Healthcare Utilization Management Solutions for Health Plans & PBMs

Discover Why the Nation’s Leading Health Plans & PBMs Choose Our Solutions To Streamline Their Utilization Management Processes

All Lines of Business

Agadia’s solutions are used across all lines of business (commercial, Medicare, Medicaid, etc.)

All Channels

Our Prior Authorization solution, PAHub is available across all channels (phone, fax, ePA, e-prescribing, etc.)

All Healthcare Services

Our solutions are applicable for all healthcare services, all benefit types (pharmacy, medical), lines of business and channels.

A Comprehensive Suite of Utilization Management Solutions

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.

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Medication Therapy Management

RxMTM+™ is Agadia’s best-in-class Medication Therapy Management (MTM) solution, providing a fully-customizable platform that allows you to take control and automate your MTM process.

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Part D Star Ratings & Adherence

Our 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.

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Formulary Benefit Design

Our Formulary Benefit Design solution, FormularyHub.com, allows you to control the building, implementation and maintenance of custom and standard formularies. With FormularyHub.com, you can easily “mix and match” modules…

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Our Team

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Careers

75+ Years of Experience

In the Managed Care Market

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

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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