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Medallion

SaaS platform streamlining credentialing, enrollment, monitoring

Overview

Medallion provides a SaaS platform that unifies provider credentialing, enrollment, and monitoring for healthcare organizations and providers. The platform automates verification steps, centralizes workflows, and is accessed via a subscription to reduce administrative task and verification times. It stands out by providing a single integrated system for multiple provider-operations tasks, delivering measurable efficiency gains and focusing on ease of use and revenue opportunities. Its goal is to simplify onboarding, reduce risk, and help healthcare organizations grow revenue through streamlined provider operations.

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About Medallion

Simplify's Rating
Why Medallion is rated
B-
Rated B on Competitive Edge
Rated B on Growth Potential
Rated C on Differentiation

Industries

Enterprise SoftwareHealthcare

Company Size

501-1,000

Company Stage

Late Stage VC

Total Funding

$128M

Headquarters

San Francisco, CA

Founded

2019

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What believers are saying

  • Medallion raised $43 million in August 2025, bringing total funding to $130 million.
  • HANYS Marketplace named Medallion a partner in March 2026, opening New York hospitals.
  • September 2026 Andros acquisition adds nearly 400 organizations and strengthens enterprise distribution.

What critics are saying

  • NCQA's July 2025 standards demand monthly monitoring; weak execution triggers accreditation failures quickly.
  • ProviderTrust, Verifiable, and symplr compress Medallion's differentiation with broader provider-data networks.
  • A credentialing error or data breach destroys health-plan trust and kills renewals fast.

What makes Medallion unique

  • Andros acquisition made Medallion the largest AI-native credentialing platform, covering one million providers.
  • NCQA Credentialing Certified plus expert oversight separates Medallion from pure-software credentialing vendors.
  • CredAlliance syndicates one verification across payer networks, shrinking duplicated credentialing work.

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Funding

Total Funding

$128M

Above

Industry Average

Funded Over

4 Rounds

Notable Investors:
Late VC funding comparison data is currently unavailable. We're working to provide this information soon!
Late VC Funding Comparison Coming Soon

Benefits

  • Company Equity

Growth & Insights and Company News

6 month growth

0%

1 year growth

2%

2 year growth

0%
Medallion
Sep 28th, 2026
Medallion named Quarterfinalist in the 2026 Digital Health & AI Awards.

