Medallion vs. DirectShifts: Which Is Right for Telehealth Employers?

Two companies keep coming up when telehealth founders and clinical ops leads go looking for help with provider licensing. Medallion and DirectShifts. They look similar from a distance — multi-state licensing, reduced admin burden, faster turnarounds. They're not the same thing.

They're built for different buyers at different stages with different cost structures. Picking the wrong one means either paying for a platform you don't need yet, or signing a retainer that doesn't flex when your hiring slows down. This piece lays out the real differences. And since we're DirectShifts, we'll say plainly where Medallion is the better fit — because that's more useful than a comparison that only goes one way.

What each company actually is

Medallion is a provider network management platform. Licensing is one module inside a larger system that also handles credentialing, payer enrollment, privileging, roster management, and ongoing compliance monitoring. You're buying into integrated infrastructure that centralizes provider data across multiple workflows. They've raised $130M and their clients include large health systems, payers, and digital health companies like Headspace.

DirectShifts started as a healthcare staffing platform and built out an employer-facing licensing service for telehealth companies and health systems that need providers deployed in new states fast. The scope is narrower: multi-state licensing, end-to-end, per license, no platform implementation. Pricing is on the website. There's no retainer.

Shortest version: Medallion is infrastructure. DirectShifts is a service. Whether that distinction matters depends on what your org actually needs right now.

Pricing - the sharpest difference

Medallion's pricing page says: "Every organization operates differently... Medallion's investment model is built around your operational goals, scope, and performance commitments." That means: talk to sales, get a custom quote, sign a contract. You can't compare costs without going through their demo process, and there's a platform fee regardless of how many licenses you actually need in a given month.

That's normal for enterprise software. Medallion is going after health systems and digital health companies with procurement cycles and IT teams. But it's worth knowing upfront.

DirectShifts publishes per-license pricing by provider type:

No retainer. Volume discounts apply automatically. Unused credits roll over.

If your licensing volume is steady and high enough to justify a platform contract, Medallion might pencil out. If your volume swings — seasonal hiring, state-by-state expansion bursts, early growth stage — per-license pricing without a floor is a lot cheaper.

Scope: licensing only vs. the full stack

This is where most buyers go wrong.

Medallion covers licensing, credentialing, payer enrollment, privileging, delegated credentialing, roster management, and sanctions monitoring. If you genuinely need all of that in one system, the case for Medallion is real. One place for your ops team, provider data stays in sync, fewer vendors to manage.

DirectShifts is built around state licensing. That's where the team, the board relationships, and the operational infrastructure point. Payer credentialing and payer enrollment are available through the broader platform, but it's not the depth Medallion has in those areas.

The question to ask yourself: how much of the Medallion platform would you actually use? A telehealth company that mainly needs providers licensed in new states quickly, without complex payer enrollment needs, is paying for a lot of software it won't touch. A health system running delegated credentialing across a large network gets more value from the integrated approach.

Speed and activation

Both claim fast turnarounds. The numbers measure different things — Medallion cites roughly 5 days from request to application submission. DirectShifts averages 21 days to active license for compact-eligible providers, with a 99.2% board pass rate over 12 months.

Submission and active license are not the same milestone. Active license is when a provider can actually see patients, which is the only number that matters operationally.

Where DirectShifts is faster: employer activation. A new employer can go from signed agreement to first submissions in under 14 days, with no implementation project. Providers fill out one intake form; applications go to all target states concurrently. Medallion requires implementation, configuration, usually an IT touchpoint. For a 20-person telehealth company that needs physicians licensed in four states by next quarter, that overhead is real.

Who Medallion fits

• Health systems or large provider groups running credentialing and licensing together, where a single system of record matters
• Digital health companies with 100+ providers where payer enrollment complexity justifies a platform investment
• Orgs with an internal credentialing team that needs software to support their work, not replace it
• Buyers who have IT resources, a procurement process, and several months to implement
• Orgs where the ROI comes from consolidating several existing vendor relationships into one platform

Who DirectShifts fits

• Telehealth founders in growth mode — launching in new states, needing providers deployed without a procurement cycle
• Health systems that want licensing handled as a managed service rather than software they configure
• Orgs with variable licensing volume that don't want to pay a retainer during slow periods
• Companies that need licensing specifically and manage credentialing and payer enrollment separately
• Anyone who wants to see pricing before getting on a sales call

Bottom line

On features, Medallion wins on breadth. More of the provider operations workflow, more enterprise integrations, deeper case studies with large health systems.

On speed to value, cost flexibility, and focus, DirectShifts wins for the licensing-specific use case. No implementation project, visible pricing, a service designed around getting providers licensed fast.

The mistake to avoid: buying a full platform when multi-state licensing is 90% of your actual problem. Medallion is most valuable when you're using most of it. If you're not, you're paying for a lot of software to do one thing.

Five questions worth asking any vendor

1. What's the all-in annual cost at my current provider volume — and what does it look like if volume drops 40%?
2. How long from signing to first license submitted?
3. Who manages board follow-ups when a state board goes quiet for three weeks?
4. What happens if a license is delayed past your stated timeline?
5. Do I need IT involvement to get started?

The answers tell you more than any comparison table.

Frequently asked questions

Is Medallion better than DirectShifts?

‍Depends what you need. Medallion is a broader platform — credentialing, payer enrollment, privileging, licensing in one system — and the stronger choice for large health systems running multiple provider operations workflows. DirectShifts is a licensing service with transparent per-license pricing and no implementation overhead, better suited for telehealth companies that need providers in new states fast without a platform commitment.

How much does Medallion cost?

‍Medallion doesn't publish pricing. Their model is custom-quoted based on org size, provider volume, and which modules you use — you'll need to go through their sales process to get a number. DirectShifts publishes per-license pricing starting at $150 per RN license and $399 per physician license, with volume discounts up to 25%.

Does Medallion handle multi-state licensing?

‍Yes. Cross-state licensing is one of Medallion's modules, covering all 50 states with automated workflows for application submission, renewals, and compliance tracking. It sits inside their broader provider network management platform.

What is DirectShifts used for?

‍For employers, DirectShifts handles state licensing end-to-end — applications, primary source verification, board tracking, and renewals — for physicians, APRNs, PAs, registered nurses, and behavioral health providers across all 50 states. Per-license pricing, no monthly retainer.

How long does multi-state provider licensing take?

‍DirectShifts averages 21 days to active license for compact-eligible providers. Non-compact states run 3 to 10 weeks depending on the board and provider type. Medallion cites roughly 5 days from request to application submission — a different milestone. Active license is when a provider can actually practice, which is what matters.

Can a telehealth company license providers without a credentialing platform?

‍Yes. State licensing and credentialing are separate workflows. Licensing — getting a provider authorized to practice in a new state — can be handled as a standalone service without a credentialing platform. Many early-stage telehealth companies handle it that way before provider volume justifies a full platform.

What's the difference between provider licensing and credentialing?

‍Licensing is state board authorization to practice in a given state. Credentialing is verification of a provider's qualifications — education, training, malpractice history — required by hospitals and payers. Both are necessary, but they're managed separately and run on different timelines.

DirectShifts handles multi-state provider licensing for telehealth companies and health systems — per license, no retainer, all 50 states. To see how costs compare for your provider mix and target states, book a 30-minute call or write to sales@directshifts.com.