Healthcare Enterprise Only

Pelica

AI operating system for value-based care quality, risk, and operations

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PricingEnterprise Only
Starting priceContact sales
Free planUnknown
Free trialYes
APIUnknown
Open sourceNo
DeploymentCloud
Last verifiedJuly 29, 2026
Overview

Tool overview

Pelica is listed under Healthcare AI tools.

Summary

What is Pelica?

Pelica Health unifies claims, EHR, pharmacy, laboratory, ADT, payer, and call data into one live member record. Its role-specific copilots support risk adjustment, Quality and Stars, pharmacy and Part D, provider networks, care management, and plain-language analytics while taking operational actions under human oversight.

Best fit

Best for

Value-based care organizations coordinating quality, risk, pharmacy, and care operations

Audience

Who is it for?

Health plans and risk-bearing groupsIPAs, MSOs, and ACOsQuality, Stars, and pharmacy teamsCare-management and provider-network teams
Recommendation

Decision note

Confirm covered populations, data sources, identity resolution, SMART-on-FHIR scope, HCC and RADV controls, outreach consent, security, BAA, implementation, support, and current pricing.

Capabilities

Key features

Canonical member record across claims and clinical data

Risk Adjustment copilot with HCC workflows

Quality and Stars gap closure

Pharmacy and Part D adherence operations

Provider Network and Care Management copilots

AI Data Analyst with source provenance

Workflows

Use cases

Closing HEDIS and Stars gaps

Capturing risk-adjustment opportunities

Coordinating pharmacy and provider outreach

Managing ADT-driven transitions of care

Strengths

Pros

  • Copilots execute work rather than only report
  • SOC 2 Type II, HIPAA, and BAA availability are stated
  • Verified founder contacts are public
Considerations

Cons

  • Commercial pricing requires a demo
  • Healthcare deployment requires complex data integration
  • Clinical and coding outcomes need expert review
Considerations

Limitations

Pelica can automate outreach, coding support, and care operations but cannot replace clinical, actuarial, coding, compliance, or member-consent responsibility. Organizations must validate data provenance, identity matching, model outputs, outreach, escalations, and every consequential action.

Cost

Pricing details

Pricing modelEnterprise Only
Starting priceContact sales
Free planUnknown
Free trialYes
Pricing context

Billing options

Custom healthcare agreement

Pricing context

Pricing note

Pelica uses a book-a-demo enterprise process and does not publish a stable starting amount. No ongoing free plan or formal free trial was confirmed. Scope depends on member volume, data sources, copilots, and implementation.

View official pricing
Compatibility

Supported languages

  • Multiple member languages
Connectivity

Integrations

Epic

Cerner

Athena

eClinicalWorks

Payer SFTP

PBM feeds

ADT feeds

Laboratory systems

Specs

Technical details

PlatformsWeb
Multilingual supportYes
Login requiredYes
Open sourceNo
DeploymentCloud
CompanyPelica Health, Inc.
Launch year2025
Models / versionsPelica AI Workforce Pelica Copilots
Editions / plansRisk Adjustment Quality and Stars Pharmacy and Part D Provider Network Care Management AI Data Analyst
Data confidenceHigh
Last verifiedJuly 29, 2026
Documentation → Data source →
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Answers

Frequently asked questions

Pelica Health unifies claims, EHR, pharmacy, laboratory, ADT, payer, and call data into one live member record. Its role-specific copilots support risk adjustment, Quality and Stars, pharmacy and Part D, provider networks, care management, and plain-language analytics while taking operational actions under…
Value-based care organizations coordinating quality, risk, pharmacy, and care operations
The listed pricing model for Pelica is Enterprise only. Pricing can change, so users should verify the latest plan details on the official website.
Yes. The current profile indicates that a free trial is available.
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