01
Pass every delegation audit
Automated PSVs and continuous monitoring keep delegated programs audit-ready.
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.
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Powering 300+ healthcare organizations to scale
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.
Achieve delegation faster, stay audit-ready
99.9%
of recredentialing completed before the deadline
66%
estimated reduction to administrative costs
1 day
average credentialing file readiness for faster care
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Accurate submissions, reduced rework
Provider data populates payer-specific rosters automatically for delegated submissions.
03
Reach payer approval sooner
Proven frameworks, policy templates, and committee support speed the path to delegation.
Your trusted AI operations partner in healthcare
FAQs
What is delegated credentialing and how does it work?
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.
What are the requirements for achieving delegated credentialing status?
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.
What role does a CVO play in a health system's delegated credentialing program?
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.
