MedallionAI Wiki

An LLM-maintained knowledge base of Medallion’s customer engagements and payer operations. Pages are built from ingested Gong call transcripts — each entry links back to the source call. Use search (⌘K), the backlinks panel, or the graph view to navigate across customer ↔ payer relationships.

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Customers

  • 3Y Health — Medallion cold-outreach prospect; BDR voicemail 2026-04-20; Mehul Agarwal contacted.
  • Aledade — active Medallion customer in early implementation phase; loading provider roster + group enrollments; weekly implementation sync; credentialing policy (no privileging); committee user structure pending.
  • ANE Staff Locums — startup anesthesia-only locum tenens staffing company (mid-Atlantic, NY–FL); Medallion prospect; below provider minimum at current stage; BDR follow-up in progress.
  • Access Medical Clinic — ambulatory clinic group; active Medallion customer in delegated credentialing implementation; sub-delegation CVO transition to Medallion pending with Humana, Devoted, Centene; bi-weekly sync cadence.
  • Advocare — multi-care-center medical group; active Medallion customer; weekly sync; Horizon NJ commercial vs. managed Medicaid line-separation issue open.
  • Cadence RPM — multi-state NP/nursing provider org; active Medallion customer; weekly sync cadence; corrective action plan issued for LPN profile credential error (Apr 2026).
  • Brigade Health — multi-entity primary care + subspecialty org (Senior Doc + Greenwell Health sub-entities); active Medallion customer; admin-driven credentialing; product feedback session on provider profile auto-completion Apr 2026.
  • BrightSpan Health — medical billing services for ABA providers; Medallion cold-outreach prospect; in business restructuring with layoffs; follow-up with Joshua Rodriguez + CFO targeted early June 2026.
  • Carelon (CareMore Health) — Anthem/Elevance subsidiary (formerly CareMore Health); Medallion customer in active licensing platform migration; weekly sync; provider add form broken since late 2025; CAQH routing issue to cmpm email.
  • Carilion Clinic — large Virginia health system (7 hospitals, ~300 clinics); Medallion prospect; CMO-driven Symplr replacement RFP underway; Josh Hartle + Paul Olzak championing Medallion; vendor selection targeted mid-to-late summer 2026.
  • Color — digital health / telehealth company; active Medallion customer; monthly EBR cadence; pursuing NCQA certification; delegated agreement in signing process.
  • Community Health Centers, Inc. — Oklahoma community health org; Medallion cold-outreach prospect; outsources credentialing to Synergy Billing; discovery call tentatively 2026-04-28.
  • Daybreak — sleep apnea MSO (dental + physician groups); launched July 2024; Medallion prospect; intro call 2026-04-20, demo 2026-04-24.
  • Eisenhower Health — health system in Rancho Mirage, CA; Medallion prospect in early BDR outreach stage.
  • Fertility Specialists Network — multi-clinic IVF/fertility network (TX, LA, FL); Medallion prospect; vendor evaluation in progress; urgency around new physician joining May 11; deal at/near $50K floor.
  • Frontier Psychiatry — standalone telehealth group psychiatry practice; non-delegated payer contracts; multi-year Medallion customer; aged enrollments down to 25; evaluating CAQH Management add-on.
  • Heartland Dental — large dental organization; Medallion cold-outreach prospect; declined BDR outreach 2026-04-20; does credentialing in-house and delegated with all major payers.
  • Heights Dermatology — 2nd-largest dermatology private practice in the US; primarily Texas + NC + OK; ~24 providers, 30 locations, ~120 payers; Medallion prospect in active sales discovery; demo + pricing proposal call 2026-04-28.
  • Complex Care Solutions — multi-entity provider org (CCS legacy + new SME Medical Delaware PA + new California entity); ~800 providers + 121 recreds/mo + 42 new/mo; NPDB Death Master File issue under active resolution.
  • Confluent Health — multi-brand PT/OT group (corporate + franchise, ~7k providers across brands); weekly ops sync + CAP; COO on Medallion advisory panel.
  • Jackson Health System — large academic health system in Miami, FL; Medallion prospect; contract red lines in progress; demo with managed care + credentialing leadership scheduled 2026-04-28.
  • Iris Telehealth
  • Journey Clinical — telehealth behavioral health company (prescribers + therapists, Spravato clinics); Medallion prospect; pricing inputs / BVA in progress; ~75 current billable providers, ~500 new projected over 12mo. — telehealth company (joint partner model); active Medallion customer; weekly ops sync; escalation protocol pending sign-off; POA language update in progress for hospital applications.
  • Key Autism Services — autism services provider; Medallion cold-outreach prospect; credentialing not a current priority per COO.
  • Marion Eye Centers — ophthalmology/optometry group (33 providers; Missouri + Illinois); Medallion prospect in early BDR discovery; primary pain is third-party payer enrollment.
  • Mederva Health — YC-backed virtual behavioral health company (collaborative care model); Medallion prospect — below $50K minimum at current provider count (2 providers); Seth Weidle following up on YC deal terms.
  • NeurAbilities — multi-specialty behavioral health + neurology group; Medallion prospect; product demo 2026-04-20; decision expected within 1–2 weeks pending CEO sign-off.
