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Medallion
Medallion
Credentialing & Enrollment
Medallion is the AI operations partner powering healthcare’s first real-time CVO, offering automated provider credentialing and enrollment to streamline processes and unlock revenue.

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About Medallion

Medallion is a leading healthcare AI company that provides an advanced platform designed to significantly streamline and automate critical administrative processes for healthcare organizations. For physicians, this translates into a dramatically accelerated and simplified experience for credentialing, payer enrollment, privileging, and ongoing compliance monitoring. The platform leverages artificial intelligence to replace traditionally manual, time-consuming, and often redundant workflows, thereby reducing administrative burden and allowing clinicians to focus more on patient care.

Medallion’s solution acts as a unified system of record for provider data, ensuring accuracy and real-time verification across various entities. Its core offering includes an AI-powered national credentialing clearinghouse, CredAlliance, which aims to eliminate duplicative verification efforts that cost the healthcare system billions annually. By automating primary source verification, generating NCQA-compliant credentialing files, and managing delegated credentialing workflows, Medallion helps healthcare providers get onboarded and billable much faster, improving access to care and operational efficiency.

Focus Areas

Provider credentialing payer enrollment cross-state licensing provider data management monitoring privileging healthcare back-office automation AI in healthcare

Business Intelligence

Key InvestorsAcrew Capital, Washington Harbour Partners, Sequoia Capital, GV (Google Ventures), Spark Capital, NFDG, Optum Ventures, Salesforce Ventures, Elad Gil
PartnershipsCredAlliance, Checkr, Family Care Center, Tampa General Hospital, Ro, Ginger, Bicycle Health, Headspace, AHIP
TechnologyAI-powered infrastructure platform, intelligent automation, AI agents, machine learning models, API-first architecture, cloud-native

What Physicians Need to Know

Provider Credentialing (CVO)
Medallion offers AI-powered, NCQA-certified credentialing, automating primary source verification and generating committee-ready files in days, not weeks. It ensures compliance with NCQA, Joint Commission, and CMS standards.
Payer Enrollment
The platform streamlines payer enrollment processes, including direct and delegated models, with automated form fills and follow-ups to accelerate billing and reimbursement.
Cross-State Licensing
Medallion tracks and manages provider licenses across multiple states, supports Interstate Medical Licensure Compact (IMLC) applications, and offers automated Continuing Education (CE) tracking.
Provider Data Management
It centralizes, automates, and syncs provider data in real-time, eliminating manual reconciliation across systems and ensuring accurate, up-to-date network information.
Monitoring
The system provides 24/7 tracking of provider credentials, licenses, and sanctions, offering real-time alerts to help organizations stay ahead of compliance risks.
Privileging
Medallion automates privilege applications, reviews, and approvals, integrating hospital privileging workflows directly into its platform to support Joint Commission (TJC) standards.
Healthcare Back-Office Automation
The platform unifies provider operations, automating complex workflows to reduce administrative burden, decrease operating costs, and improve overall efficiency for healthcare organizations.
AI in Healthcare
Medallion leverages purpose-built AI agents and machine learning models for tasks like real-time credentialing, provider outreach, and data validation, with expert oversight to ensure accuracy and responsible use.
Key Differentiators
Medallion stands out with its AI-powered automation combined with human expertise ('experts-in-the-loop'), guaranteed outcomes with SLA-backed results, and real-time operational visibility. It boasts significant speed (78% faster) and cost savings (49.8% reduction) compared to traditional methods, offering a unified platform for end-to-end provider operations.
Technology Stack
The platform is built on an API-first architecture, enabling seamless integrations. It utilizes AI and machine learning, connects directly with industry databases like CAQH, FSMB, and licensing boards, and operates on cloud infrastructure (e.g., Amazon EC2).
Physician Tip

For physicians, Medallion significantly reduces administrative burden and paperwork associated with credentialing, licensing, and enrollment, allowing them to focus more on patient care. It accelerates onboarding and time-to-bill, simplifies the process for submitting required information through a user-friendly interface, and ensures a smoother, less frictional experience with healthcare operations.

Medallion's API-first platform is designed for seamless integration with internal systems and various healthcare technology stacks. It connects directly with key provider data sources such as CAQH, FSMB, and state licensing boards. Additionally, it offers integrations with third-party services like Checkr for background checks, enabling a unified provider data experience.

Products by Medallion

1 product in the directory

Medallion
Medallion
Credentialing & Enrollment
Medallion is the AI operations partner powering healthcare’s first real-time CVO, offering automated provider credentialing and enrollment to streamline processes and unlock revenue.

