As noted in the following article posted on AMJC.com by Kelly Davio, prior authorizations are having a significant negative impact on clinical outcomes and causing a delay in care. This challenge is the driving force behind Agadia’s prior authorization solution,...
Agadia Relocating to Morris Plains, NJ to Support Continued Growth We are thrilled to announce that Agadia’s corporate headquarters will be relocating to 201 Littleton Road in Morris Plains, New Jersey, with the move planned for early 2026. “This move...
In healthcare, regulatory oversight is constant. Organizations must demonstrate that grievance cases are resolved within mandated timelines, tracked appropriately, and documented with accuracy. The Centers for Medicare & Medicaid Services (CMS), for example,...
GLP-1 medications are creating new challenges for health plans due to rising demand and costs. Originally developed for type 2 diabetes, these drugs are now widely prescribed for weight management, sleep apnea, and other clinical uses. As this surge continues,...
The healthcare industry is facing unprecedented challenges in streamlining prior authorization (PA) processes effectively. According to a report by the Arthritis Foundation, the average wait time for medical procedure PAs ranges from a few days to several weeks,...
Prior authorization (PA) is a process used by health insurance companies to determine whether certain medications, procedures, or treatments are medically necessary before approving coverage. While the goal is to control costs and prevent unnecessary treatments, PA...
In today’s rapidly advancing healthcare industry, managing grievances has become more complex than ever. With rising regulatory scrutiny, evolving patient expectations, and a growing demand for efficiency, health plans and pharmacy benefit managers (PBMs) need...
Agadia Expands Market Reach with a ePA Portal for Specialty Drugs Empowering Specialty Pharmacies, Hub Service Companies, and Drug Manufacturers to Expedite Patient Access Agadia is proud to announce the expansion of its electronic prior authorization (ePA)...
Last year, the Centers for Medicare & Medicaid Services (CMS) finalized the CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F), a significant step toward improving healthcare efficiency, enhancing patient access to care, and reducing...
One of the most common and often misunderstood components of insurance plans is prior authorization (PA). While it might seem like an extra hurdle, PA plays a significant role in healthcare cost management and patient safety. Key Takeaways: Prior authorization ensures...
