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Medallion's 2025 Geography of Payer Enrollments Report

On October 14, 2025, Medallion published an insightful report titled the 2025 Geography of Payer Enrollments, which sheds light on how payer enrollment timelines vary significantly across different states in the U.S. Having analyzed over 64,000 enrollment records, the report aims to assist health systems and provider organizations in planning their strategic growth effectively.

Key Findings

One of the report's primary revelations is the disparity in turnaround times (TAT) for providers to get enrolled and billable, which can vary based on geographical location. Some of the key insights from the analysis include:

• - The national median TAT for payer enrollments stands at 60 days.
• - In certain states, the enrollment timeline can extend to as much as 196 days, potentially hindering the accessibility of healthcare services in those regions.
• - Conversely, states such as Hawaii and Maine have optimized their processes to enable enrollments in under 40 days, showcasing best practices in efficiency.

Interestingly, regions with substantial rural populations—like South Dakota, North Dakota, and Vermont—tend to experience longer delays. This aligns with findings that indicate those states also have a higher concentration of Health Professional Shortage Areas (HPSAs), exacerbating existing access challenges for communities already struggling to connect with healthcare providers.

Identifying Opportunities for Improvement

The analysis further highlights that while some states lag in enrollment speed, others demonstrate that faster processing is attainable. For instance, Maine, despite being the highest in terms of enrollment volume, ranks as one of the fastest states for process completion. Georgia and Indiana, both also high-volume states, consistently complete enrollments in under 50 days.

Matt Ortiz, Vice President of Payor Strategy Relations at Family Care Center, emphasized the intricacy of managing enrollment across multiple states and payers. He stated, "When you're operating across multiple states and working with dozens of different payers, the complexity adds up fast. Having a partner who knows the common landmines—such as which payers are slow to respond and what documentation may cause delays—is crucial."

Implications for Health Systems

The specifics of this report offer vital insights for health systems and provider organizations on how to navigate the complexities of payer enrollments. By pinpointing where and why delays typically occur, organizations can engage in more strategic resource planning, enhance revenue forecasting accuracy, and refine their market expansion strategies.

Accelerating Enrollments

Moreover, the report underscores various strategies that organizations can adopt to overcome these delays. Through technology, Medallion is positioned at the forefront of transforming the enrollment process by employing AI and automated workflows targeted at improving efficiency from provider onboarding to application follow-ups. Though state-specific requirements and payer variability complicate matters, the right technological infrastructure can significantly expedite processes and boost revenue generation timelines.

To explore the full contents of the Geography of Payer Enrollments Report, including interactive heat maps and detailed state-by-state analysis, visit medallion.co/geography-of-enrollments.

About Medallion

Medallion stands as a leader in AI-driven infrastructure for managing provider network operations, such as credentialing, enrollment, and maintaining provider information scalably. By removing tedious administrative tasks with intelligent workflows, Medallion enables healthcare organizations to onboard and manage their providers more efficiently, allowing teams to focus on delivering quality patient care.
Medallion has earned recognition on various prestigious lists, including the 2025 Inc. 5000 List of America's Fastest-Growing Private Companies and continues to be a game-changer in healthcare provider network management.