Medallion

Today we’re chatting about Medallion and how it’s being used at your company. Before we jump into that, could you give a brief overview of the company and your role there?

I’m the COO of a direct to consumer telemedicine clinic.

How long have you been using Medallion?

About a year and a half. Initially, we were using another provider to monitor credentials for physicians. However, as we started looking for in-network contracts, we wanted a more comprehensive solution. So, we did some research on different companies and ultimately chose Medallion.

What caused you to look into purchasing Medallion?

We looked at Medallion, CertifyOS, and Verifiable, and we were also looking into smaller companies that specialize in this area, but we didn’t find many recommendations. In hindsight, I might have considered them if I had known about them earlier.

When I spoke with Verifiable, I realized that they didn’t have much experience in contracting. It seemed like they were trying to develop that aspect of their service, but it wasn’t their forte yet. So I didn’t think Verifiable was the right fit for us.

Ultimately we felt that the core team at Medallion had more experience and a track record in this field.

What is the problem that Medallion solves for you?

Two things. First, since we are a nationwide telemedicine clinic, we wanted a technology solution that can notify us if a physician’s medical license, DEA license, or any other required licenses have expired. Since our physicians prescribe controlled substances, it’s crucial to ensure they are properly licensed and compliant. Additionally, when hiring new physicians, we want to make sure their licenses are in order and won’t cause any complications.

The second issue we faced was getting contracted in-network with payors all over the country. Medallion has both manpower and experience in this area, and we needed help to ensure we could work with a wide range of payors and provide our services to as many patients as possible.

Did you have a set of requirements when you were evaluating Medallion and some of the other competitors?

We knew we needed solutions for credential monitoring and for contracting with payors, so we conducted the interviews with that perspective in mind.

In terms of the product itself, how would you characterize the relative strengths and weaknesses of Medallion?

I have found that they excel in understanding the challenges entities face when dealing with payors. So if a payor presents a contract, they are able to assess if it is fair and normal in the market. They are also able to advise on which aspects to push back on and which to accept without question. They can help me evaluate whether certain terms in a contract are reasonable or not. As for the team, overall, they have been great. There have been a few less competent individuals who were let go, but our main contact for contracting has been amazing. She knows exactly what she’s doing and has been a tremendous help to us.

As far as weaknesses, I feel that ultimately their solution tries to use technology, but for many issues there isn’t really a technical solution.. While it’s certainly valuable to have a system that organizes and maintains information on providers, there is still a significant amount of work that requires interaction between various internal Medallion teams and the payor. This includes obtaining contracts, reviewing open items, and verifying physicians’ credentials. These tasks heavily rely on the Medallion team’s communication and coordination with the payer. Additionally, there may be situations where team members aren’t proactively pushing the payor for more feedback or they simply cannot get feedback from a payor, so this can cause delays or complications. While the technology aspect of Medallion’s solution is beneficial, I don’t believe it significantly enhances the overall solution they offer.

One area where they can improve is internal communication. We totally understand it’s a complex challenge to handle contracting and credentialing for so many companies, but without internal systems that their teams can use, they can miss key items that payors need or end up not pushing payors to respond like they should.

How did you find the sales process overall?

Pretty good. I actually had the opportunity to collaborate with one of their VPs. He was incredibly talented, and I enjoyed working with him. We quickly aligned on pricing and other aspects, and we were able to finalize deals with ease. They were really efficient when it came to transitioning from negotiation to the final stage.

How was the onboarding and setup process?

Pretty good. However, I would have appreciated more context and guidance regarding our objectives. They assumed that we knew about all the different elements of contracting and credentialing, but we really needed more education. Overall, though, they were really good at onboarding. Their process for that is great. They provide clear instructions and have dedicated individuals to guide you through the onboarding calls. I consider this to be one of their core strengths.

What use cases do you use Medallion for?

We use it to onboard new physicians. We prompt them to complete their full profile, which helps us with the credentialing process. This is essentially the main feature we utilize. The platform is able to extract data from CAQH. If a physician already has a complete CAQH profile, which is the case for most of them, they simply log in there and authenticate to pull the data. Only a few additional details need to be added, making the process relatively painless.

How reliable is Medallion?

I can’t remember any time where I went to use it and it was down.

Have you interacted with any of their APIs?

No, we haven’t, but it’s not critical for us. From my understanding, their APIs can provide information on licensure data. So if we had thousands of providers and wanted to check if a specific provider is active and licensed in a particular state, we could utilize their API for that. However, since we’re not that large, we haven’t allocated development resources to interact with it.

Did you integrate Medallion with other products in your tech stack?

We have not.

How is Medallion’s account management and support?

They know contracting and credentialing. Their senior team members are knowledgeable and experienced in the process. Moreover, their tech platform efficiently consolidates all the necessary information. However, their weak point lies in internal communication, which affects the overall customer experience. They’ve recognized this and are working on developing technology to enhance internal communication. In the past, different teams didn’t communicate well or had incomplete information. As a customer, all you really care about is getting the contract finalized, not the inner workings of the teams.

Recently, I feel that their performance has significantly improved. This could be attributed to the fact that they assigned more competent team members to our project. We have been fortunate to have an exceptional team for the past two months who have demonstrated remarkable skills. As a result, our service quality has greatly improved.

Looking back, do you feel like you made the correct decision to go with Medallion?

For tech-based credentialing/contracting platforms, I think it was as good as we could get. I know people who use other solutions and frankly face the same issues we do, so I don’t think we would have fared any differently with another platform.

Do you have any advice for buyers who are selecting this type of product right now?

Yes, definitely. My core piece of advice is that you’ll have a better overall experience if you put effort into managing the Medallion team as if it were your own. It’s not simply a matter of setting it up and leaving it alone. If you’re expecting to just delegate the task of securing 20 contracts and be done with it, that approach won’t work. You really need to have regular meetings with them, push them to perform, ensure they share their information with you, and actively manage the whole process. That will help you obtain the best results.