Medallion
AI operations partner for provider credentialing and payer enrollment
About Medallion
Medallion is a provider network management platform for healthcare organizations that combines AI agents with credentialing specialists to handle credentialing, payer enrollment, state licensing, privileging, and ongoing monitoring. It operates as a credentials verification organization (CVO) with turnaround-time guarantees, and serves provider groups, health systems, payers, RCM firms, and digital health companies. Medallion acquired Andros, another AI credentialing company, .
Pros & Cons
Pros
- Covers credentialing, payer enrollment, licensing, privileging, and monitoring in one platform, so teams don't stitch together separate vendors
- AI agents work payer portals, fax, and phone follow-ups, which cuts the manual chasing that slows enrollment
- Specialists review exceptions and critical stages, with turnaround times written into the contract
- Capterra users rate it 4.7/5 and cite an easy-to-use dashboard and responsive chat support
- Used by 300+ healthcare organizations, including Headspace, CareBridge, and WellBe Senior Medical
Cons
- No public pricing; every engagement is quoted after a sales conversation
- Reviewers report limited customization of provider profiles, reports, and data fields
- Some customers describe onboarding and rollout as process-heavy and say training is needed to find daily tasks
- Phone support is harder to reach than chat, according to user reviews
- Built for organizations managing many providers; solo practices may find it more than they need
Key Features
Provider enrollment
AI agents handle commercial, Medicare, and Medicaid payer enrollment and revalidation across payer portals, CAQH, email, fax, and phone, including IVR calls for status checks.
CVO credentialing
Primary source verification and credentialing file assembly with expert checkpoint review, with files typically ready in about one day.
Cross-state licensing
Manages new state license applications and renewals for providers expanding into multiple states.
Ongoing monitoring
Continuously monitors licenses, sanctions, and exclusions and sends automated alerts before compliance lapses.
Delegated credentialing
Supports delegated credentialing arrangements with payers so organizations can scale network-wide without adding headcount.
Privileging
Moves hospital privileging applications through review and approval workflows faster.
Roster management
Keeps provider data and payer rosters current across the enterprise from a single provider data record.
Payer contract management
Turns payer contracts into a searchable system of record to support rate negotiations.
CredAlliance
A credentialing clearinghouse that lets participating organizations reuse verified credentialing for overlapping providers instead of re-credentialing them.
Command center visibility
Real-time status dashboard across credentialing, enrollment, licensing, and monitoring, plus an API for integrations.
Pricing
- Engagement scoped to provider volume, delegation structure, and payer complexity
- Performance-backed turnaround guarantees
- Credentialing, enrollment, licensing, and monitoring modules
- Integration requirements assessed during scoping
Best For
Multi-state telehealth expansion
Digital health companies use Medallion to license and enroll clinicians in new states quickly so they can start billing sooner.
Outsourced CVO credentialing
Provider groups and health systems hand off primary source verification and file assembly instead of building a larger in-house credentialing team.
Payer delegated credentialing
Payers and delegated entities scale credentialing across a provider network while keeping audit-ready compliance records.
Revenue cycle acceleration
RCM organizations shorten time from provider hire to in-network billing by automating payer enrollment follow-ups.
Continuous compliance monitoring
Compliance teams track license expirations, sanctions, and exclusions with automated alerts ahead of audits.
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