MedallionAI Wiki

Experity

· 3 Gong sources · 1 SF source

Experity

Snapshot

RCM vendor, dominant in the urgent care space. Medallion partner for roughly 3–4 years. Experity originally built its own credentialing + enrollment team ~5 years ago (circa 2021); it grew faster than they could staff it, which drove them to bring Medallion in as the back-end enrollment engine. Used by Medallion sales as the canonical reference case for RCM-partner resale models (cited to both Sunbound and Raintree in March 2026).

Commercial

  • Customer · Tier 1 · ARR $1.38M · renewal 2027-03 (Pending Renewal) — per SF diff, 2026-04-19.
  • Y1 of 2: Closed Won $2,750,249 — closed 2025-03-15 (006PO00000IxyDtYAJ)
  • Current: Y2 of 2 — Closed Won $1,375,124 — closes 2026-03-31 (006PO00000BHhewYAD)
  • Renewal: Experity - Renewal - 2027 — Pending Renewal $2,750,249 — closes 2027-03-31 (006PO00000JFqkwYAD)

Profile

  • Vertical: urgent care RCM.
  • Industry: Software (SF 2026-04-19).
  • Annual revenue: ~$95.9M; 600 employees (SF 2026-04-19).
  • Partnership length: ~3–4 years as of March 2026.
  • Deal structure: enterprise contract + bucket-of-enrollments + API integration + Experity resells on consumption basis.
  • Medallion contract sits at Experity enterprise level (not with Experity’s sub-customers).
  • Experity buys a bucket of enrollment applications per year from Medallion (~500 or ~1,000 apps per Mallory’s description to Raintree).
  • Experity bills its own customers on a consumption basis (per application) with an upcharge on top of the Medallion rate.
  • Events: Experity runs an annual conference that Medallion has attended multiple times (per Mallory Smith).

Operations

  • As of 2026-03-19, Experity had 87 unique customer instances inside the Medallion platform (sub-customers scoped under the Experity enterprise account), each with its own organizational access — Scott Everline’s canonical example during Sunbound BVA demo of how Medallion isolates RCM-partner sub-customers.
  • Medallion does not charge per instance for RCM-partner sub-customers; pricing is facility/transaction-based.
  • Medallion does the credentialing + enrollment work directly (submissions, follow-ups, revalidations); Experity is the client-facing “white glove” layer and the point of billing to the end clinic.
  • Systems connected via API between Experity platform and Medallion.

Active Work

Recurring cadences

  • EBR: irregular; last none logged; next 2025-07 (1 scheduled) (SF 2026-04-19)

Open Issues & Requests

Operational pain

  • Custom-payer-name on-hold lines surfacing as unassigned (2026-03-30) — During PE weekly ops review, Nicole called out that 57 “unassigned” rows in Sigma included Experity items — on-hold lines where a custom payer name had been entered, which doesn’t auto-assign via the payer distribution list and falls through to manual assignment. Custom payer names can no longer be created going forward, but legacy ones still pull into this bucket. Source: 2026-03-30 Weekly PE Operating Review.

Feature requests

  • Bulk demographic updates — when a user changes information requiring a demographic update, prompt for bulk updates across multiple providers (SF case 500PO00000a7EazYAE — Committed/P2; per SF diff, 2026-04-19).
  • Group enrollment dependency — if a new group enrollment request is in process, automatically make provider enrollment requests dependent upon the group request (SF 500PO00000XeCqjYAF — Committed/P2; SF 2026-04-19).
  • IPA payer-line automation — when an IPA application payer line (e.g. IPA-NY covering Humana, Aetna, UHC, CareSource) is marked Complete, automatically expand to individual payer lines under Existing Enrollment so specialists only need to enter effective dates rather than whole payer lines (SF 500PO00000NBF1kYAH — Committed/P2; SF 2026-04-19).
  • Enrollment export from existing enrollments — ability to report/export from existing enrollments regardless of whether Medallion or Experity submitted them (SF 500PO00000NBEAXYA5 — Closed/P2; SF 2026-04-19).
  • CAQH “Ready to link” email to include provider name — reduce provider abrasion in onboarding (SF 500PO00000NB3JzYAL — Closed/P2; SF 2026-04-19).
  • Third email recipient on PAR acceptance notification — add client admin (per group) to automated enrollment-acceptance email alongside Experity admin team and provider (SF 500PO00000NBGSQYA5 — Closed/P2; SF 2026-04-19).
  • Outcome-based request modals — move to outcome-driven enrollment request model rather than individual request submission; e.g. provide group + associated providers and have Medallion map out the enrollment requests automatically (SF 500PO00000NBDXmYAP — Closed/P2; SF 2026-04-19).
  • Bulk add providers across multiple payers for new location — current process requires individual requests per provider/payer (SF 500PO00000NBCzyYAH — Committed/P2; SF 2026-04-19).
  • New enrollment status for payer-approval-pending lines — allow billing to proceed while Medallion tracks outstanding official approval letters, without losing visibility on pending letters (SF 500PO00000NBE0tYAH — Committed/P2; SF 2026-04-19).
  • Contract details storage in Medallion — store payer contract details per client to eliminate need for VerityStream; would allow PM API integration for fee schedule automation (SF 500PO00000NB63IYAT — Needs More Market Signal/P2; SF 2026-04-19).
  • Medicare revalidation date tracking via CMS API — surface revalidation dates from CMS NPI-based API to prevent lapsed enrollments (SF 500PO00000NBG0zYAH — Needs More Market Signal/P2; SF 2026-04-19).
  • Automated revalidation initiation — automatically start revalidation process N days prior to revalidation date, similar to how recredentialing works (SF 500PO00000NBG10YAH — Needs More Market Signal/P2; SF 2026-04-19).
  • CAQH reattestation date visible without CAQH management contract — expose reattestation date in platform for customers managing CAQH themselves (SF 500PO00000NBFzNYAX — Not Doing/P2; SF 2026-04-19).
  • Group/facility profile copy — when completing a group profile, copy identical demographic data to the linked facility profile to save duplicate entry (SF 500PO00000NB46KYAT and 500PO00000MJHtJYAX — Closed/Committed P2; SF 2026-04-19).

Source History

  • 2026-03-19 — Medallion & Sunbound II — Scott Everline used Experity’s 87-instance Medallion footprint as a demo example of RCM-partner architecture.
  • 2026-03-20 — Medallion <> Raintree Reconnect — Mallory Smith described the full Experity resale model as a template Raintree could adopt; “3–4 years” partnership; “they built their own cred team ~5 years ago, grew too fast, came to us.”
  • 2026-03-30 — Weekly PE Operating Review — Experity on-hold custom-payer-name lines causing Sigma unassigned-bucket noise.
  • 2026-04-19 — SF bootstrap — ARR $1.375M, Tier 1, 2027 renewal opportunity at $2.75M pending, 14 open feature request cases.

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