Autonomous, explainable AI executes two of the most administratively intensive payer workflows — inside the health plan’s own AWS environment.
PALO ALTO, Calif., Aug. 19, 2026 /PRNewswire/ — Penguin Ai, a healthcare-native artificial intelligence company, today announced that its Utilization Management and HCC Risk Adjustment solutions are now available in AWS Marketplace, a digital catalog with thousands of software listings from independent software vendors that make it easy to find, test, buy, and deploy software that runs on Amazon Web Services (AWS).
Utilization management and risk adjustment depend on manual review of complex clinical records against payer medical policies and CMS coding rules — work that contributes to delays in care, inconsistent decisions, and mounting administrative cost. Penguin Ai’s AI Workers review documentation for completeness and medical necessity, apply each plan’s own policies through a governed Context Layer, and return audit-ready recommendations with Glassbox reasoning — a human-readable rationale for every decision, with configurable human review on every workflow. For utilization management, the solution compresses prior authorization turnaround from days to under 10 minutes, with up to 92 percent of cases resolved without human intervention. For risk adjustment, plans capture accurate HCC codes across the HCC V24 and V28 models and 72,000+ ICD-10 codes, with compliance safeguards built in.
Customers can now access Penguin Ai’s Utilization Management and HCC Risk Adjustment solutions directly within AWS Marketplace. Because the solutions deploy inside the customer’s own AWS account and governance perimeter, member, claims, and clinical data remain in the plan’s environment, with no new business associate agreement required. Health plans can procure through AWS Marketplace with consolidated AWS billing and standardized terms, then move from contract to production in weeks rather than quarters. Built-in governance, versioned medical policy, and traceable decisions mean every recommendation can withstand audit and regulatory scrutiny, including CMS-0057-F interoperability and prior authorization requirements.
“Health plans have accepted ‘normal processing time’ as if it were inevitable. It is not — it is a choice. By putting utilization management and risk adjustment intelligence directly inside the plan’s own AWS environment, we eliminate that burden at the source. Members get decisions in minutes instead of days, plans get accuracy and auditability they can defend, and no one has to move their data to get there.”
— Fawad Butt, CEO, Penguin Ai
Penguin Ai’s Utilization Management and HCC Risk Adjustment solutions are now generally available in AWS Marketplace. For more information, visit penguinai.co or find Penguin Ai in AWS Marketplace.
ABOUT PENGUIN AI
Penguin Ai is a healthcare-native artificial intelligence platform that automates complex administrative and clinical workflows for payers, providers, and risk-bearing organizations. Purpose-built with domain-specific reasoning, agentic automation, and transparent auditability, Penguin Ai accelerates prior authorization, HCC coding and risk adjustment, claims adjudication, payment integrity, appeals, and other mission-critical processes. Penguin Ai integrates with leading cloud ecosystems, including AWS, and is deployed across health plans, provider organizations, and revenue cycle operations to reduce administrative burden and improve financial performance.
MEDIA CONTACT
Penguin Ai Communications
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SOURCE Penguin Ai
