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

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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:

DataMartrix Medical's prior authorization services are perfect for those practices backed up by the burden of prior authorizations and are not reimbursed promptly. We will handle PAs throughout the entire process. We can work alongside current staff to support orders, submissions, approvals, and the denial/appeal process or handle the whole process to free up time for you and your staff.

Our HIPAA-compliant and secure service is EHR and EMR agnostic, so we can work with any system with a minimum setup cost that is, on average, 70% less than AI-centered RCM tools and 50% less than an hourly employee. DataMatrix is 99+% accurate and offers 24/7 capabilities, so there is no downtime. The prior authorization service by DataMatrix Medical accommodates all private insurance, no-fault, and worker's comp.

For over 25 years, DataMatrix Medical has been a leader in healthcare business process support. The prior authorization product can work seamlessly with other products, such as medical scribing, document indexing, and medical credentialing.

Try the DataMatrix Medical prior authorizations service risk-free and no long-term contracts; cancel anytime.

About DataMatrix Medical:

DataMatrix Medical is a leader in medical scribing and prior authorization outsourcing

Our BPO services, like proofreading, insurance eligibility verifications, voicemail to EHR transcription, document management, charge posting, billing, and coding services, have boosted productivity for over 250 medical practices and hospitals nationwide. We adhere to the highest standards and have excellent references from clients of 20+ years. 

Our clients love our 24-hour customer service, rapid turnaround, and the convenience of easily customized service

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:

The DataMatrix Medical prior authorization product is used by small to mid-size practices and as large as those that will do hundreds of PAs weekly. The service is medical specialty agnostic so that DataMatrix can support orthopedics, pediatrics, cardiology, and more. We specialize in authorizations for Radiology, DME, Injections, Surgeries, and more. This service is best for practices that need to cut overhead costs while working to increase reimbursement rates. 

Pediatric use cases:

The application is the same across all medical specialties, taking into account the obvious rules and appropriate restrictions. The PA service is HIPAA-compliant and audited regularly under gregarious scrutiny. 

Users:
  • Office Administrators
  • VP of Operations
  • Operations Managers
  • Office Managers
  • Clinical Coordinators
  • Any Medical Practices with PA Needs

EHR Integrations

Integrations:

None provided

EMR Integration & Relevant Hardware:

None provided

EMRs Supported:

None provided

Hardware Compatibility:

None provided

Integrations:

None provided

EMR Integration & Relevant Hardware:

None provided

EMRs Supported:

Epic, Cerner, Meditech, Allscripts, NextGen, athena, GE, eClinicalWorks, McKesson, Other, Allscripts/Eclipsys, Athenahealth, Azalea Health/Prognosis, CPSI, Evident, Healthland, MEDHOST, MedWorx, QuadraMed, Self-developed, Would prefer not to disclose, Point Click Care

Hardware Compatibility:

None provided

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:

DataMatirx Medical can support ALL EHR systems and functionality 

Differentiators vs Competitors:
  • Minimus is 70% Less than leading RCM tools
  • Hourly rates are 50% of the cost of full-time specialist
  • Hybrid module so that service is more accurate than AI-centric SAAS competitors
  • EHR agnostic meaning all EHRs or EMRs are supported 

Health Equity

Keywords

Images

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PromptPA-Screen.png

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Prior Authorization Team at AAOE 2024

Videos

No videos provided

1 of 3

As Per Month.mp4

Downloads

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PAHub-PA-Case-Study-199-IRR.pdf
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DataMatrix Solutions Booklet 24.pdf

Alternatives

Company Details

Founded in 2007

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