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Press & Coverage

Medallion Press Release
Medallion Raises $43 Million to Expand AI Infrastructure and Launch the First National Credentialing Clearinghouse
Medallion announced a $43 million funding round led by Acrew Capital, bringing their total funding to $130 million. The investment will be used to expand their AI-powered platform and launch CredAllianceu2122, a national credentialing clearinghouse aimed at streamlining provider onboarding.
2025-08
PR Newswire
Medallion Expands Credentialing and Privileging Capabilities to Align with Joint Commission Standards, Enhancing Provider Onboarding and Risk Mitigation for Healthcare Organizations
Medallion has expanded its automated credentialing and privileging capabilities to meet Joint Commission standards, which includes electronic privileging workflow management and automated submission of applications to hospitals. This aims to accelerate provider onboarding and mitigate risks for healthcare organizations.
2025-03
PR Newswire
New Report from Medallion Finds That Only 12% of AI Investments Touch Credentialing--Despite Mounting Financial Losses
A 2026 report by Medallion highlights a significant operational crisis, revealing that over half of hospitals and provider groups experience measurable revenue loss due to credentialing delays, with many losing over $1 million annually. Despite this, only 12% of AI investments in healthcare are directed towards credentialing.
2026-01
Medallion Press & News
Medallion Announces Elevate 2026, Marking Fifth Annual Conference for Healthcare Leaders
Medallion announced its fifth annual Elevate conference for healthcare leaders in 2026.
2026-06
Medallion Blog
Medallion Named to Inc. 2026 Fastest-Growing Companies in the Pacific Region
Medallion was ranked No. 60 on Inc.'s sixth annual Inc. Regionals: Pacific list for 2026, recognizing it as one of the fastest-growing privately held companies in the Pacific region.
2026-03
Digital Health Wire Show
Medallion CEO Derek Lo - Replacing Manual Workflows With Intelligent Automation
Medallion CEO Derek Lo discussed how the company's CredAlliance national credentialing clearinghouse is set to transform the healthcare industry by replacing manual workflows with intelligent automation.
2025-08
Medallion Whitepaper/Blog
Comparing the outcomes and costs of Medallion vs. traditional provider operations methods
A comparison by Medallion highlights that their platform is 78% faster and offers a 49.8% cost savings compared to traditional provider operations methods, by automating credentialing, enrollment, licensing, provider data management, and monitoring with AI-driven technology.
2026-07
GlobeNewswire
Medallion Financial Corp. Exposes ZimCal's Latest Campaign of Distortion and the Risks of Electing Its Unqualified Nominees
Medallion Financial Corp. issued a statement addressing what it called 'distortionary claims' by ZimCal and warned shareholders about the risks of electing ZimCal's nominees to its board, citing their lack of relevant expertise.
2026-06

Frequently Asked Questions

Medallion offers an AI-powered platform that automates the entire provider lifecycle, including credentialing, payer enrollment, cross-state licensing, and privileging. It accelerates processes by performing primary source verification, generating committee-ready files, and automating application submissions and follow-ups to get providers billable faster.
Medallion provides comprehensive cross-state license management, including tracking and renewal automation, and supports multi-state licensing across all 50 states. For privileging, the platform offers automated workflows and simplified multi-hospital privileging, helping organizations accelerate approvals and maintain compliance with standards like those from the Joint Commission.
Medallion centralizes provider data management, creating a single source of truth and syncing data across systems in real-time to eliminate manual entry. It also offers continuous compliance monitoring for licenses, certifications, sanctions, and exclusions across hundreds of sources, providing real-time alerts to mitigate risks and ensure audit readiness.
Medallion leverages AI-powered automation to significantly reduce administrative burden, cutting credentialing time by up to 80% and streamlining complex workflows. The platform is NCQA-certified and SOC 2 compliant, adhering to rigorous standards for security, availability, and data protection, with a commitment to the responsible use of AI.
Medallion operates on a custom pricing model tailored to each organization's specific needs, provider volume, and operational goals, and does not offer a free plan. They emphasize strong customer support and dedicated account management, aiming to be a strategic partner rather than just a software vendor.
Founded in 2020, Medallion has demonstrated significant growth and stability, having raised a total of $194 million across multiple funding rounds from prominent investors including Sequoia Capital, GV, Spark Capital, and Acrew Capital. They partner with health systems, digital health companies, payers, and provider groups, supporting approximately 1 million providers in the U.S.
CredAlliance is Medallion's national credentialing clearinghouse, designed to eliminate the significant administrative burden and costs associated with redundant provider verification. It aims to verify providers once and share that validated data across participating payer networks, streamlining the process for both providers and payers.

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