Transforming Healthcare
with Proven Innovation
Industry-leading utilization management solutions built on decades of expertise—empowering health plans, PBMs, and healthcare organizations with advanced automation, efficiency, and compliance.
Next-Gen Utilization Management Solutions:
AI-Powered, Expert-Driven
Trusted By Over
Health Plan, PBM & TPA Customers
Covering Nearly
Million Lives
Backed By
Years in Business
Why Choose Agadia?
Beyond a Vendor: Your Trusted Business Partner in Healthcare Innovation
We proudly go beyond traditional vendor relationships by continuously investing in the evolution of our solutions. We proactively implement global enhancements driven by new CMS regulations, industry requirements, and emerging technological trends, ensuring our clients stay ahead in an ever-changing healthcare landscape.
Increased Processing Speed by
133%
For Prior Authorizations Using PAHub
Explore How a Health Plan
Specializing in State Medicaid
Doubled Their Prior Authorization Volume
with an actual reduction in staff, and increased their processing speed by more than 133%
What our clients are saying
Trusted By Leading Health Plans & PBMs
“Agadia has been pivotal in our go-to-market strategy—both from a product stand-point as well as strategic leadership demonstrated by their team.” — VP, IT
First Year IRR of
199%
While Using PAHub
Learn how a Health Plan with both commercial and medicare business
Saw an Internal Rate of Return of 199%
within one year of using PAHub
OUR MISSION
Agadia is dedicated to
improving the quality of care and expediting the delivery of health care services by advancing and automating utilization management processes.
What Our Clients Are Saying
"Agadia has been a fantastic partner for several years. As MedOne has grown as a market leader in medication stewardship, we have directly benefited from the efficiencies afforded through the PAHub platform. We would not have been able to enhance the level of care we provide to our members while scaling our operations without the support of the Agadia software and team." - Dr. Nathan Harold, RPh, PharmD., MedOne
"I wanted to pass along that the CDAG portion of our CMS audit last week went well and complement Agadia on the PAHub systems display. The ease of navigation through the full report helped us display the information very smoothly and precisely which is often half the battle in a CMS audit." - Manager - PBM
"I just wanted to drop a quick note letting you know how well PAHub has worked out for us. It has been instrumental in ensuring compliance with various regulations and increased the overall productivity of the Clinical staff. This is a terrific product that has allowed CMS audit events to go very smoothly. Thank you for helping us be successful!" - A.P.; SVP PBM
"Agadia has consistently lead product development with out-of-the-box thinking focusing on a replicable feature-sets to reduce our overall cost of ownership. Their commitment to project management best practices has allowed us to prioritize tactically and avoid potential budget escalations. Agadia’s growing market foot-print clearly demonstrates their commitment to innovation in the healthcare IT space and have been phenomenal to work with." - VP, PBM
In the News
Build vs. Buy: The UM Software Decision Health Plans Can’t Afford to Oversimplify
Executive Insight Build vs. Buy The UM Software Decision Health Plans Can’t Afford to Oversimplify Utilization management modernization is no longer just a technology conversation. It is an operational strategy decision. UM Modernization Interoperability Health Plans...
Prior Authorization Is at a Crossroads: How AI Can Help Restore Trust, Accelerate Care, and Improve Outcomes
AI-Powered Prior Authorization Prior Authorization Is at a Crossroads: How AI Can Help Restore Trust Health plans are rethinking outsourced utilization management and embracing AI-enabled platforms that restore control, transparency, and operational efficiency....
Automation in Prior Authorization: Real Opportunities vs. False Promises
Medical Prior Authorization Isn’t Just Under Pressure, It’s Structurally Breaking
Executive Insight Medical Prior Authorization Isn’t Just Under Pressure.It’s Structurally Breaking. Why health plans need to rethink intake, clinical review, and decision workflows before outdated operating models create even greater pressure. Brandon Noffsinger...
CMS-0057-F: What’s Changing Next and What Health Plans Should Focus On Now
Unlocking Clinical Data: Introducing ClinIntel in PAHub
In prior authorization, speed and accuracy depend heavily on one critical factor: data. But much of that data, such as faxed forms, clinical notes, attachments, and supporting documentation, arrives unstructured, incomplete, spread across multiple sources and is...
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Contact Us Today
NOTE FOR PATIENTS: We are a software company. Please contact your physician or pharmacy for any drug related questions.
