by Karen Apwah | 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...
by Karen Apwah | 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...
by Karen Apwah | 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....
by Karen Apwah | Oct 18, 2023 | Adherence, Formulary Benefit Design, Medication Therapy Management, Part D Star Ratings, Prior Authorization
Health plans face the constant challenge of providing high-quality care while managing costs and ensuring regulatory compliance. One crucial area where they can make a significant impact is in the realm of utilization management programs. Traditionally, many health...
by Karen Apwah | Sep 26, 2023 | Adherence, Formulary Benefit Design, Medication Therapy Management, Part D Star Ratings, Prior Authorization
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,...
by Karen Apwah | Sep 18, 2023 | Electronic Prior Authorization, Prior Authorization
Pharmacy Benefit Managers (PBMs) play a pivotal role in ensuring access to cost-effective, quality treatments for self-funded employers and their members. One PBM stood out for its commitment to transparency and advanced clinical management, but they faced a challenge...
