Provider credentialing & network · Provider data / credentialing API
CertifyOS
CertifyOS provides API-first provider data infrastructure for credentialing, licensing, enrollment, and network monitoring, mainly for health plans and digital health. It is not a clinical EHR.
Strong fit
- Health plans and digital health companies that need API-first credentialing, licensing, and roster monitoring
- Network teams measuring onboarding days and provider-data accuracy across primary sources
- Buyers consolidating CVO, enrollment, and ongoing monitoring onto one provider data layer
Weak fit
- A solo clinic that only needs a shared credential folder for a handful of physicians
- Buyers shopping an EHR or staffing marketplace
- Organizations that will not fund primary-source verification workflows the product assumes
Bottom line
CertifyOS earns a Recommend and sits with Medallion at the top of our provider-credentialing board for API-first provider data, credentialing, and network monitoring. Outcomes show up in shorter onboarding and cleaner rosters when plans treat Certify as the source of truth across licenses and enrollments. Product strength is provider data infrastructure for plans and digital health rather than a physician-facing credential vault alone. Implementation needs network-operations ownership and data-use agreements. Pricing is quote-based. LinkedIn-class revenue is often cited near $25M with a $40M Series B in 2025, under the hard cap. Score ties Medallion on overall for a more API-and-plan shaped product, above Andros and Assured on this board.
Score breakdown
Weights: Outcomes 35% · Product 30% · Implementation 20% · Pricing clarity 15%.
CertifyOS (Certify) is a New York provider-data company that automates credentialing, licensing, enrollment, and network monitoring through an API-first platform fed by primary sources. Founder and CEO Anshul Rathi leads the firm; 2025 brought a $40M Series B.
It is not an EHR. Compare Medallion when provider enrollment software for growing groups is the buy, Andros when CVO services dominate, Assured when agentic AI credentialing is the pitch, and Modio when a shared credential vault for hospitals and locums is enough.
Score reflects strong plan-side outcomes and product depth at the top of this board.
Competitor landscape
| Vendor | Overall | Ease of implementation |
|---|---|---|
| CertifyOS | 7.7 | 7.4 |
| Medallion | 7.7 | 7.3 |
| Andros | 7.6 | 7.3 |
| Assured | 7.4 | 7.2 |
| Credentially | 7.2 | 7.0 |
| Verifiable | 7.1 | 6.9 |
| Modio Health | 6.8 | 6.8 |
| ProviderTrust | 6.8 | 6.6 |
Pricing
| Item | Detail |
|---|---|
| Model | Provider data and credentialing platform packaging for plans and digital health; quote-based. |
| What usually drives cost | Provider volume, modules (credentialing, enrollment, monitoring, API), and verification depth. |
| What to ask in diligence | Annual platform cost at your active provider count, with primary-source and monitoring SLAs defined. |
| Published pricing | Public list price: not published. Expect provider-volume platform pricing. |
Prerequisites for purchase
| Need | Why it matters |
|---|---|
| What you need to get CertifyOS to function | |
| Named credentialing or network-ops owner | Software without owners becomes shelfware. |
| Baseline onboarding days and application defect rates captured | You cannot prove value without a before number. |
| Source-system list for licenses, CAQH, and payer portals documented | Missing sources recreate manual chase. |
| Staffing plan for incomplete applications after go-live | Unworked incomplete files never enroll. |
| NCQA or payer audit expectations written down | Surprise audit rules erase the gain. |
| What will maximize your value | |
| Track median days-to-in-network weekly for 90 days | Portal logins are not outcomes. |
| Start with one specialty or line of business first | Narrow wins beat empty enterprise banners. |
| Turn off duplicate spreadsheet trackers after parallel month | Dual entry doubles cost. |
| Review stalled applications in a standing huddle | Silent aging hides failure. |
| Publish a monthly network-ops digest to growth leaders | Hidden enrollment delays surprise revenue. |
| Deal-breakers | |
| Nobody will own incomplete credentialing files. | |
| You refuse primary-source or payer enrollment work the product needs. | |
| You expect an EHR replacement from a credentialing tool. | |
| Leadership will not measure onboarding turnaround. | |
| Legal blocks the data-use agreements required. | |
Value creation time frame
| # | Stage | Typical range |
|---|---|---|
| 1 | Scope & baseline | 2-4 weeks - Metrics, sources, LOB scope. |
| 2 | Configure | 4-12 weeks - Verifications, workflows, integrations. |
| 3 | Pilot | 4-8 weeks - One specialty or region; audit sample. |
| 4 | Scale | 2-4 months - Add lines; retire shadow trackers. |
Methodology
| Weight | Factor | What it measures |
|---|---|---|
| 35% | Customer outcomes | Whether buyers get measurable operational or clinical-workflow results after go-live |
| 30% | Product | Capability depth, reliability, and fit for the job the category actually buys |
| 20% | Implementation | How hard it is to stand up, integrate, train, and stabilize |
| 15% | Pricing clarity | Whether a buyer can model total cost without a mystery quote |
| Label | Meaning |
|---|---|
| Highly recommend | Strong outcomes and product with manageable caveats |
| Recommend | Solid fit for the right buyer; know the tradeoffs |
| Conditional | Only with a specific use case or heavy caveats |
| Not recommended | Avoid for most buyers in this category |
Read our full methodology for how we weight scores and assign recommend labels.