Agadia to Exhibit in an Upcoming Connect19 Conference

Streamlining Prior Authorization: The Role of Interoperability, Automation and AI in Improving Efficiency and Patient Care

by Hargun Ghai | May 15, 2025 | Electronic Prior Authorization, Prior Authorization

Current Industry Challenges The healthcare industry is facing unprecedented challenges in streamlining prior authorization (PA) processes effectively. According to a report by the Arthritis Foundation, the average wait time for medical procedure PAs ranges from a few...

The Impact of Prior Authorization on Patient Care: Pros and Cons

by Hargun Ghai | Mar 27, 2025 | Electronic Prior Authorization, Healthcare Technology, Prior Authorization

Prior authorization (PA) is a process used by health insurance companies to determine whether certain medications, procedures, or treatments are medically necessary before approving coverage. While the goal is to control costs and prevent unnecessary treatments, PA...

The Future of Grievance Management: Trends & Innovations

by Hargun Ghai | Mar 7, 2025 | Grievance Management, Healthcare Technology

In today’s rapidly advancing healthcare industry, managing grievances has become more complex than ever. With rising regulatory scrutiny, evolving patient expectations, and a growing demand for efficiency, health plans and pharmacy benefit managers (PBMs) need...

Press Release: Agadia Expands Market Reach with a New ePA Portal for Specialty Drugs

by Hargun Ghai | Feb 19, 2025 | Electronic Prior Authorization, Prior Authorization, Uncategorized

Agadia Expands Market Reach with a ePA Portal for Specialty Drugs Empowering Specialty Pharmacies, Hub Service Companies, and Drug Manufacturers to Expedite Patient Access Agadia is proud to announce the expansion of its electronic prior authorization (ePA)...

Preparing for the CMS Interoperability and Prior Authorization Final Rule

by Hargun Ghai | Feb 10, 2025 | CMS, Electronic Prior Authorization, Healthcare Technology, Prior Authorization

Last year, the Centers for Medicare & Medicaid Services (CMS) finalized the CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F), a significant step toward improving healthcare efficiency, enhancing patient access to care, and reducing...

What is Prior Authorization and Why is it Important?

by Hargun Ghai | Jan 23, 2025 | Electronic Prior Authorization, Prior Authorization

One of the most common and often misunderstood components of insurance plans is prior authorization (PA). While it might seem like an extra hurdle, PA plays a significant role in healthcare cost management and patient safety. What is Prior Authorization? Prior...

Navigating the Evolving CMS Medication Therapy Management Landscape in 2025

by Hargun Ghai | Jan 8, 2025 | CMS, Medication Therapy Management

The Centers for Medicare & Medicaid Services (CMS) recently released updated guidelines for the Medication Therapy Management (MTM) program, effective January 1, 2025. These changes significantly impact how health plans and PBMs can participate and deliver...

Streamlining Prior Authorization: Insights on the Improving Seniors’ Timely Access to Care Act of 2024

by Karen Apwah | Nov 25, 2024 | CMS, Electronic Prior Authorization, Healthcare Technology, Prior Authorization

Streamlining Prior Authorization: Insights on the Improving Seniors’ Timely Access to Care Act of 2024 The bipartisan momentum behind the Improving Seniors’ Timely Access to Care Act of 2024 marks a critical step forward in addressing a longstanding issue in...

Medicare Part D Star Ratings: Understanding the 2024 Changes and Their Implications

by Karen Apwah | Sep 11, 2024 | Opioid Overutilization, Part D Star Ratings

The Centers for Medicare & Medicaid Services (CMS) recently finalized changes to the Medicare Part D Star Ratings for 2024, introducing several new initiatives aimed at improving the quality of care and enhancing patient outcomes. These changes not only affect how...

Staying Compliant: Preparing for New AI Guidelines in Prior Authorization

by Karen Apwah | Jul 17, 2024 | CMS, Electronic Prior Authorization, Healthcare Technology, Prior Authorization

Are you prepared for potential upcoming AI Guidelines in Prior Authorization? As AI continues to revolutionize various aspects of healthcare, including prior authorization (PA) management, it’s crucial for Health Plans and Pharmacy Benefit Managers (PBMs) to stay...

Agadia to Exhibit at the Upcoming Connect19 Conference

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