Medallion named Quarterfinalist in the 2026 Digital Health & AI Awards. September 28, 2026 By Medallion Team Medallion has been named a Quarterfinalist in the 2026 Digital Health & AI Awards, in the Best in Class - Transformative Care Delivery category. The Digital Health & AI Awards, run by the Digital Health Hub Foundation, brings together innovators across digital health, AI, and healthcare technology and puts them in front of judges spanning healthcare, investment, technology, and clinical care. Medallion were recognized for the problem Medallion exists to close: the distance between a provider being hired and a provider seeing a patient. McKinsey estimates the administrative burden on U.S. healthcare at roughly $1 trillion a year, and a meaningful piece of that cost sits in a step patients never see - a provider can be hired, licensed, and ready to work, then spend weeks waiting on credentialing and payer enrollment before that first appointment happens. Medallion pairs AI-assisted automation with credentialing specialists to help close that distance, so healthcare organizations spend less time chasing paperwork and providers get to patients sooner. Nearly 500,000 providers already ran on Medallion before this year's acquisition of Andros - a combined platform that's grown meaningfully larger since. Medallion's customer, Tampa General Hospital, is one of the clearer examples of what that looks like in practice. The 1,040-bed academic medical center brought its credentialing turnaround down from 30 days to a median of three (a 90% efficiency gain) and realized an estimated $2.4 million in ROI within six months of working with Medallion. "This kind of work rarely gets a spotlight, so we don't take it lightly when it does. Every day we cut from that gap between hired and patient-ready is a day a provider gets to actually practice instead of wait," said Kyle Carbine, Chief Revenue Officer at Medallion. "It's good to see that it counts as more than back-office plumbing." Quarterfinalists advance to the next round of judging, with Finalists announced October 12, 2026. The competition culminates at the Digital Health & AI Awards Grand Finale on November 16 at HLTH in Las Vegas, where the 2026 Rising Star and Best in Class winners will be announced live. About the Digital Health & AI Awards. The Digital Health Hub Foundation is a nonprofit founded in 2017 on UCSF's campus in San Francisco. Its 30,000+ member ecosystem connects healthcare innovators, industry leaders, investors, clinicians, and researchers, and the Digital Health & AI Awards is one of its year-round programs recognizing the people and companies advancing healthcare through innovation. FAQ about the 2026 Digital Health & AI Awards. What are the Digital Health & AI Awards? An annual awards program run by the Digital Health Hub Foundation, a nonprofit founded in 2017 on UCSF's campus in San Francisco. Now in its eighth year, it recognizes companies and innovations shaping the future of healthcare, judged by leaders spanning healthcare, investment, technology, and clinical care. What's the difference between the Best in Class and Rising Star tracks? Best in Class recognizes organizations already making significant, sustained contributions to digital health - the track Medallion competed in. Rising Star highlights earlier-stage companies showing exceptional promise. Winners in both tracks are crowned live at the Grand Finale. What happens after a company is named a quarterfinalist? Quarterfinalists move into another round of expert judging. Finalists are announced October 12, 2026, then go through further review and pitch sessions before winners are revealed. When is the 2026 Digital Health & AI Awards Grand Finale? November 16, 2026, at HLTH in Las Vegas, where the 2026 Rising Star and Best in Class winners are announced live. For closing the administrative distance between a provider being hired and a provider seeing a patient - pairing AI-assisted automation with credentialing specialists to help healthcare organizations move providers into billable, patient-facing work faster.

Insurance Business
Sep 16th, 2026
AI credentialing deal targets provider network gaps at scale.

AI credentialing deal targets provider network gaps at scale. Medallion's acquisition of Andros puts more than one million providers on a single credentialing platform. Credentialing delays have long been a quiet drag on health plan network performance. A new deal signals the industry is starting to address the problem at a different scale. Medallion, a San Francisco-based AI-assisted credentialing and enrollment platform, acquired Andros, a National Committee for Quality Assurance (NCQA)-certified credentials verification organization. Andros has served health plans, health systems, provider groups, and telehealth companies since 2013. The combined platform now covers more than one million providers across nearly 400 healthcare organizations and health plans, according to Medallion. When credentialing stalls, employer-sponsored plans end up with thinner networks than their directories suggest. Employees who cannot find an available in-network provider face out-of-pocket cost exposure, and the resulting member complaints typically surface at renewal. Medallion's own 2026 State of Payer Enrollment and Medical Credentialing report, based on responses from more than 550 healthcare leaders, puts a number to the delay cost. Among hospitals that could quantify the impact, one in five reported losing more than $1 million annually from delayed provider activation. The pattern they describe - credentialing backlogs limiting network capacity - is one benefits advisers encounter when plan directory accuracy becomes a dispute point at renewal. Medallion's own 2026 State of Payer Enrollment and Medical Credentialing report, based on responses from more than 550 healthcare leaders, puts a number to the delay cost. The report found that one in five hospitals able to quantify the impact reported losing more than $1 million annually from delayed provider activation. What gives the problem independent standing is regulatory. NCQA updated its credentialing standards effective July 1, 2025, cutting maximum verification timelines from 180 days to 120 days for accredited organizations and introducing mandatory monthly monitoring of all enrolled providers. Organizations currently failing 2026 NCQA review cycles are being cited specifically for non-compliance with those new requirements. Consolidating a fragmented process. The Andros acquisition is an attempt to bring credentialing infrastructure under a single AI-driven platform. Andros contributes NCQA certification and 13 years of health plan relationships. Medallion's platform handles primary source collection and provider outreach through automation, with credentialing specialists stepping in when the system flags exceptions. Andros customers will move to Medallion over time, with access to real-time status tracking alongside the automated workflow. The deal also shows a gap in where AI investment has gone in healthcare. According to Medallion's January report, only 12 percent of AI investments touch credentialing or enrollment, with most resources directed at clinical and patient-facing functions. That concentration has left the administrative infrastructure underpinning network accuracy largely manual. The consequences show up in plan performance data that benefits advisers can examine at renewal. When the directory is wrong. Outdated or incomplete credentialing creates the conditions for ghost providers: practitioners listed as in-network who are unavailable or no longer affiliated. Regulators have flagged ghost networks as a compliance risk, and employees encounter the problem when their coverage does not work as described. As recent coverage of provider data errors across health systems and health plans found, fewer than one in three health systems maintains a single verified source of truth for provider data. Those errors cascade into the AI-driven claims and network management functions health plans are actively investing in. That backdrop is why AI adoption across health plans without matching governance infrastructure compounds the credentialing problem rather than solving it. A platform that keeps provider records current at scale addresses a problem upstream of where most AI spending is currently focused. Financial terms were not disclosed. Bailey & Company served as exclusive financial advisor to Andros.

