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

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...

Optimizing Electronic Medical Prior Authorizations: The Transformative Power of PAHub

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...

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

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....

How a Prior Authorization Solution Supercharged This PBM’s Efficiency

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...

Transforming Electronic Prior Authorization for Drugs Under the Medical Benefit with Agadia’s eMPA Solution: PAHub

by Karen Apwah | Aug 31, 2023 | Electronic Prior Authorization, Prior Authorization

In the ever-evolving landscape of healthcare, streamlining processes while ensuring compliance is crucial to delivering efficient patient care. One significant challenge that has long plagued the healthcare industry is the manual and time-consuming process of...

The Vital Role of Flexibility and Control in Prior Authorization Management

by Karen Apwah | Aug 8, 2023 | Electronic Prior Authorization, Prior Authorization

In the dynamic realm of healthcare, striking a balance between providing optimal care for members and maintaining operational efficiency is a constant challenge. For Health Plans and Pharmacy Benefit Managers (PBMs), the ability to exercise flexibility and control in...