Medallion

OpenAI

Medallion

Medallion charges healthcare organizations a subscription based on the number of providers being managed. The platform handles initial credentialing (verifying a new provider) and ongoing monitoring (ensuring licenses stay current, no disciplinary actions arise).

The value is measured in speed and cost savings. Credentialing departments at hospitals can cost millions annually in staff salaries.

Medallion replaces much of that manual labor with software. Faster credentialing also means faster time-to-revenue — a doctor who can start seeing patients weeks earlier generates revenue weeks earlier.

The platform also manages payer enrollment — getting providers into insurance networks — which is a related but separate bureaucratic process that's equally painful and equally automatable.

OpenAI

OpenAI makes money primarily through API access and subscriptions. The API charges developers per token (roughly per word) for using GPT models in their applications.

ChatGPT Plus costs $20/month for individual users, ChatGPT Team is $25-30/user/month, and ChatGPT Enterprise is custom-priced. Microsoft pays OpenAI licensing fees and also resells OpenAI models through Azure OpenAI Service.

OpenAI's annualised revenue ran past $13 billion during 2025 and kept climbing from there, which is the kind of growth curve that normally only exists in a pitch deck.

Medallion

Derek Lo was working in healthcare operations when he encountered credentialing — the process of verifying that healthcare providers have the proper licenses, education, training, and malpractice history to practice medicine. Every doctor, nurse, and therapist in America must be credentialed before they can see patients at a new facility or join an insurance network.

The process was absurdly manual. It involved contacting medical schools, state licensing boards, previous employers, malpractice insurers, and the DEA — often by fax or mail.

A single credentialing verification could take 90-180 days. Healthcare organizations employed entire departments of people doing nothing but chasing down verifications through a patchwork of government databases, phone calls, and paper forms.

Lo founded Medallion in 2020 to automate this process. The platform connects directly to primary sources — state licensing boards, the National Practitioner Data Bank, DEA databases, and medical school registries — and pulls verification data automatically.

What used to take months of manual work now takes days or weeks.

OpenAI

OpenAI was founded in December 2015 as a nonprofit AI research lab. The founding donors — including Elon Musk, Sam Altman, Peter Thiel, Reid Hoffman, and Jessica Livingston — pledged $1 billion with a mission to build artificial general intelligence (AGI) that would benefit all of humanity.

The idea was that AI was too important and too dangerous to leave in the hands of Google alone.

Sam Altman became chairman while Greg Brockman (former CTO of Stripe) became president. Ilya Sutskever, one of the most respected AI researchers alive, left Google Brain to become chief scientist.

The early team was stacked with world-class researchers who published their work openly — hence "Open" AI.

But AI research turned out to be staggeringly expensive. Training large models required millions of dollars in compute.

In 2019, OpenAI created a "capped-profit" subsidiary — investors could earn up to 100x their money, but profits beyond that would flow to the nonprofit. Microsoft invested $1 billion.

The mission was still to save humanity. The method now involved making a lot of money first.

Medallion

Medallion grew by targeting healthcare organizations that were drowning in credentialing backlogs. Telehealth companies scaling rapidly during COVID were the first ideal customers — they needed to credential hundreds of providers quickly across multiple states, and the manual process couldn't keep up.

The platform expanded to hospitals, health systems, and staffing agencies that manage large provider networks. Each customer type faces the same fundamental problem: too many providers to credential, too few staff to do it, and too many regulatory requirements to track manually.

Integration partnerships with HR systems and practice management platforms drove distribution. When Medallion plugs into a health system's existing tech stack, the switching costs climb and the data integration deepens.

OpenAI

ChatGPT's launch in November 2022 was the growth strategy — it just wasn't planned that way. The team expected a modest research preview.

Instead, ChatGPT hit 1 million users in 5 days and 100 million monthly active users in 2 months, making it the fastest-growing consumer application in history. The product went viral because it felt like magic — for the first time, anyone could have a natural conversation with a machine that seemed to understand them.

The Microsoft partnership provided distribution at massive scale. Microsoft integrated OpenAI models into Bing, Office 365 (Copilot), GitHub (Copilot), and Azure.

Overnight, hundreds of millions of Microsoft users had access to OpenAI technology. Microsoft's $13 billion investment was the largest AI bet in history and gave OpenAI nearly unlimited compute.

The API created an ecosystem. Thousands of startups built products on top of OpenAI's models — from customer service bots to coding assistants to content generators.

Each API customer locked themselves into OpenAI's ecosystem, creating switching costs and recurring revenue.

Medallion

Healthcare is notoriously slow to adopt new technology. Decision-makers at hospitals and health systems are risk-averse and procurement cycles are long.

Selling enterprise software to healthcare organizations requires patience, compliance certifications, and relationships that take years to build.

The credentialing ecosystem involves hundreds of independent data sources — each state licensing board has its own system, formats, and response times. Building and maintaining connections to all of these sources is operationally complex and requires constant updating as boards change their processes.

Competition from established credentialing verification organizations (CVOs) and legacy software providers means Medallion is displacing existing processes and vendors, not entering a greenfield market.

OpenAI

The board crisis of November 2023 nearly destroyed the company. The nonprofit board fired Sam Altman as CEO on a Friday, citing a loss of confidence.

Within 48 hours, 95% of employees threatened to quit and follow Altman to Microsoft. By Tuesday, Altman was reinstated and the board was restructured.

The incident exposed the fundamental tension between OpenAI's nonprofit governance and its for-profit ambitions — a tension it finally addressed in late 2025 by restructuring the business as a public benefit corporation sitting under the original nonprofit.

The cost of training frontier models is eye-watering. Each new GPT generation costs hundreds of millions to train.

OpenAI is reportedly spending over $7 billion annually on compute. The company is burning through cash faster than almost any startup in history, which is why it keeps raising at higher and higher valuations.

If revenue growth slows before costs stabilize, the math gets ugly.

Safety concerns are not going away. Multiple prominent researchers have left OpenAI over disagreements about the pace of development versus safety research.

Ilya Sutskever, the chief scientist who was central to the board's decision to fire Altman, left in 2024 to start a safety-focused AI lab. The public debate about whether OpenAI is moving too fast — and whether its safety commitments are genuine — grows louder with every capability improvement.

Medallion

Medallion Credentialing — automated primary source verification of healthcare provider qualifications including licenses, education, training, and malpractice history. Medallion Monitoring — continuous license and exclusion monitoring that alerts organizations when a provider's credentials change or expire.

Medallion Payer Enrollment — automated management of insurance network applications and re-enrollments across multiple payers. Medallion Provider Network Management — a unified platform for managing the complete provider lifecycle from recruitment through credentialing to ongoing compliance.

Medallion Analytics — dashboards showing credentialing pipeline status, bottleneck identification, and compliance metrics.

OpenAI

ChatGPT is the consumer chatbot — the product that made AI mainstream overnight. The flagship GPT models are multimodal, handling text, images, and audio in one system.

The OpenAI API lets developers integrate GPT into any application. DALL-E generates images from text descriptions.

Whisper transcribes and translates audio. Sora generates videos from text prompts.

GPT Store lets users create and share custom GPT agents. ChatGPT Enterprise gives businesses a private, secure version of ChatGPT with admin controls and no data training.

Medallion

Sequoia Capital led the Series B. Optum Ventures (part of UnitedHealth Group) invested — a significant strategic validation from the largest healthcare company in America.

Tiger Global and GV (Google Ventures) participated in earlier rounds.

OpenAI

Microsoft ($13B), Thrive Capital, Khosla Ventures, Sequoia Capital, Founders Fund, Tiger Global, SoftBank, a16z