Provider Partners
Overview
Custom Third-Party Administrator (TPA) operating in Indiana and Missouri. Not in Medallion’s standard payer catalog.
Active Work / Processes
- Amy investigating whether to model Provider Partners as a TPA-line-of-business workaround inside Medallion (since custom payer names aren’t supported).
- Theoria’s contract scope: IN + MO only going forward (post-amendment).
Pain Points / Open Issues
- Not in Medallion’s standard payer catalog — Brittany was blocked when trying to add the amendment via the standard flow.
- No clear modeling path — Medallion doesn’t support custom payer names; TPA-LOB workaround is being researched.
Decisions & Commitments
- 2026-04-15 — Theoria signed amendment to add Missouri and end complex care on the Provider Partners contract; only IN + MO needed going forward. Amendment processed by Medallion same week. Source: Svetlana in 15 weekly sync.
Key Facts
- Type: custom TPA
- States: Indiana, Missouri
- Catalog status: not in Medallion’s standard payer catalog (workaround pending)
Related Customers
- Theoria Medical — IN + MO contract post-amendment; complex care line ended
Source History
- 2026-04-14 — Theoria Cred Hold sync — Brittany blocked on standard catalog; Amy researching TPA-LOB workaround
- 2026-04-15 — Complex weekly sync — amendment signed, MO added, complex care ended