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As costs rise and vendors consolidate, plans get less nuance and less attention. Penstock brings it back with a human-led, tech-enabled, auditor-controlled model built for depth and defensibility.
We support:
About Us: Who We Serve
For plans that don’t settle for surface-level.
Penstock supports national and regional health plans—and integrated health systems—across every line of business.
Health Plans
Built for every line of business. Designed for the realities plans face today.
Medicare Advantage
Higher scrutiny. Complex rules. Our findings align to CMS intent and the terms of your plan–provider contracts.
Managed Medicaid
Medicaid varies by state. We ground every finding in the exact regulation and network contracts.
Commercial Plans
Contract-driven accuracy that protects plan assets and minimizes provider abrasion.
Individual Exchange / Marketplace Plans
Fast-changing benefits and billing patterns. We surface trends others miss.
Trusted by National and Regional Health Plans
Plans choose Penstock for the accuracy— and stay for the attention.
Health plans choose Penstock because we bring depth, partnership and transparency back to payment integrity. What our clients value most:
An extension of your team
Why consistent recoveries can signal stagnation, not optimization, and how to tell the difference.
Support that shows up
What pre-pay genuinely can't catch, and why that won't change even with AI.
Explainable, documented findings
The one question to ask your vendor every month that reveals whether there's any real innovation happening.
Provider education & appeal support
How defensible post-pay findings drive system changes, policy updates, and pre-pay accuracy.
Root-cause prevention
Detailed overpayment trend insights to advance pre-payment prevention.
Fully visible by design
What payment integrity looks like when it becomes a lever for long-term financial performance.
Reporting built around your needs
Customized reporting and Quarterly Business Reviews give your team clear insight into performance, opportunities, and priorities—keeping the partnership aligned and accountable.
Our Services
Post-pay payment integrity services.
Penstock partners with national, regional, and local health plans to bring back the depth, attention, and transparency missing in today’s consolidated PI landscape. Our human-led, auditor-controlled model uncovers what others overlook and protects your data with rigorous, enterprise-grade safeguards.
Data mining
Sophisticated overpayment concepts across all lines of business (Commercial, MA, Medicaid).
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Itemized Bill Review
Tech-enabled line-level analysis that uncovers billing errors across complex invoices.
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Upcoding Prevention Program
Analytics that flag unsupported E/M levels and reduce persistent upcoding patterns.
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