Agadia Blog

Company and Industry News

Navigating the CMS Interoperability & Prior Authorization Final Rule

Jan 31, 2024 | CMS, Electronic Prior Authorization, Healthcare Technology, Prior Authorization

The healthcare landscape is undergoing a transformative shift with the introduction of the Centers for Medicare & Medicaid Services (CMS) Interoperability and Prior Authorization Final Rule (CMS-0057-F). This comprehensive regulation sets forth a series of...

Biden-Harris Administration Propels Transparency in Medicare Advantage: What Health Plans and PBMs Need to Know

Jan 29, 2024 | Healthcare Technology, Prior Authorization

The Biden-Harris Administration's recent announcement on promoting competition in healthcare includes a significant focus on increasing transparency in the Medicare Advantage (MA) insurance market. The U.S. Department of Health and Human Services (HHS) and the Centers...

Elevating Security Standards: The Significance of HITRUST Certification in Healthcare Vendors

Jan 4, 2024 | Healthcare Technology, HITRUST & Security

Ensuring the security and confidentiality of patient data is paramount. Healthcare vendors play a crucial role in maintaining the integrity of sensitive information. One key aspect that highlights a commitment to robust security practices is achieving HITRUST...

ChatGPT Produces Unreliable Results in Recent Pharmacy Studies

Dec 8, 2023 | Electronic Prior Authorization, Healthcare Technology, Prior Authorization

Per a recent article posted by MedPage Today, researchers revealed that "ChatGPT provided incorrect or incomplete information when asked about drugs, and in some cases invented references to support its answers, two evaluative studies found. In the first, 39 questions...

Navigating Opioid and Controlled Substance Programs in Healthcare

Dec 4, 2023 | Adherence, Opioid Overutilization

Addressing the opioid epidemic requires more than just awareness—it demands strategic and efficient solutions. Health Plans and PBMs play a crucial role in curbing this crisis, and Agadia's RxSentinel+ is at the forefront, empowering organizations to configure and...

Empowering Health Plans and PBMs to Address the Prior Authorization Burden: Insights from Medical Groups

Nov 21, 2023 | Electronic Prior Authorization, Healthcare Technology, Prior Authorization

In response to the recent report from the Medical Group Management Association (MGMA), it's evident that the prior authorization process remains a significant challenge for medical groups, impacting patient care and straining operational efficiency. The report...

Optimizing Electronic Medical Prior Authorizations: The Transformative Power of PAHub

Nov 15, 2023 | Electronic Prior Authorization, ePrescribing, Prior Authorization

Efficiently processing medical prior authorizations is crucial for Health Plans and Pharmacy Benefit Managers (PBMs) seeking to enhance operational efficiency and improve patient outcomes. In this blog post, we'll explore the importance of streamlined eMPA workflows...

Democrats Express Concerns About CMS’s Prior Authorization Requirements and the Use of AI-Driven tools

Nov 7, 2023 | Electronic Prior Authorization, Healthcare Technology, Prior Authorization

As per an article published last Friday, House Democrats are pressuring the Centers for Medicare & Medicaid Services (CMS) to better evaluate how artificial intelligence is utilized by Medicare Advantage (MA) plans, hoping to prevent eye-catching rates of denial....

Agadia Announces Game Changing Solution for Grievance Management

Nov 6, 2023 | Grievance Management

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...

The Human Touch in Healthcare Technology: Navigating the AI Revolution

Oct 30, 2023 | Healthcare Technology

Technological advancements in the Healthcare industry have become synonymous with progress. The surge of AI technology in healthcare is not only revolutionizing patient care but also reshaping how healthcare operations are conducted. While AI is indeed a powerful...