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Solutions
Description
Compatibility Level
Clients
Use cases
EHR integrations
Client types
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Jump to:
Categories
Solutions
Description
Compatibility Level
Clients
Use cases
EHR integrations
Client types
Differentiators
Keywords
Media
Company details
PAHub™
PAHub™

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Direct
Direct

0 review

Categories

Solutions

Description

Product Description:
PAHub™, is a HITRUST certified solution that puts the tools at your fingertips to streamline and control all clinical, compliance and administrative aspects of Prior Authorization to improve compliance, automation, reduce turn-around times and costs.
About Agadia:

Agadia is a leading healthcare management technology company addressing the evolving needs of the managed care market with a suite of utilization management solutions in electronic prior authorization, MTM, part d star ratings & adherence, and formulary benefit design. Used by the nation’s largest health plans and PBMs, Agadia’s advanced technology solutions help drive operational efficiency, appropriate utilization, compliance, and profitability. For more information, visit www.agadia.com.

Product Description:

Direct is the leading EHR-integrated cost transparency solution. The solution brings real-time, pharmacy benefit cost information, coverage restrictions, and alternatives into native EHR workflows. Giving providers cost information at the point-of-care enables data-driven and evidence-based decisions that help patients get the care they need at prices they can afford.

Features and Benefits:

 - Access to lower-cost alternatives increases care adherence and patient health and satisfaction

 - Select medications that do not require prior authorization

 - Reduced pharmacy/PBM/payer call-backs, prior authorization denials, and other uncompensated provider hassles

 - Uses native order workflows, is easy to implement

- Surfaces pharmacy alternatives to drive continuity of care and patient satisfaction

- Integrates patient affordability program offerings into RTPB results, showing best-cost options when insurance coverage isn't found or doesn't apply. 

About Arrive Health (RxRevu):

Arrive Health is a healthcare technology company dedicated to putting the needs of patients and providers first. We improve access to the most affordable, quality care by delivering accurate, patient-specific cost and coverage data to providers, care teams, and patients. Collaborating with premier health systems, pharmacy benefit managers, payers, and healthcare IT vendors, Arrive Health is clearing the way for better health by reducing friction in care workflows and enabling meaningful conversations about access to care. To learn more, please visit ArriveHealth.com.

Compatibility level

Select which hospital or health system you work at and see a personalized compatibility level.

Clients

Select which hospital or health system you work at and see the client list

Use Cases

Description:

Electronic Prior Authorization Process & Automation Software

Improve Clinical Efficiency & Compliance with Agadia’s fully customizable web-based solution, PAHub.

End-to-End Management of Electronic Prior Authorizations

Delivering Electronic Prior Authorization Efficiency & Compliance

As Prior Authorization volumes continue to rise, and as specialty drugs create additional clinical complexities, Health Plans, Pharmacy Benefit Managers (PBMs) and Third-Party Administrators (TPAs) are challenged to adapt while maintaining or improving operational and clinical efficiencies. PAHub, is a HITRUST certified solution that puts the tools at your fingertips to streamline and control all clinical, compliance and administrative aspects of Prior Authorization at the point-of-care to improve compliance, reduce turn-around times and costs.

By leveraging the latest technologies for data mining, data analytics, content management and advanced decision support trees, PAHub, enables customers to automate the end-to-end prior authorization process.

All Lines of Business

Supported across all lines of business (commercial, Medicare, Medicaid, etc.)

All Channels

Available across all channels (electronic prior authorization (ePA), phone, fax, web, e-prescribing, etc.)

All Healthcare Services

Applicable for all healthcare services, all benefit types (pharmacy & medical)

Pediatric use cases:

None provided

Users:

HealthSystem

Description:

With accurate coverage and cost information displayed at the point-of-care, providers can:

- Avoid medications that require prior authorization

- Improve patient interactions and experience

- Streamline ordering workflows

- Reduce patient costs and non-adherence 

- Support continuity of care

Pediatric use cases:

Deliver accurate costs and alternatives at the point-of-care. For children covered under a PBM/payer we're connected to, we can deliver details on medication options and restrictions. 

