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.

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.

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.

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.

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.

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.