Medallion is an end-to-end, AI-powered provider network management platform designed to automate and streamline clinician operations, including credentialing, ongoing monitoring, payer enrollment, state licensure, and privileging. Built specifically for healthcare organizations like health systems, digital health companies, payers, and provider groups, the platform aims to accelerate time-to-revenue, improve provider satisfaction, and decrease operating costs.
Key Benefits:
- Accelerated Provider Readiness: Medallion uses AI-powered automation to cut credentialing time by up to 80%, generating committee-ready files in days instead of weeks.
- Guaranteed Compliance: The platform is NCQA-certified and compliant with Joint Commission (TJC) and CMS standards, with built-in quality assurance and automated validations to ensure organizations are always audit-ready.
- Operational Efficiency: It centralizes provider data management (PDM), eliminating manual data entry and syncing data across the tech stack in real-time. The CredAlliance™ solution further reduces redundant recredentialing efforts for payers.
- Improved Provider Experience: The system simplifies the process for providers with mobile-friendly interfaces, fewer tasks, and automated follow-ups, allowing them to focus on patient care.
Main Features and Capabilities:
- Automated Credentialing (CVO): Primary Source Verification (PSV), committee management, and auto-generated credentialing files.
- Payer Enrollment: Direct and delegated payer enrollment, with automated form fills and follow-ups to get providers billable faster.
- Licensing: Cross-state license management, tracking, and renewal automation.
- Ongoing Monitoring: Continuous compliance monitoring for licenses, certifications, and exclusions.
- Privileging: Automated privileging workflows and simplified multi-hospital privileging.
- Provider Data Management: Centralized, real-time provider data syncing and validation.
- AI-Powered Workflows: Dynamic, configurable workflows that adapt based on payer, state, and provider type.