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How AI Is Closing the Gap in Prior Authorization and Utilization Management
['James Andrew', 'Angela Scott-Briggs']
TechBullion
For decades, prior authorization has been one of the most quietly expensive problems in American healthcare.
Agadia, a healthcare technology company serving health plans and PBMs, positions its software explicitly as“AI-powered automation for modern utilization management,” covering electronic prior authorization, medication therapy management, formulary benefit design, and grievance management for organizations processing millions of authorization decisions a year.
It’s worth noting that prior authorization is only one piece of the utilization management workload.
What Responsible Adoption Looks LikeThe health plans getting this right aren’t treating AI as a black box that approves or denies care unsupervised.
Health plans and PBMs looking to modernize prior authorization, formulary management, and utilization review can learn more about Agadia’s AI-powered automation platform at agadia.com.