manchester Grand Hyatt September 2–4. Bring the workflow taking up your team’s week, and she’ll walk through how Pelica would handle it. We’ll buy the coffee.
Book 20 minutes →Prefer email? Write Catherine directly: catherine@pelica.com