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Penguin Funding, Cohere Acquires ZignaAI, and a Look at the 2026 CPT Codes
September 18, 2025
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Together with
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“People aren’t very good at making sense of exponentials. If something is doubling every six months, then two years before it happens it looks like it’s only 1/16th of the way there.”
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Anthropic CEO Dario Amodei on predicting AI’s potential.
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Payors and providers are in an AI arms race, and Penguin Ai just raised $30M to supply both sides with agents to outcompete each other.
Penguin goes far beyond point solutions. The enterprise AI platform combines proprietary LLMs with AI tooling that both payors and providers can use to configure custom agents for their own back-office processes.
- The platform enables customers to prep their data for AI, use pre-built LLMs via APIs, or start with a ready-made agent for medical coding, prior auths, claims adjudication, appeals management, risk adjustment, medical chart summarization, or payment integrity.
- The ultimate goal is streamline high-volume workflows and cut down on the billions of dollars of administrative waste that the healthcare industry generates every year.
The agent wars have begun. Payors and providers across the country are racing to enlist AI agents to fight for an advantage in a system that’s historically been plagued by inefficiencies and headbutting.
- Providers vs. Payors: Doctors and hospitals are leveraging agents to fight back against billing denials – filing floods of appeals and automating responses faster than any human could manage alone.
- Payors vs. Providers: Health plans are rolling out agents to instantly review claims, prior auths, and appeals requests – enabling mass, automatic care decisions that overwhelm providers.
Penguin CEO Fawad Butt has been in the buyer seat. He spent his career serving as the chief data officer at some of the biggest names in the industry: UnitedHealthcare, Kaiser Permanente, and Optum.
- He founded Penguin to build the platform he saw was missing, and that adds a lot of credibility as Penguin takes on incumbent admin agent dealers like Innovaccer and Autonomize AI.
The Takeaway
The agent wars are in full swing, and Penguin is bringing a comprehensive platform to a battlefield full of point solutions.
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2025 State of Payer Enrollment & Credentialing
With increasing costs and shifting regulations, outdated processes won’t cut it. Medallion’s new report breaks down the biggest challenges, emerging trends, and how automation is transforming the landscape. Get the insights you need – read the full report today.
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AI Science Breakthrough: Hallucination-Free Clinical Documentation
Abridge has invented a novel system to classify, identify, and eliminate hallucinations from medical documentation before they reach clinicians for final review. This technology performs 6x better than standard AI models at finding and fixing hallucinations. Abridge delivers the best-in-class ambient AI for healthcare by investing in foundational AI science and research. Read this game-changing interactive whitepaper to learn more.
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- AMA Releases CPT 2026 Code Set: The AMA just dropped the CPT 2026 code set, which included 418 total changes – 288 new codes, 84 deletions, and 46 revisions. Advanced lab tests made up the largest share of new codes (27%), along with CPT III codes for emerging medical services that regulators use to consider government approval (another 27%). Notable digital health inclusions were new RPM codes that allow for shorter duration monitoring of just two to 15 days within a 30-day period.
- Cohere Acquires ZignaAI: Cohere Health acquired ZignaAI as it looks to expand beyond prior authorization to clinical payment integrity. The acquisition was geared toward unifying the separate ecosystems of PAs, post-service claims, and coding validation into one seamless workflow. It sounds like Cohere is ramping up to launch an entire suite dedicated to payment integrity and optimizing revenue for payors and providers.
- Meditech AI Upgrades: Meditech debuted several AI enhancements to its MyHealth patient portal and Expanse EHR at this week’s customer event, including new chatbots and the debut of Commure’s ambient AI tech in the Expanse Now app. The new MyHealth assistant can help patients understand the info in their portal and schedule appointments, while other AI agents are still on the roadmap for Meditech’s billing and operational workflows.
- The Genetic Answer to Rare Diseases: GeneDx CEO Katherine Stueland penned a great opinion piece in the Wall Street Journal outlining how her company screens babies’ DNA for mutations that cause thousands of treatable disorders. Standard newborn screenings can identify a few dozen of the most common congenital disorders, but miss about 95% of the 4,800 disorders that GeneDx can pick up. They’ve already sequenced over 850k individuals, and they’re not using AI to connect even more dots between genes and disease.
