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Solutions

The work, executed. Accelerated. Automated. Delivered.

Three Solutions. Countless use cases. Built on three coordinated layers — pre-built where best practice is well-defined, composable where your specifics are not.

Talk to usExplore the Operating System

What a Solution actually is

The end-to-end workflow. The Operating System is what makes it possible.

Most healthcare AI buyers are sold a tool and given an integration project. Penguin Ai's Solutions are different. Each one is a coordinated agentic system, governed by the Context Layer, working over the Data Layer, deployed through the Ai Workforce.

You get the workflow, the governance, the reporting, and the human review checkpoints together. Not five vendors. Not seven integrations. One Solution that does the whole job.

  1. Step 1

    Data Layer

    Your data, resolved.

  2. Step 2

    Context Layer

    Your policies, applied.

  3. Step 3

    Ai Workforce

    The work, executed.

Workflow Solutions

Three Solutions. Countless use cases.

Each Solution is an end-to-end workflow system. Inside each one, countless use cases — composable, governed, and deployable independently or together.

Payer Solutions

Intelligent UM.

Prior auth, concurrent, retro, and appeals on one closed loop.

Documentation hunting, criteria lookups, and evidence assembly come off your clinicians' desks. Every recommendation arrives at the reviewer's queue with the time-consuming work already done.

  • Prior Authorization. Cuts turnaround from 30 minutes to 4, saves $20+ per case, CMS-0057-F compliant.
  • Claims Adjudication. Payer-specific rules applied automatically. Consistent, explainable outcomes.
  • Payment Integrity. Anomaly detection and risk scoring for fraud, waste, and abuse prevention.
Explore Intelligent UM
Provider Solutions

HCC Coding & Risk Adjustment.

HCC identification, coding, and documentation — end to end.

Accurate codes. Complete records. Compliant submissions. Governed by your coding standards across the patient record.

  • Medical Coding. Automates code identification and validation, reduces undercoding, keeps pace with regulatory changes.
  • Claims Scrubbing & Billing Review. AI-powered billing validation prevents denials before they happen and boosts clean claim rates.
  • Denials & Appeals Management. Intelligent denial triage and auto-generated appeal letters, with an 87% overturn rate.
  • Chart Summarization. AI-generated patient chart summaries extract key insights and accelerate review cycles.
Explore HCC Coding & Risk Adjustment
Provider Solutions

Intelligent RCM.

Pre-submission review and denial recovery as one closed loop.

Claim ingestion through outcome reconciliation. No point-solution stitching. Every denial recovered feeds back to pre-submission so the same error does not repeat.

  • Intake Portal. Streamlined patient intake workflows that reduce friction at the front of the revenue cycle.
  • OASIS Scrubbing. Home health OASIS assessment validation ensures accuracy and compliance before submission.
Explore Intelligent RCM

Use cases

The work your team does every day. Pre-built and ready to deploy.

Every use case below runs on the same Operating System — governed, auditable, and composable across your other products.

Intelligent UM

Prior Authorization

Cuts turnaround from 30 minutes to 4 minutes, saves $20+ per case, and is CMS-0057-F compliant with built-in auditability.

Intelligent UM

Claims Adjudication

Applies payer-specific rules automatically to reduce rework and ensure consistent, explainable outcomes.

Intelligent UM

Payment Integrity

Anomaly detection and risk scoring for fraud, waste, and abuse prevention.

Coding & Risk Adjustment

Medical Coding

Automates code identification and validation, reduces undercoding, and keeps pace with regulatory changes.

Coding & Risk Adjustment

Denials & Appeals Management

Intelligent denial triage and auto-generated appeal letters, with an 87% overturn rate.

Coding & Risk Adjustment

Claims Scrubbing & Billing Review

AI-powered billing validation to prevent denials before they happen and boost clean claim rates.

Coding & Risk Adjustment

Chart Summarization

AI-generated patient chart summaries to extract key insights and accelerate review cycles.

Intelligent RCM

Intake Portal

Streamlined patient intake workflows that reduce friction at the front of the revenue cycle.

Intelligent RCM

OASIS Scrubbing

Home health OASIS assessment validation to ensure accuracy and compliance before submission.

And countless others, buildable on Gwen.

If no pre-built product fits your workflow, your team can build it — same governance, same Operating System. Explore Gwen

Foundation

The three Operating System principles every Workflow Solution stands on.

Buy a Workflow Solution and the foundation comes with it. Or deploy a foundation product on its own when your team builds the workflow logic.

01 · The Builder

Gwen.

The no-code builder for custom Ai Workers.

For workflows your team wants to build itself, when no pre-built Solution fits. Same governance as the rest of the Operating System. Most teams build their second and third on the foundation the first one proved.

Learn more
02 · Audit Posture

Trust & Compliance.

Audit posture as a default state.

Glassbox traceability, policy versioning, and audit-readiness built in across every Solution. The governance posture healthcare requires, not bolted on after a security review.

Learn more
03 · The Connections

Data Integrations.

Integration as a Solution, not a six-month services engagement.

EHRs, claims systems, eligibility, enrollment, clinical, and the rest. Connectors that ship rather than estimates that slip. Your data lands where your operations need it, on the timeline your team can actually plan against.

Learn more

Composable by design

Build once. Use everywhere.

The same Worker can run inside multiple Solutions. The coding Worker that powers HCC Coding & Risk Adjustment also runs inside Intelligent RCM.

One Worker. Many Solutions. Same governance.

01

One Worker

Solves one job, well.

02

Many Solutions

Workers compose into end-to-end products.

03

Reused everywhere

The same Worker runs in many Solutions.

04

Governed identically

Same Context Layer. Same Glassbox.

Governance

Same governance across the board. Every Solution carries the same audit posture.

  • Glassbox traceability

    On every decision that matters.

  • Human in the loop

    Configurable per workflow.

  • Policy-governed

    Versioned, approved, audited.

  • Enterprise-ready

    SOC 2 + HIPAA aligned.

FAQ

Questions we get most.

  • What is the difference between a workflow Solution and a foundation Solution?

    Workflow Solutions (Intelligent UM, HCC Coding & Risk Adjustment, Intelligent RCM) execute end-to-end work. Foundation Solutions (Gwen, Trust & Compliance, Data Integrations) are the Operating System products that make workflow Solutions possible. Most customers deploy both. Some deploy only foundation when their workflow logic is unique enough to build themselves.

  • Yes. Most Solutions are composed of multiple Ai Workers, and each Worker can be deployed independently. Most customers start narrow and expand. The Workers compose cleanly because they all sit on the same Operating System.

  • Scope sets the timeline, and phased rollouts are the norm: the first workflow proves itself in production, then each one after deploys faster on the same foundation. Talk to us for a timeline scoped to your systems and workflows.

  • No. Solutions deploy alongside what you already run. We integrate with your EHR, claims system, and revenue cycle platform. Penguin Ai is not a rip-and-replace.

  • That is what Gwen is for. The pre-built workflow Solutions cover the workflows we have already built. Gwen is for the workflows your team wants to build itself.

  • Configurable per workflow. Every case. A sample. Edge cases only. By risk score. By dollar amount. You decide where review happens. Workers handle the rest, with full Glassbox logging on every decision.

  • Solution-specific. UM measures turnaround, FTE redeployment, audit prep hours, and reviewer turnover. Appeals measures overturn rates and dollars recovered. Patient 360 measures care gap closure and quality measure performance. We help define metrics during discovery and track them in the Operating System.

Let's talk

Not sure where to start? Tell us the workflow that hurts most.

We will route you to the right Solution and the right demo.

Talk to us