Users:

Any prescriber or care team member can utilize our solution within their EHR's workflow. 

EHR Integrations

Integrations:

None provided

EMR Integration & Relevant Hardware:

None provided

EMRs Supported:

None provided

Hardware Compatibility:

None provided

Integrations:

Acute care EMR, Ambulatory EMR

EMR Integration & Relevant Hardware:

Required

EMRs Supported:

Epic, Cerner, Athenahealth

Hardware Compatibility:

Desktop, Mobile / Tablet (web optimized), Mobile / Tablet (native app)

Client Types

None provided

Differentiators

Differentiators vs EHR Functionality:

None provided

Differentiators vs Competitors:

CONTINUALLY INNOVATING TO MEET INDUSTRY NEEDS

Addressing Electronic Prior Authorization for Drugs Under the Medical Benefit

With an influx of infused medications being administered in physician offices, prior authorizations for drugs billed under the medical benefit are presenting challenges across the industry. While there is an industry NCPDP SCRIPT standard for electronic prior authorization (ePA) for drugs billed under the pharmacy benefit, driving significant ePA volume, an industry standard does not currently exist for drugs under the medical benefit.

The challenge with adopting the NCPDP SCRIPT standard for drugs under the medical benefit is that these medications typically do not go the standard route of provider e-prescribing to a traditional retail or mail-order pharmacy location. Often times, the specialty medications are being purchased by the provider (physician/infusion center) directly from drug distributors and administered in the office setting. As a result, health plans continue to receive the drugs under the medical benefit prior authorization requests via phone, fax, or portal which is placing an enormous administrative burden on the health plans operations team, provider office, and the patient.

Agadia continues to innovate and has addressed these challenges by providing eMPA capabilities to reduce the prior authorization administrative burden through a more efficient channel that increases automation and improves turnaround times. Providers will benefit by quickly being informed whether the drug is under the pharmacy or medical benefit, allowing them to efficiently manage requests. Hub companies will experience improved efficiencies as well such as faster turnaround times for a prior authorization decision, improved patient speed to therapy and better adherence.

LEVERAGE ADVANCED TECHNOLOGIES

Save Valuable Time & Resources with PAHub’s Auto-Decision

PAHub’s Auto-Decision rules engine increases automation be leveraging data mining techniques across enterprise systems data to electronically adjudicate prior authorization requests. Auto-Decision helps a customer to allocate staff to high-touch requests instead of requests that can be adjudicated automatically.

ENGAGE PHARMACIES, MEMBERS & PROVIDERS

In the Prior Authorization and Pre-Certification Process

PromptPA is a self-service, web based solution that enables our customers’ pharmacies, members and providers to request prior authorizations electronically, initiate renewals and check the status of requests using any web browser, reducing operational costs and call volume to Health Plans and Benefit Managers.

Differentiators vs EHR Functionality:

Our solution is seamlessly embedded into EHR workflows, allowing for direct connections to payer and PBM source-of-truth data. EHRs typically allow for one or many connections to Real-Time Prescription Benefit solutions, but rarely have their own prescription price transparency capabilities built-in. 

Differentiators vs Competitors:

Arrive Health delivers the industry's most accurate, patient-specific cost and coverage information to the EHR. Many providers do not trust the pricing information displayed in their workflow because of its obsolete or incorrect nature (see whitepaper below). However, Arrive Health delivers data that providers can rely on, taking into consideration up-to-date copay and deductible information, benefit details, and preferred locations. We also display therapeutic alternatives that are covered under the patient's insurance, options that might not require prior authorization, and options at a health system's own internal pharmacy. 

Keywords

Images

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Videos

No videos provided

No videos provided

Downloads

Alternatives

Company Details

Founded in 2007

Founded in 2013

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