Table of Contents
- Key Highlights:
- Introduction
- The Great Need for Automation in Healthcare Credentialing
- Medallion's AI-Powered Solutions
- Launching CredAlliance: A Game Changer in Credentialing
- Utilizing Funding to Drive Expansion
- Momentum Leading to Record Growth
- The Future of Credentialing and Healthcare Access
Key Highlights:
- Medallion has raised $43 million to enhance its AI platform and introduce CredAlliance™, the first national credentialing clearinghouse.
- The innovative clearinghouse is expected to reduce healthcare credentialing redundancies, potentially saving the industry $1.2 billion annually.
- The company currently supports around 1 million providers across the U.S., significantly cutting administrative workflows and clinician burnout.
Introduction
The healthcare sector continually grapples with inefficiencies that burden providers and hinder patient access to quality care. A significant contributor to these challenges has been the labor-intensive process of provider credentialing, which can be slow, costly, and fraught with redundancy. Medallion, a leader in AI-driven infrastructure for provider networks, has sought to address these issues effectively. On August 18, 2025, the company announced a significant $43 million funding round aimed at expanding its innovative AI capabilities and launching CredAlliance™, a groundbreaking national credentialing clearinghouse. This new initiative promises to streamline the credentialing process, reducing costs and improving efficiency in healthcare operations.
The Great Need for Automation in Healthcare Credentialing
Credentialing is a crucial component of the healthcare system, ensuring that healthcare providers meet the established standards for quality and safety. However, this process has traditionally been a cumbersome and manual endeavor. With over a million providers working in the U.S. healthcare system, the duplication of efforts across various payer networks can translate to inefficiencies and substantial costs.
Every health plan typically requires its own verification process for each provider, which is both time-consuming and labor-intensive. According to industry estimates, this unnecessary repetition costs the healthcare system approximately $1.2 billion annually. Medallion’s aim to introduce a unified and efficient credentialing approach is not just timely; it is essential.
Medallion's AI-Powered Solutions
Medallion's platform leverages intelligent automation to streamline credentialing and provider onboarding processes, significantly alleviating administrative burdens. By replacing repetitive manual workflows with advanced AI technologies, Medallion allows healthcare organizations to manage credentialing, enrollment, onboarding, and ongoing compliance more efficiently. This transformation has enabled the company to support nearly 10% of the U.S. healthcare workforce, delivering substantial time savings for provider organizations.
The Medallion platform acts as a centralized system of record for provider data, facilitating the verification of credentials and ensuring that providers remain in-network. Derek Lo, CEO and Founder of Medallion, emphasizes the mission of the company, stating, "In a system where inefficiency and clinician burnout are systemic, our mission is to eliminate the operational waste that stands in the way of care."
Launching CredAlliance: A Game Changer in Credentialing
The newly announced CredAlliance will serve as the first shared credentialing infrastructure, designed to maximize efficiency across the payer landscape. Instead of each health plan duplicating credentialing processes for the same providers, CredAlliance will allow for a standardized verification once, with results to be shared across participating networks. This streamlined effort can vastly improve the speed at which providers are deemed billable across multiple networks, consequently enhancing the patient’s journey to care.
CredAlliance has already garnered interest from major national payers, reflecting a strong desire within the industry for collaborative models that reduce redundancy. Medallion's underlying AI and automation technologies not only facilitate real-time verification but also purpose to dramatically cut onboarding timelines.
Utilizing Funding to Drive Expansion
The capital gained through the latest funding round is earmarked for multiple strategic initiatives, including:
- Enhanced AI Functionality: Medallion plans to expand its AI platform to automate thousands of workflows specific to various states, providers, and payers.
- Market Growth Initiatives: Investment in go-to-market teams and partnerships will help accelerate Medallion's footprint across health systems, provider groups, and payer networks.
- Scalability of CredAlliance: Funding will support further scaling of the clearinghouse and facilitate the onboarding of additional payer participants.
Vishal Lugani, General Partner and Co-founder of Acrew Capital, voiced his support for Medallion's innovative solutions, stating, "Medallion is delivering what the healthcare industry has needed for years: a scalable, intelligent infrastructure layer that automates the administrative burden behind care delivery. We're proud to back Medallion’s next phase of growth."
Momentum Leading to Record Growth
Medallion's growth trajectory is notable. The company has accelerated provider onboarding by an astonishing 40 times, reducing intake time from eight days to under two hours. Advanced automations like AI-powered phone agents and automated mapping of web forms to Medallion's data model are contributing to this efficiency. The fruit of these efforts is evident in the impressive 106% increase in enterprise annual recurring revenue (ARR) and the introduction of multiple new products designed to address the complexities within healthcare networks.
Throughout this growth phase, Medallion has successfully supported access to care for approximately 240 million patients nationwide. The company's achievements have not gone unnoticed, earning accolades such as inclusion in the 2025 Inc. 5000 List of America's Fastest-Growing Private Companies and recognition in the Newsweek Excellence Index for 2025.
The Future of Credentialing and Healthcare Access
As healthcare systems grapple with challenges such as provider shortages, rising operational costs, and increasingly complex regulatory environments, Medallion's innovations aim to create a cohesive and efficient framework. The company is strategically positioned to enhance the connectivity between providers, payers, and patients, ensuring timely access to care while alleviating the burdens associated with administrative processes.
With their commitment to intelligent automation, Medallion not only seeks to streamline operational workflows but also aspires to improve the overall healthcare delivery system. The impact of initiatives like CredAlliance promises to be profound, potentially redefining how credentialing is approached across the industry.
FAQ
What is Medallion's CredAlliance?
CredAlliance is the first national credentialing clearinghouse designed to eliminate redundant verification processes across various health plans, facilitating faster provider onboarding and reducing costs.
How much money has Medallion raised?
Medallion has raised a total of $43 million in the latest funding round, bringing its total funding to $130 million.
How does Medallion's AI platform benefit the healthcare system?
Medallion's AI platform streamlines provider credentialing, enrollment, onboarding, and compliance processes, resulting in substantial time savings and reduced administrative burdens for healthcare organizations.
Why is credentialing important in healthcare?
Credentialing ensures that healthcare providers meet specific standards for quality and safety, playing a crucial role in maintaining the integrity of healthcare services.
What impact does reducing redundancy in credentialing have?
Eliminating redundant credentialing processes can save the healthcare system approximately $1.2 billion annually while improving the speed of provider onboarding and overall patient access to care.