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Agadia

Revolutionizing Healthcare Management Technology.

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Overview

Agadia is a healthcare technology company that provides software solutions primarily for health plans, PBMs, and specialty pharmacies. Their flagship product, PA+, is an enterprise platform for managing electronic prior authorization (ePA) across all healthcare services, including pharmacy and medical. The platform is designed to automate and streamline the entire PA workflow, from intake and clinical review to determination and communication.

✨ Key Features

  • Prior Authorization Management (PA+)
  • Electronic Prior Authorization (ePA)
  • Configurable Clinical Criteria
  • Workflow Automation
  • Integration with Provider Portals and EMRs
  • Reporting and Analytics

🎯 Key Differentiators

  • Enterprise focus on the payer side of prior authorization.
  • Highly configurable platform to accommodate complex and unique clinical criteria.
  • Manages PA for both pharmacy and medical benefits.

Unique Value: Provides a highly configurable and automated enterprise platform for payers to efficiently manage the entire prior authorization lifecycle, reducing costs and improving consistency.

🎯 Use Cases (3)

Automating the prior authorization process for a health plan or PBM. Managing complex clinical criteria for specialty drugs. Improving turnaround times and reducing administrative costs for utilization management.

✅ Best For

  • Used by various health plans and PBMs to manage their prior authorization processes.

💡 Check With Vendor

Verify these considerations match your specific requirements:

  • A standalone e-prescribing tool for a doctor's office.

🏆 Alternatives

CoverMyMeds Surescripts In-house payer systems

Offers a more payer-centric, enterprise-grade solution for managing internal PA workflows, as opposed to tools that are primarily focused on the provider-facing submission process.

💻 Platforms

Web API

🔌 Integrations

EHR/EMR systems Provider Portals Clinical Guideline Providers

🛟 Support Options

  • ✓ Email Support
  • ✓ Phone Support
  • ✓ Dedicated Support (Enterprise tier)

🔒 Compliance & Security

✓ SOC 2 ✓ HIPAA ✓ BAA Available ✓ SSO ✓ SOC 2 Type II

💰 Pricing

Contact for pricing

Free tier: NA

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