Ensemble has formed a strategic partnership with Penelope Health to bring real-time payer policy intelligence into its revenue cycle operations.
Ensemble will integrate Penelope’s structured, continuously updated payer policy data into its intelligence engine, according to a Sept. 24 news release from the companies. Penelope’s platform covers policies for more than 200 million Americans and spans more than 15,000 procedure and drug codes.
Penelope will use Ensemble’s operating scale and revenue cycle expertise to speed development of its platform for health systems nationwide.
The partnership targets denial prevention, prior authorization and appeals, according to the release. The companies said the goal is to move payer policy requirements upstream so providers understand them before care is delivered, rather than after a claim is denied. Payer clinical policies vary in location and format by payer and are applied differently by line of business.
Ensemble manages revenue cycle operations for more than 200 hospitals and more than $55 billion in net patient revenue.
