Agadia Systems
Overview
Agadia's PAHub is a HITRUST-certified utilization management platform used by health plans, PBMs, and TPAs to automate end-to-end electronic prior authorization for both pharmacy and medical benefits, with auto-decisioning rules, NLP, and FHIR-based interoperability for CMS-0057-F compliance.
Notable
Used by some of the largest US health plans and PBMs; case study showed a Medicaid plan increased PA processing speed by 133%.
Key services
- PAHub electronic prior authorization
- medical and pharmacy UM automation
- auto-decisioning rules engine
- CMS-0057-F compliance tooling
Subcategories
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