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Delegated credentialing

Unlock more revenue with quicker in-network status

Automate workflows, maintain compliance with payer agreements, and accelerate enrollments — all within NCQA and regulatory standards.

Powering 300+ healthcare organizations to scale

  • Iris Telehealth
  • Tampa General Hospital
  • Confluent Health
  • UnitedHealthcare
  • CareSource
  • Headspace
  • FOLX
  • Antidote Health
  • Virta Health
  • VNS Health
  • CareBridge

An expert partner in achieving and maintaining delegation

  • AI-assisted workflows and dedicated specialists help your organization achieve payer delegation agreements and maintain compliance through every renewal cycle.

  • Proven workflows navigate payer requirements and reach delegated status without the operational bottleneck.

  • Automated workflows with expert oversight maintain NCQA compliance across credentialing and monitoring — so audits don't catch you off guard.

  • Provider, group, and facility data automatically populate into payer-specific templates — meeting payer requirements across submissions.

Delegation agreement renewal checklist marked audit complete

Establish delegated agreements with confidence

Simplify the complexity of delegated credentialing with compliant program structures, required policies development, and documentation preparation needed to support payer delegation agreements.

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Your trusted AI operations partner in healthcare

“Medallion helps us scale without having to build a much larger internal credentialing team.”

Steven Shterenberg, M.D., SVP of Operations & Clinical Care Strategy at CareBridge

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“It has allowed us to score over 95% on all credentialing audits.”

Katie Dave, Director of Partner Operations at Headspace

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“Medallion’s platform is very intuitive, and we have very few providers reaching out asking for help.”

Matthew Ortiz, VP of Payor Strategy and Relations at Family Care Center

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FAQs

Delegated credentialing is an arrangement where a payer authorizes a healthcare organization to credential providers on its behalf using payer-approved standards, rather than submitting each application individually for payer review. To earn delegation, organizations must meet NCQA accreditation requirements and pass a formal audit of their credentialing program. When done right, it removes the payer bottleneck that typically adds weeks to provider onboarding. Medallion helps health systems build and maintain delegation-ready credentialing programs backed by AI-assisted automation, specialist oversight, and better turnaround times.

To earn delegation from a payer, a healthcare organization must demonstrate a credentialing program that meets NCQA accreditation standards — including compliant policies, committee oversight, documented PSV processes, and file accuracy. Payers conduct a formal pre-delegation assessment before granting status, and re-audit annually to maintain it. Most delegated arrangements involve organizations credentialing 150 or more providers. Medallion helps health systems build delegation-ready programs from the ground up, with contract-backed turnaround times and audit-ready documentation at key stages.

Building and sustaining a delegation-ready credentialing program requires infrastructure most health systems can't cost-effectively maintain in-house — compliant policies, dedicated specialists, robust PSV workflows, and ongoing audit readiness. A CVO provides that infrastructure as a service, allowing health systems to achieve delegation status faster and protect it through re-audits without scaling internal headcount. Medallion pairs AI-assisted automation with embedded credentialing specialists, delivering the speed, throughput, and documentation health systems need to earn delegation and sustain it long-term.

Trusted by 300+ healthcare organizations.

See how Medallion can support yours.

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