PR Newswire
Sep 15th, 2026
Medallion acquires Andros to bring over 1M providers onto AI-native credentialing platform

Medallion has acquired Andros, an NCQA-certified credentials verification organisation, bringing over a million providers across nearly 400 healthcare organisations and health plans onto a single credentialing platform. The acquisition makes Medallion the largest AI-native credentialing platform in the US. Andros, which has credentialed providers for health plans, health systems, provider groups, and telehealth companies since 2013, will gain access to Medallion's AI-assisted features. These include automated primary source collection, AI agents for provider outreach, and real-time status tracking. Medallion will continue serving health plans, health systems, provider groups, digital health companies, and telehealth organisations. Bailey Company served as financial adviser to Andros. Transaction terms were not disclosed.

Medallion
Sep 15th, 2026
Medallion acquires Andros to expand ai-native credentialing across health plans and provider organizations.

Medallion acquires Andros to expand ai-native credentialing across health plans and provider organizations. The acquisition brings over one million providers across nearly 400 healthcare organizations and health plans onto a single credentialing platform. SAN FRANCISCO, Sept. 15, 2026 - Medallion, the only AI-assisted credentialing and enrollment platform with expert oversight, today announced it has acquired Andros, an NCQA-certified credentials verification organization that has credentialed providers for health plans, health systems, provider groups, and telehealth companies since 2013. The acquisition makes Medallion the largest AI-native credentialing platform in the country and advances its strategy to bring credentialing, enrollment, licensing, and provider data management onto one system for every organization that touches a provider record. "Over the past 13 years Andros has developed strong, trusted relationships with many of the top health plans in the country," said Derek Lo, founder and CEO of Medallion. "The success Andros has already achieved will only be strengthened by Medallion's AI-native credentialing solution." Andros customers will gain access to Medallion over time, including automated primary source collection, AI agents that handle provider outreach and follow-up, real-time status tracking, and the credentialing specialists Medallion embeds alongside its automation. "Our customers have pushed us for 13 years to make credentialing faster and more accurate, and we have delivered on that in a category where most people accept the status quo," said Jake Hirschfeld, VP of Sales at Andros. "Joining Medallion enables us to deliver the next chapter of meaningful work to our customers." Medallion will continue to serve health plans, health systems, provider groups, digital health companies, and telehealth organizations, spanning credentialing, payer enrollment, licensing, and provider data management. Bailey & Company served as the exclusive financial advisor to Andros for this transaction. Terms of the transaction were not disclosed. About Medallion Medallion is the only AI-assisted credentialing and enrollment platform with expert oversight, built to deliver speed and accuracy at scale, with contract-backed performance. Healthcare organizations are empowered to manage and grow their provider networks with unparalleled speed, accuracy and elevated provider satisfaction levels with its AI-assisted model, freeing teams to focus on what matters most: delivering care. Through this, Medallion enables healthcare organizations to prioritize clinical excellence instead of admin overhead. Medallion has been named to the 2026 and 2025 Inc. 5000 lists of America's fastest-growing private companies and ranked on Inc. magazine's 2026 list of Fastest-Growing Private Companies in the Pacific Region. The company was named one of LinkedIn's Top Startups in both the U.S. and San Francisco for 2025, recognized on the Newsweek Excellence Index 2025, and named to Inc.'s 2026 Best Workplaces list and Glassdoor's Best Places to Work in 2025. Medallion is paving the future of provider network management. To learn more, visit Medallion.co or join the conversation on LinkedIn.