- Mayo Clinic Virtual Trials: Mayo Clinic developed a new way to accurately predict whether existing drugs can be repurposed to treat heart failure. Researchers trained the AI model on real-world data from 59k HF patients to conduct “virtual clinical trials” in order to better predict which existing drugs might make good candidates in RCTs for HF. The findings in npj Digital Medicine highlighted the model’s “remarkable predictive accuracy” after validating it by comparing predictions to actual clinical trial data.
- Ardent Rolls With Ambience: Ardent Health kicked off an enterprise-wide rollout of Ambience Healthcare’s AI platform for documentation, coding, and clinical workflows across its ambulatory network. The expansion follows a pilot across 17 specialties that saw impressive clinician utilization rates of 90%, and every one of those clinicians said Ambience improved their job satisfaction. Checks out considering they saved an average of 5 hours/week in documentation time.
- Healthcare Turnover Picks Up: A recent Harris poll found that healthcare turnover is still accelerating five years after the peak of the pandemic. Of the 1,504 healthcare workers surveyed, 84% reported that they feel “taken for granted” by their employers, while just 37% said they’re satisfied with their current role. An aging Baby Boomer population is driving unprecedented demand for care, and 55% of workers apparently plan to switch to a new job next year.
- Imagine Pediatrics Series B: Imagine Pediatrics hauled in $67M of Series B funding to expand the reach of its virtual and in-home care model for children with special healthcare needs. The pediatric medical group partners with health plans, providers, caregivers, and community resources to deliver fully integrated medical, behavioral, and social care. It already serves 40k+ children nationwide and the check size reflects its results: partners are saving $65M annually due to less avoidable ER visits and hospitalizations.
- SonderMind AI Notes Launch: Virtual mental healthcare provider SonderMind announced the commercial launch of its AI Notes feature purpose-built for therapists and psychiatrists. The tool reduces note completion time by 80% (20 minutes to 4 minutes), and has been saving providers about 90 minutes per day. We’ve seen Grow, Headway, and several others roll out similar tech already, but SonderMind is the first to assume compliance responsibility and guarantee that its claims are all 100% ready for submission.
- Hyro + Sutter: Sutter Health’s customer support teams now have access to Hyro’s suite of AI agents for handling calls and messages. Hyro’s AI agents will provide one cohesive Sutter experience across all channels, offering patients 24/7 self-service options for appointments, scheduling, prescriptions, and billing. Sutter fields 13M visits a year for about 3.5M patients, so the more automation the merrier.
- Peerbridge Peers Ahead: Peerbridge Health closed a $7M funding round to continue its mission of expanding access to affordable cardiac diagnostics through its Cor MDx remote monitoring device. The Cor MDx is a wearable monitor that will offer real-time, hospital-grade monitoring when it launches later this year pending its FDA 510(k) clearance. Peerbridge tagged the funding for expanding the teams ahead of the commercialization push.
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Start Getting Leads From ChatGPT and Google AI
If your healthcare company isn’t getting leads from ChatGPT and Google AI Overviews, it’s probably because your content isn’t optimized for AI search. Tely AI runs keywords and questions research, generates and publishes GEO content, and captures new leads – all on autopilot. Create your first article on us to start filling your pipeline with patients and partners from today’s lead sources.
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Scale RPM With BPM Pro 2
BPM Pro 2 is the next generation cellular blood pressure monitors, empowering care teams to scale remote patient monitoring and streamline operations. Discover why leading providers are choosing BPM Pro 2 to collect highly precise measurements and enrich data with Patient Insights from their daily lives.
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- Under the Hood of Navina’s AI: Navina’s AI engine harnesses over 600 proprietary algorithms to transform fragmented patient data into actionable clinical intelligence at the point of care. It’s shaped with the expertise of physicians to turn multiple data sources (EHR, HIE, claims, care gap files, etc.) into contextualized insights like suspected conditions or evidence for care gap closures – each linked back to the original source. Download the whitepaper to see examples of Navina’s AI in action.
- Next Generation Ambient Technology and Agents: The ambient AI transformation is already sweeping across health systems, reducing administrative burdens and improving patient outcomes. So, what’s next? Tune into this on-demand session to learn how systems like Carle Health and Denver Health are leveraging Nabla to eliminate Pajama Time and build a future where agentic AI unlocks true workforce sustainability.
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