The need for effective Prior Authorization (PA) management for health plans, Pharmacy Benefit Managers (PBMs), and Third-Party Administrators (TPAs) continues to evolve. To propel your organization to new heights, it’s not just about managing authorizations but...
Planning for the Future of Healthcare Legislation: Agadia’s Response to Colorado Revised Statutes When it comes to healthcare legislation, staying ahead is not just a necessity; it’s our commitment at Agadia. As of February 20, 2024, the Colorado Revised...
In response to escalating concerns voiced by providers and patients regarding delayed and denied care, an increasing number of states are taking decisive steps to impose limitations on prior authorization (PA) requirements. These legislative efforts, reaching beyond...
The healthcare landscape is undergoing a transformative shift with the introduction of the Centers for Medicare & Medicaid Services (CMS) Interoperability and Prior Authorization Final Rule (CMS-0057-F). This comprehensive regulation sets forth a series of...
The Biden-Harris Administration’s recent announcement on promoting competition in healthcare includes a significant focus on increasing transparency in the Medicare Advantage (MA) insurance market. The U.S. Department of Health and Human Services (HHS) and the...
Ensuring the security and confidentiality of patient data is paramount. Healthcare vendors play a crucial role in maintaining the integrity of sensitive information. One key aspect that highlights a commitment to robust security practices is achieving HITRUST...
Per a recent article posted by MedPage Today, researchers revealed that “ChatGPT provided incorrect or incomplete information when asked about drugs, and in some cases invented references to support its answers, two evaluative studies found. In the first, 39...
Addressing the opioid epidemic requires more than just awareness—it demands strategic and efficient solutions. Health Plans and PBMs play a crucial role in curbing this crisis, and Agadia’s RxSentinel+ is at the forefront, empowering organizations to configure...
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...
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...
