Medallion keeps building its case to be the go-to platform for provider network management by locking in another $43M and unveiling the industry’s first national credentialing clearinghouse, CredAlliance.
Less friction, more healthcare. Providers have to jump through countless operational and compliance hoops before they can start caring for patients, and Medallion specializes in AI-powered hoop jumping.
- Medallion helps automate away the back-office workflows that delay care – and revenue – such as credentialing, enrollment, and monitoring.
- The platform not only onboards providers 40X faster (cutting intake time from 8 days to under 2 hours), but it also serves as a unified system of record that allows customers to verify credentials, stay in-network, and connect patients to care more efficiently.
Own the market by shrinking it. There’s roughly 4M credentialed providers in the U.S., and they’re each contracted with an average of 19 payors. That adds up to about 25M times a year that providers need to get credentialed.
- The launch of CredAlliance will allow payors to verify providers once and syndicate results, eliminating duplicative work and reducing costs for everyone involved.
- It also has the potential to both eliminate $1.2B in duplicative spend annually and shrink the exact market Medallion exists to serve. That’s a risk it’s willing to take.
Where do we go from here? The fresh funds will bring Medallion’s AI automation to thousands of state-, provider-, and payor-specific workflows, while simultaneously scaling CredAlliance across more payors.
- CredAlliance already has dozens of payors signed on, and it’s in talks to bring on five of the nation’s 10 largest health plans.
- If that ends up making credentialing so efficient that there’s less of a need for automation, we’ll chalk it up as a good thing for the industry and Medallion will be just fine (enterprise ARR is up 106% in the wake of launching three new products – Privileging, Integration Engine, and CAQH Management).
The Takeaway
Medallion had a front row view of the wasteful spending in the credentialing trenches, and it raised $43M to help eliminate it with the first national credentialing clearinghouse. Bravo.
