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
Agadia Expands Suite of Healthcare Technology Solutions with the Launch of GrievancesHub
Parsippany NJ, April 2, 2024– Agadia, a leading provider of healthcare technology solutions, is pleased to announce the launch of GrievancesHub, a web-based Grievance Management solution designed to empower Health Plans and Pharmacy Benefit Managers (PBMs) in...
Improving Operational Efficiencies with Utilization Management Solutions
As our industry continues to evolve, efficiency, security, and adaptability are non-negotiables. Health plans, Pharmacy Benefit Managers (PBMs), and Third-Party Administrators (TPAs) need robust solutions that not only streamline operations but also ensure compliance,...
Unleash the Power of Prior Authorization Data with PAHub Insights
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
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 Statutes...
Navigating Prior Authorization Reforms Across Multiple States: A State of Change
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...
Navigating the CMS Interoperability & Prior Authorization Final Rule
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...

Ready to Get Started?
Contact Us Today
NOTE FOR PATIENTS: We are a software company. Please contact your physician or pharmacy for any drug related questions.
Phone
877-575-2533
contact@agadia.com
Location
9 Campus Drive, Parsippany NJ 07054
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