#USA #San Francisco #AI Infrastructure #Medallion #CredAlliance

Medallion Secures $43 Million for AI Deployment and Credentialing Innovation

Medallion, a frontrunner in artificial intelligence-driven healthcare provider network infrastructure, has just announced the successful raising of $43 million in a new funding round. This strategic investment was spearheaded by Acrew Capital and involved participation from firms such as Washington Harbour Partners, Sequoia Capital, GV, and others, marking a significant milestone that brings Medallion's total funding to $130 million.

Buying the Future of Healthcare
Medallion's goal is to revolutionize back-office operations in healthcare by replacing manual, repetitive workflows with intelligent automation. This transformation is critical for provider organizations and health plans as it streamlines processes related to credentialing, enrollment, onboarding, and compliance. By acting as a comprehensive system of record for provider data, Medallion enhances the efficiency of verification tasks, promotes in-network participation, and connects patients with providers more effectively.

Currently, Medallion supports around 1 million providers, amounting to approximately 10% of the U.S. healthcare workforce. This achievement significantly reduces time spent on administrative tasks, saving countless hours that can instead be channeled into patient care.

Derek Lo, CEO and Founder of Medallion, emphasizes, "Our mission is to eradicate the operational waste that hampers care delivery in a system plagued by inefficiencies and clinician burnout. The new funding will help us intensify our focus on AI automation and successfully launch CredAlliance, which will make the verification process genuinely scalable."

What is CredAlliance?

CredAlliance is touted as the nation’s first shared credentialing clearinghouse in the healthcare industry. This innovative platform aims to eliminate the redundancy of multiple health plans repeating the same credentialing processes for every provider. By verifying providers once and disseminating the results across various payer networks, CredAlliance could save the industry an estimated $1.2 billion annually.

Currently, several major national payers are already utilizing CredAlliance, and there is growing interest from others wishing to join. The AI-driven infrastructure supports real-time verification, which significantly curtails onboarding time and allows providers to become billable more swiftly, thereby improving patient access and continuity of care.

Future Plans and Growth

The newly acquired capital allows Medallion to expand its AI capabilities further by automating numerous state-, provider-, and payer-specific workflows. Additionally, investments will be made in go-to-market initiatives to promote growth among health systems, provider groups, and plans. Furthermore, Medallion is committed to scaling up the CredAlliance clearinghouse and onboarding more payer participants over the coming months.

Vishal Lugani, General Partner and Co-founder of Acrew Capital, expressed satisfaction with Medallion's progress, stating, "Medallion is finally delivering what the healthcare landscape has desperately needed—a scalable, intelligent infrastructure that alleviates the administrative load associated with care delivery. Their momentum is a testament to the demand across the entire ecosystem from provider groups to national payers."

The recent funding comes on the heels of impressive growth for Medallion. The company has managed to onboard providers 40 times faster, reducing intake time from an average of eight days to under two hours. Additionally, they have developed advanced automation solutions, such as AI phone agents and systems that autonomously map web forms to the company’s provider data model.

In business terms, Medallion has achieved a 106% increase in annual recurring revenue (ARR) and launched new products, including Privileging, an Integration Engine, and CAQH Management tools. Their efforts have already improved patient access for an estimated 240 million individuals across the nation.

In the context of ongoing provider shortages, escalating costs, and increasing regulatory complexities in the U.S. healthcare system, Medallion is creating essential connections among providers, payers, and patients with unprecedented efficiency and intelligence. The company's innovative approach is setting new standards in how healthcare organizations manage and operate their networks.