Medallion
Mar 31st, 2026
Inc. names Medallion to its 2026 list of the fastest-growing private companies in the Pacific.

Inc. names Medallion to its 2026 list of the fastest-growing private companies in the Pacific. March 31, 2026 Inc., the leading media brand and playbook for the entrepreneurs and business leaders shaping its future, today revealed that Medallion has been ranked No. 60 on its sixth annual Inc. Regionals: Pacific list - positioning the company within the top 45% in the region. The list is the most prestigious ranking of the fastest-growing privately held companies in the Pacific, which includes California, Oregon, Washington, Hawaii, and Alaska. An extension of the national Inc. 5000 list, the Regionals list offers a data-driven look at the independent small businesses driving growth across the Pacific economy. Companies on this year's list demonstrate exceptional revenue expansion, resilience, and job creation during a challenging economic period. Between 2022 and 2024, these 134 private companies had a median growth rate of 94 percent; by 2024, they'd also added 7,503 jobs and $2.5 billion to the region's economy. Complete results of the Inc. Regionals: Pacific, including company profiles and an interactive database sortable by industry and metro area, will be available beginning March 31 at: https://www.inc.com/regionals/pacific. "The honorees on this year's Inc. Regionals list achieved exceptional growth at a time when the odds were against them. Amid inflation, supply chain disruptions, and ongoing economic uncertainty, they didn't just persevere - they innovated, adapted, and thrived. Their resilience made them standouts in their industries and true growth engines in their regions," said Bonny Ghosh, editorial director at Inc. Medallion is the AI operations partner for healthcare credentialing, combining AI agents, credentialing experts, and outcome ownership to execute provider onboarding and enrollment end-to-end. Healthcare organizations use Medallion to manage and grow their provider networks more efficiently, improving provider satisfaction while reducing administrative burden so teams can focus on delivering care. Medallion was previously recognized on Inc.'s list of fastest-growing companies in the Pacific Region in 2024 and continues to build the future of provider network management. To learn more, visit Medallion.co or connect on LinkedIn. More about Inc. and the Inc. Regionals Methodology The Inc. Regionals lists are ranked according to percentage revenue growth over two years. To qualify, companies must have been founded and generating revenue by March 31, 2022. They had to be U.S.-based, privately held, for-profit, and independent - not subsidiaries or divisions of other companies - as of December 31, 2024. (Since then, a number of companies on the list may have gone public or been acquired.) The minimum revenue required for 2022 is $100,000; the minimum for 2024 is $1 million. As always, Inc. reserves the right to decline applicants for subjective reasons. About Inc. Inc. is the leading media brand and playbook for the entrepreneurs and business leaders shaping its future. Through its journalism, Inc. aims to inform, educate, and elevate the profile of its community: the risk-takers, the innovators, and the ultra-driven go-getters who are creating the future of business. Inc. is published by Mansueto Ventures LLC, along with fellow leading business publication Fast Company. For more information, visit www.inc.com.

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