CAQH CORE

As validated in the following article, the healthcare industry’s approach to prior authorization is evolving. In parallel, such rapid change results in the need for advanced technology to streamline workflows. Agadia, an innovator in healthcare technology, is addressing these needs for the nation’s leading health plans and PBMs with PAHub, a web-based solution uniquely designed to automate the end-to-end management of Electronic Prior Authorization (ePA) across all healthcare services, all lines of business, and all channels.

Processing thousands of ePAs daily, Agadia’s PAHub solution is changing the landscape of prior authorizations and driving better patient outcomes as the end goal. Contact us today to request a live demo and explore how PAHub can bring operational and clinical efficiencies to your prior authorization management.


The following article was originally posted on HealthPayerIntelligence.com on July 27th, 2018 by Thomas Beaton.

CAQH CORE supports and urges industry-wide collaboration on how to improve prior authorizations to be more beneficial for patients, payers, and providers.

CAQH CORE is urging healthcare payers, providers, and other stakeholders to promote industry-wide collaboration on how to improve prior authorizations.

Leading provider and payer organizations, including AHIP, AHA, the BlueCross BlueShield Association, and MGMA, have already signed an agreement to reduce complexity and standardize the processes of prior authorization.

“We are greatly appreciative of the consensus statement authors’ commitment to this critical issue,” said Robin J. Thomashauer, President of CAQH. “CAQH CORE participating organizations have spent considerable time developing ways to promote greater automation in the prior authorization process. We agree wholeheartedly with the consensus statement, and are eager to work together to make a difference.”

CAQH CORE and the signatories of the consensus letter aim to improve prior authorizations with two-way communications and transparency, so all stakeholders can easily process prior authorization requests.

In addition, both CAQH CORE and the signatories want to add features to prior authorizations that address continuity of care concerns and leverage electronic prior authorizations to enhance efficiency.

Prior authorizations help payers contain care costs for expensive medications and services, but can also contribute to delays in care and add patient safety risks. Payers that utilize electronic and streamlined prior authorization processes could help reduce patient delays in care and experience significant savings

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