Agadia is delighted to introduce GrievancesHub – a cutting-edge web-based resolution system engineered to redefine Grievance Management for Health Plans and Pharmacy Benefit Managers (PBMs). Live demos will begin this December. We invite you to schedule a demo and discover the key advantages that come with this transformative solution:

✅ Efficient Member Grievance Resolution: GrievancesHub is your all-encompassing answer for the efficient management and resolution of member grievances. Bid farewell to cumbersome processes and usher in a responsive, high-efficiency approach.

✅ CMS Compliance: We have your regulatory obligations covered. GrievancesHub ensures seamless alignment with CMS requirements, providing peace of mind concerning compliance.

Grievance Management


Key Features Redefining Grievances Management:

Complaint Tracking

Streamline grievance management with GrievancesHub’s centralized system. Efficiently log and monitor member complaints to ensure timely resolution and improved member satisfaction.

Customizable Turnaround Times

Tailor the grievance resolution process to your specific needs. Set internal deadlines and adjust timelines to meet CMS requirements to optimize efficiency and compliance.

Robust Reporting Capabilities

Gain valuable insights with GrievancesHub’s comprehensive reporting features. Access CMS required reports for audits and monitor productivity effortlessly with standard and customizable reporting options.

Integration Capabilities

Enhance the member experience through seamless integration. Facilitate electronic delivery of communications to members to ensure secure and timely access to crucial grievance-related information.

Role-Based Access

GrievancesHub provides role-based access, allowing different users to perform specific functions based on their roles. The system offers roles such as triage, caseworker, manager, and admin, ensuring appropriate access and data security.

Letter Templates

The solution houses letter templates that are used to respond to grievances. Admins and managers can upload and manage letter templates, while caseworkers can use them to generate responses for specific cases.

Intelligent Automation*

The system aims to incorporate intelligent automation to streamline processes further. For instance, it can automatically dismiss cases that fall outside the CMS-mandated timeline, reducing manual intervention.

Enhanced Workflow

GrievancesHub offers a well-defined workflow, ensuring that cases are appropriately handled. It allows for case escalation to managers when needed and facilitates effective communication within the team.

Client Focused

The system is designed to cater to the specific needs of health plans and PBMs. It recognizes the unique requirements of each client and can be customized accordingly to align with their internal processes and preferences.

Comprehensive Training & Support

Agadia provides comprehensive training and support to clients during the implementation phase and beyond. This ensures smooth adoption and optimal utilization of GrievancesHub.

GrievancesHub isn’t just a solution; it’s a transformative tool empowering organizations to navigate the intricacies of member grievances with efficiency and efficacy, setting the stage for a more responsive, compliant, and ultimately professional future in healthcare management.

Stay tuned for future updates and contact us to get your live demo on the calendar!

*Upcoming Enhancement

Related Articles

Enhancing Healthcare Utilization Management: Agadia’s Suite of Comprehensive Solutions for Health Plans and PBMs

Enhancing Healthcare Utilization Management: Agadia’s Suite of Comprehensive Solutions for Health Plans and PBMs

In an ever-evolving healthcare landscape, Health Plans and Pharmacy Benefit Managers (PBMs) face the intricate challenge of utilization management efficiency while ensuring optimal care for their members. Agadia, a trusted partner with a decade-long track record,...

Schedule Live Demo