  • NFL Surgeons — North Florida Surgeons multi-division surgical group; Medallion customer for credentialing + practice-location management; NPDB registration outstanding, blocking credentialing start; monthly sync with Collette Waddell.
  • NVISION Eye Centers — multi-location ophthalmology/optometry group (ASCs + clinics); active Medallion customer in implementation phase; weekly sync; par analysis in flight; optometrist residency diploma requirement open issue.
  • OneOncology — oncology provider network; active Medallion customer in implementation phase; weekly sync; Evolent enrollment blocked (client-specific, unresolved); non-par payer tracking gap forcing dual-system management.
  • Oaklawn — behavioral health / child & adolescent services org; Medallion prospect; BDR outreach in progress as of 2026-04-20.
  • Cortica — multi-specialty pediatric healthcare group; Medallion engagement includes weekly Q/A with Sarah Aloisi + Deanna Purchiaroni.
  • Experity — urgent-care RCM vendor; 3–4yr Medallion partner; bucket-of-enrollments resale model + API integration; 87 sub-customer instances inside Medallion.
  • PM Pediatrics — pediatric urgent care + behavioral health group; weekly sync + exec aged-line review; ~950 aged lines in 90+ bucket dominated by NY/NJ/MD.
  • Pacific Inpatient Medical Group — Medallion cold-outreach prospect; BDR voicemail 2026-04-20; Fabiola Cobarrubias (CEO) not available.
  • PhyNet — multi-specialty physician network; active Medallion customer post-Symplr migration; ~300 providers, 254 in Medallion; exploring hospital applications + delegated credentialing.
  • Pomelo Care — virtual maternity + women’s health provider; weekly sync; 59+ licenses in requested status with renewal processing delays; support ticket quality issues.
  • Renew Medical Group — medical group; active Medallion customer; weekly sync; ~29 open Redlands hospital credentialing requests; Kristen task-save bug under investigation.
  • Revere Medical — multi-provider network (Arizona); active Medallion customer in implementation phase; NCQA credentialing + delegated agreements with Humana and Imperial (AZ); Village provider group subset; weekly check-in with Naomi Denson.
  • Ria Health — active Medallion customer; contact transition underway (Anna Schneider departing, Samantha Joseph backfill); new credentialing manager onboarding Apr 2026.
  • Raintree
  • RAYUS Radiology — radiology group (CDI Radiology); Medallion cold-outreach prospect; BDR voicemail 2026-04-20. — EHR+RCM for multi-disciplinary therapy (PT/OT/behavioral); early partnership discovery, referral-agreement pending GC transition; user conf Austin 2026-08-19→21.
  • SLEA Therapies — active Medallion customer in implementation phase; weekly sync; provider loading, group enrollments, and payer enrollment in progress; provider profile completion decision (SLEA vs. providers) pending.
  • Spectrum Medical Partners — multi-entity post-acute provider group (Psych Health Associates primary entity); Medallion prospect; process mapping + demo stage; evaluating Medallion to replace Modio + Excel for partner applications + payer enrollment; 90-building acquisition driving scale pressure.
  • SimplePractice — EHR/practice-management for solo + small behavioral-health practices; embedded Medallion enrollment integration; daily-sync architecture; launch last week of April 2026.
  • Southwest Health — active Medallion customer in weekly implementation sync; SSO live 2026-04-20; ~110 payer enrollment requests in flight, TJC credentialing and DOPs loaded; non-clinical staff training planned.
  • Spring Health — digital behavioral health company; active Medallion customer in post-implementation steady-state; weekly sync; SIPAC licenses blocking Highmark roster; license monitoring + platform UX issues in triage.
  • SkyTherapist — VA network staffing org (therapists, counselors, NPs); rebuilding provider network after exiting Andros; Medallion prospect; demo 2026-04-20, scoping questionnaire pending.
  • Sobe Innovative Rehab — behavioral health/therapy rehab org (FL, GA, AL); 282 billable therapists; Medallion prospect; product demo 2026-04-20, proposal call 2026-04-22.
  • Sunbound — senior-living RCM prospect; BVA in progress; facility-level enrollment only; 120→1,500 NPI 5-yr scale plan; referred by Brigade.
  • Theoria Medical — multi-state nursing-home physician group (Midwest H/M, Northeast H, Southeast H entities); ~$500K BCBS-MI AR + 1-year BCBS-IL zero-providers crisis + Georgia Medicaid retro dispute; Complex Care Medical Group billing entity transition eff 2026-04-01.
  • Turnout Medical Group PA — prospect; previously chose competitor Assured; BDR re-engagement in progress as of 2026-04-20.
  • Twin Health — active Medallion customer; credentialing + renewal management across multi-provider roster; Thursday sync cadence with Lorraine Millas, Larissa Brefka, Tamara Ragland.
  • Valley Baptist Health System — general acute care hospital; Tenet Healthcare subsidiary; Medallion cold-outreach prospect; buying decisions controlled by Tenet parent, locked into Tenet CVO + Healthstream; not a near-term fit.
  • WellBe — active Medallion customer; monthly call cadence with Kimberly Jones (Credentialing Supervisor); open question on board cert PSV pass-through fees outside credentialing events.
  • Zarminali — active Medallion customer in late implementation phase; multi-state IPA-based enrollment + hospital privileging; transitioning out of implementation 2026-04-25.

