PARSIPPANY, N.J. – Feb 18, 2021- Agadia Systems, Inc. (Agadia), a recognized healthcare technology solution provider for Health Plans & PBMs is announcing an agreement with Blue Cross and Blue Shield of Kansas City (Blue KC), to utilize PAHub, Agadia’s HITRUST certified, end-to-end Electronic Prior Authorization management solution.
PAHub™ is a web-based solution uniquely designed to automate the end-to-end management of prior authorization across all healthcare services, all lines of business, and all channels, enabling health plans and PBMs to facilitate electronic prior authorization, reduce costs, enhance compliance, and increase productivity.
The Implementation of PAHub, will provide Blue KC with the ability to control all clinical, compliance and administrative aspects of prior authorization at the point-of-care to reduce turn-around times, integrate, in real-time, with leading enterprise systems and EMR vendors, and increase productivity.
“We are very excited to welcome Blue KC to PAHub. We take great pride in the vast capabilities of our electronic prior authorization solution and look forward to observing the operational and clinical efficiencies that Blue KC will now reach with a fully automated end-to-end management of their prior authorization process.” says Ross Loomis, Vice President, Sales of Agadia.
About Agadia:
Agadia is a leading healthcare technology company addressing
the evolving needs of the managed care market with a suite of utilization management solutions in electronic prior authorization, MTM, Medicare Part D star ratings and adherence, and formulary benefit design. Used by over 40 of the nation’s leading health plans and PBMs, and covering over 70 million lives, Agadia’s advanced technology solutions help drive operational efficiency, appropriate utilization, compliance, and profitability. For more information, visit
www.agadia.com.
The full press release can be viewed here.
Please Note:
- This tool is for outpatient services only.
- Inpatient services and non-participating providers always require prior authorization.
- This tool does not reflect benefits coverage1 nor does it include an exhaustive listing of all noncovered services (i.e., experimental procedures, cosmetic surgery, etc.). Refer to your Provider Manual for coverage/limitations.
- Services may be listed as requiring prior authorization that may not be covered benefits for a particular member. Please verify benefit coverage prior to rendering services.
To determine coverage of a particular service or procedure for a specific member:
- Access eligibility and benefits information on Availity*.
- Use the Precertification Lookup Tool accessed through Payer Spaces in Availity.
Call Provider Services at:
833-405-9086
To request authorizations:
- From the Availity homepage, select Patient Registration from the top navigation.
- Select Auth/Referral Inquiry or Authorizations.
Provider Tools & Resources
- Log in to Availity
- Learn about Availity
- Precertification Lookup Tool
- Prior Authorization Requirements
- Claims Overview
- Eligibility Overview
- Provider Manual and Guides
- Referrals
- Forms
- Training Academy
- Electronic Data Interchange (EDI)
- Quality of Care Incident Form
Interested in becoming a provider in the Healthy Blue Network?
We look forward to working with you to provide quality service for our members.
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BlueCross BlueShield of Kansas's Preferred Method for Prior Authorization Requests
Our electronic prior authorization (ePA) solution provides a safety net to ensure the right information needed for a determination gets to patients' health plans as fast as possible.
Improving efficiencies without sacrificing the essentials
- 70%1 of users reported time savings
- 35%2 faster determinations than phone or fax
- HIPAA compliant and available for all plans and all medications
- No cost to providers and their staff
How it works
Three Easy steps to completing requests electronically
- Create a free account in minutes
- Verify your NPI to receive all requests initiated at your patient’s pharmacies
- Use your account to initiate, access and submit requests
Want to learn more? Join a webinar.
“I have been using this service since last year and it simply gets better and better. It has significantly reduced the paperwork burden of my office and office staff as far as prior authorizations go.
CoverMyMeds Provider
No hold times. We know PA requests are complex. That's why we have a team of experts and a variety of help resources to make requests faster and easier. LET’s GET STARTED
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1 - CoverMyMeds Provider Survey, 2019
2 - Express Scripts data on file, 2019