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Description:Healthcare Utilization Management Solutions by Agadia helps Health Plans and PBMs to better streamline their utilization management...

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Solutions Electronic Prior Authorization Medication Therapy Management Formulary Benefit Design Grievances Management Part D Star Ratings & AdherenceLeadership Testimonials Careers News News Events Case Studies 386% Increase in PA Volume Decreased PA Phone Volume 133% Processing Speed Increase First Year IRR of 199% Contact Us Select Page Healthcare Utilization Management Solutions for Health Plans, PBMs & TPAs Discover Why the Nation’s Leading Health Plans & PBMs Choose Our Solutions To Streamline Their Utilization Management Processes SCHEDULE A DEMO WHY AGADIA All Lines of Business Commercial, Medicare, Medicaid All Channels Phone, fax, ePA, e-prescribing, etc. All Healthcare Services Pharmacy & Medical Electronic Prior Authorization PAHub™ , is a HITRUST certified solution that puts the tools at your fingertips to streamline and control all clinical, compliance and administrative aspects of Prior Authorization to improve compliance, automation, reduce turn-around times and costs. Learn More Medication Therapy Management RxMTM+™ is a web-based solution leveraged by Health Plans & PBMs to streamline their workflow and clinical modules, increase staff productivity, consult patients in a quick and efficient manner, and ultimately improve the quality of care. Learn More Formulary Benefit Design FormularyHub simplifies formulary management by enabling Health Plans and PBMs to create, administer, manage and publish both pharmacy and medical benefit formularies through a centralized solution in an automated fashion. Learn More Grievance Management GrievancesHub is a cutting-edge web-based solution designed to streamline Grievance Management. Discover how Health Plans and PBMs can efficiently capture, track, and resolve member grievances, ensuring compliance with regulatory requirements and enhancing customer satisfaction. Learn More Part D Star Ratings & Adherence Our Part D Star Ratings & Medication Adherence software, RxSentinel+ ™ , allows Health Plans and PBMs to customize programs leading to better patient outcomes, higher levels of adherence and improved CMS Star Ratings. Learn More  Our Team  Careers Why Choose Agadia? Trusted by over 50 Health Plans, PBMs & TPAs Our Mission is to improve the quality of care and expedite the delivery of critical health care services by advancing and automating utilization management processes Contact Us Increased Processing Speed by 133 % For Prior Authorizations Using PAHub Explore How a Health Plan Specializing in State Medicaid Doubled Their Prior Authorization Volume with an actual reduction in staff, and increased their processing speed by more than 133% Read the Case Study What our clients are saying Trusted By Leading Health Plans & PBMs Agadia has been pivotal in our go-to-market strategy—both from a product stand-point as well as strategic leadership demonstrated by their team.” — VP, IT Read More Testimonials First Year IRR of 199 % While Using PAHub Learn how a Health Plan with both commercial and medicare business Saw an Internal Rate of Return of 199% within one year of using PAHub Read the Case Study OUR MISSION Agadia is dedicated to improving the quality of care and expediting the delivery of health care services by advancing and automating utilization management processes. What Our Clients Are Saying " Agadia has been a fantastic partner for several years. As MedOne has grown as a market leader in medication stewardship, we have directly benefited from the efficiencies afforded through the PAHub platform. We would not have been able to enhance the level of care we provide to our members while scaling our operations without the support of the Agadia software and team.” " - Dr. Nathan Harold, RPh, PharmD. , MedOne "I wanted to pass along that the CDAG portion of our CMS audit last week went well and complement Agadia on the PAHub systems display. The ease of navigation through the full report helped us display the information very smoothly and precisely which is often half the battle in a CMS audit." - Manager - PBM "I just wanted to drop a quick note letting you know how well PAHub has worked out for us. It has been instrumental in ensuring compliance with various regulations and increased the overall productivity of the Clinical staff. This is a terrific product that has allowed CMS audit events to go very smoothly. Thank you for helping us be successful!" - A.P.; SVP PBM "Agadia has consistently lead product development with out-of-the-box thinking focusing on a replicable feature-sets to reduce our overall cost of ownership. Their commitment to project management best practices has allowed us to prioritize tactically and avoid potential budget escalations. Agadia’s growing market foot-print clearly demonstrates their commitment to innovation in the healthcare IT space and have been phenomenal to work with." - VP, Genetic Benefit Manager In the News Driving Efficiency & Compliance in Formulary Benefit Management May 6, 2024 | Formulary Benefit Design For Health Plans, PBMs, and TPAs, formulary management stands as a critical pillar in ensuring optimal patient care while managing costs effectively. As complexities surrounding formularies continue to mount, traditional approaches lack efficiency and are proving... Enhancing MTM Programs: Impact of CMS’s 2025 Final Rule for Health Plans and PBMs Apr 15, 2024 | Adherence , CMS , Medication Therapy Management The recent final rule for the 2025 contract year issued by the Centers for Medicare & Medicaid Services (CMS) carries significant implications for Health Plans and Pharmacy Benefit Managers (PBMs) managing Medication Therapy Management (MTM) programs. This change... Agadia Expands Suite of Healthcare Technology Solutions with the Launch of GrievancesHub Apr 2, 2024 | Grievance Management , Healthcare Technology Parsippany NJ, April 2, 2024– Agadia, a leading provider of healthcare technology solutions, is pleased to announce the launch of GrievancesHub, a web-based Grievance Management solution designed to empower Health Plans and Pharmacy Benefit Managers (PBMs) in... Improving Operational Efficiencies with Utilization Management Solutions Mar 18, 2024 | Adherence , Formulary Benefit Design , Grievance Management , Healthcare Technology , Medication Therapy Management , Part D Star Ratings , Prior Authorization As our industry continues to evolve, efficiency, security, and adaptability are non-negotiables. Health plans, Pharmacy Benefit Managers (PBMs), and Third-Party Administrators (TPAs) need robust solutions that not only streamline operations but also ensure compliance,... Unleash the Power of Prior Authorization Data with PAHub Insights Mar 8, 2024 | Electronic Prior Authorization , Prior Authorization The need for effective Prior Authorization (PA) management for health plans, Pharmacy Benefit Managers (PBMs), and Third-Party Administrators (TPAs) continues to evolve. To propel your organization to new heights, it’s not just about managing authorizations but... Planning for the Future of Healthcare Legislation: Agadia’s Response to Colorado Revised Statutes Feb 26, 2024 | Healthcare Technology , Prior Authorization Planning for the Future of Healthcare Legislation: Agadia’s Response to Colorado Revised Statutes When it comes to healthcare legislation, staying ahead is not just a necessity; it’s our commitment at Agadia. As of February 20, 2024, the Colorado Revised Statutes... « Older Entries Ready to Get Started? Contact Us Today NOTE FOR PATIENTS: We are a software company. Please contact your physician or pharmacy for any drug related questions.  Phone 877-575-2533  Email contact@agadia.com  Location 9 Campus Drive, Parsippany NJ 07054 © 2024 Agadia Systems, Inc. All Rights Reserved. Legal Information | Sitemap Electronic Prior Authorization Medication Therapy Management Part D Star Ratings & Adherence Formulary Benefit DesignTestimonials Careers Blog Events Schedule a Demo © 2024 Agadia Systems, Inc. All Rights Reserved....

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