Payers

  • Aetna — Aetna Better Health complex care (Theoria IL + Ellen White) flipped client-owned 2026-04-17; Aetna Better Health exited Ohio in 2026.
  • AmeriHealth Caritas DC — dual-Medicaid (DC+MD) approval required; top MD volume driver for PM Pediatrics.
  • Anthem — par analysis must be per-state (not bundled); PMP group-vs-facility roster ambiguity; Theoria Fareed Ahmad WI mis-categorized as GP.
  • Arizona Medicaid — 3-phase enrollment across two portals; top focus for Cortica; domain-transfer line H workaround in use.
  • BCBS Illinois — applications closing without clear reason; Theoria 1-year stretch with zero providers enrolled; compliance risk.
  • BCBS Kansas — two-letter flow (cred approval ≠ par); no retro beyond first info-request; 24–48h email SLA; drove Confluent claim write-offs.
  • BCBS Michigan — Blue Plus must enroll at individual level (not group); NP-vs-MD distinction; ~$500K Theoria AR.
  • California Medicaid — PAVE portal demographic update pending admin signature; Medallion task wording caused confusion.
  • CDPHP — upstate NY plan; termed-provider resubmissions caused payer conflict for PM Pediatrics.
  • Cigna — national contract (Nov 2025); do-NOT-route-to-ASH rule; 74 Cortica lines processing; entangled with Evernorth; Healthspring rebrand is separate.
  • Evernorth — Cigna-adjacent; NJ requires LBA not BCBA; cross-payer verification discrepancies.
  • Gainwell — application denials under investigation by Cortica.
  • Georgia Medicaid — retro window is 60 days from welcome letter (not effective date); Theoria Southeast H + Midwest M repeatedly rejected on docs.
  • Healthspring — formerly Cigna Healthspring; national-roster contract possible via NP Ops; Confluent contracting exploring; NFL Surgeons first roster submission pending.
  • Humana — national commercial + Medicare Advantage payer; monthly roster submissions from NFL Surgeons; manual process due to report-builder CSV cell-collapsing.
  • Healthy Blue NC — NC Medicaid managed care; Theoria submitted 2026-04-16 after being missed in bulk enrollment.
  • Horizon NJ — delegated credentialing requires provider credentialing-approval emails; blocks global email-off toggle.
  • Independence Blue Cross — historical issue (apps stuck in automation queue >30d) remediated Jan/Feb 2026.
  • Massachusetts Medicaid — group enrollment requires fee-for-service providers (not ORP); facility-contract path allows ORP.
  • Medicare Railroad — process gap: welcome letters loaded by client not picked up by Medallion automation queue.
  • Meridian Illinois — Centene-owned IL Medicaid; distinct from CDPHP (common naming confusion); Theoria Midwest M client-owned.
  • North Carolina Medicaid — 100% QC flagged; training-task gap causing rejections; Dr Goh missing NC DEA blocks multiple providers.
  • Optum — BH network; medicaid-first dependency holds on PM Pediatrics providers despite active medicaid numbers; delegated with Confluent for Commonwealth Hand Therapy + Advanced.
  • Paramount Health — Ohio client-owned; Michigan group + 3 providers re-requested 2026-04-15 (Midwest H only).
  • PCCN — severe issue: Medallion emailing wrong contact since Aug 2025; flagged for 100% QC; flipping to client-owned.
  • Provider Partners — custom TPA in IN + MO; not in Medallion standard payer catalog; Theoria amendment 2026-04-15 added MO + ended complex care.
  • Tricare West — routing/rules change ~every 6 weeks; contact-dependent; Confluent informally relaxed SLA.
  • UnitedHealthcare — active Cortica enrollments (Baldwin, Masterson, Koul, Barros) tracked week-by-week; Theoria national contract ask + 4 unmapped GD-numbered contracts.

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