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Nothing slips through the cracks
Primary sources like OIG, SAM, and state boards queried continuously as changes happen.
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.
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Powering 300+ healthcare organizations to scale
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.
Stay ahead of every credential change
~200k
providers continuously monitored
55M
PSVs completed
74%
of license verifications fully automated
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Act before issues hit operations
Expiring, suspended, or sanctioned credentials surfaced the moment they change.
03
Trade fire drills for follow-through
AI classifies each update and triggers the next step, cutting manual review.
Your trusted AI operations partner in healthcare
FAQs
What is provider monitoring in healthcare?
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.
What happens if a healthcare organization misses a provider exclusion?
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.
How often should healthcare organizations screen providers against exclusion databases?
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.
