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Monitoring

Provider monitoring for proactive compliance

Surface compliance issues early — licenses, sanctions, exclusions, and expirables monitored across primary sources and regulatory databases, so your organization isn’t caught off guard.

Powering 300+ healthcare organizations to scale

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

Comprehensive monitoring across your provider network

  • Timely alerts surface expiring, suspended, or changing licenses across SAM, OIG, NPDB, Medicare Opt Out, state licenses, DEA, and CSR, before they become compliance risks.

  • Sanctions, exclusions, and expirables monitored across Medicaid, OFAC, Death Master, and CMS Preclusions — so your team responds before issues escalate.

  • AI-assisted workflows classify updates, trigger next steps, and reduce the manual burden on compliance and operations teams — so your team stays ahead of what needs attention.

  • As provider rosters grow and regulations evolve, automated monitoring scales across your enterprise without adding operational overhead.

Monitoring settings for Carry Smith with alerts across OIG, SAM, NPDB, and more

Compliance teams that stay ahead start with better monitoring

From license expirations to sanctions and exclusions, timely alerts and AI-assisted workflows surface compliance signals and trigger action — reducing administrative burden and improving operational readiness.

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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

Provider monitoring is the ongoing process of tracking changes to a provider's credentials, licenses, sanctions, and exclusions after initial credentialing is complete. This includes checking against the OIG exclusion list, SAM.gov, NPDB, and state licensing boards on a continuous or periodic basis. A single missed exclusion or lapsed license can trigger CMS payment clawbacks, compliance violations, and patient safety risks. Medallion's comprehensive provider data monitoring captures information across all major databases, alerting teams to changes before they become regulatory or revenue problems.

If a healthcare organization employs or bills for services from a provider on the OIG exclusion list, it risks significant consequences — including repayment of all Medicare and Medicaid claims associated with that provider, civil monetary penalties, and potential program exclusion. The OIG updates its exclusion list monthly, making manual spot-checks insufficient for most organizations. Medallion monitors providers against the OIG, SAM.gov, and state exclusion databases, flagging changes so compliance teams can act before a billing issue occurs.

The OIG requires screening providers against the exclusion list at the time of hire and monthly thereafter — and most healthcare compliance programs follow this cadence at minimum. However, for organizations managing hundreds or thousands of providers, monthly manual checks are operationally unsustainable. Medallion runs comprehensive automated monitoring across all providers, helping to eliminate the manual screening burden while ensuring organizations don’t miss an exclusion update between monthly cycles.

Trusted by 300+ healthcare organizations.

See how Medallion can support yours.

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