Payment Integrity

Payment integrity is the work of confirming that a claim was paid the right amount under the right terms — validating reimbursement against contract rates and fee schedules, identifying underpayments and variance, and reconciling disputed balances through to a closed outcome. The work is contract-specific and evidence-heavy, and the variance that matters is often too small per claim to chase manually and too large in aggregate to ignore. Penguin Ai's Ai Workers price each claim against the governing contract and fee-schedule terms, surface the calculation behind every finding, and rank the exceptions by recoverable value so specialists spend their time on the balances worth pursuing. Every finding carries its evidence and reference data, and a human reviewer owns the decision to pursue, adjust, or close.