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.

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:

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Medicare Advantage

Higher scrutiny. Complex rules. Our findings align to CMS intent and the terms of your plan–provider contracts.

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Managed Medicaid 

Medicaid varies by state. We ground every finding in the exact regulation and network contracts.

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Commercial Plans

Contract-driven accuracy that protects plan assets and minimizes provider abrasion.

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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

A multidisciplinary team—data scientists, coders, analysts, and clinicians—focused on delivering accurate, defensible reviews.

Support that shows up

Dedicated client services leader, timely responses, weekly worklists, and clear status updates.

Explainable, documented findings

Detailed explanations with supporting documentation, overpayment reason codes, contract/config references—full visibility, every time.

Provider education & appeal support

Clear documentation and in-market support for your team.

Root-cause prevention

Detailed overpayment trend insights to advance pre-payment prevention.

Fully visible by design

Auditor-led, tech-powered, no hidden algorithms, no vendor-owned IP.

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.

See the impact this attention and accuracy deliver.

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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Chart review

Initial review + second-look review of prior “no-finding” charts.

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NY State Health Care Reform Act (HCRA)

Retrospective, prospective and state audit support.

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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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Has your PI strategy stalled? Big promises, flat results?

It might be time for a fresh look.

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