Important Announcements
National Core Indicator for Aging and Disabilities (NCI-AD) Survey
The NCI-AD initiative helps measure and track performances to improve services for older adults and individuals with physical disabilities. Between Aug. 1 and Nov. 1, 2024, individuals from these groups who receive long-term services and supports may be asked to complete an NCI-AD Survey. If a Vaya member or recipient you serve is selected, we may ask you to help obtain their consent or provide information. Thanks in advance for your time!
2024 Perception of Care Survey
Perceptions of Care Survey is set to open Aug. 12, 2024. Vaya will email survey guidelines, links, tips, and other resources to participating providers before that date. We appreciate your participation!
Need technical support?
Use our Provider Service Desk Request Form to get help with Vaya IT systems and provider applications. You can also continue to submit requests to servicedesk@vayahealth.com or call 1-800-893-6246, ext. 1500.
Request Form
Provider Resources
Forms and Resources
Get forms and tools needed to do business with us and support Vaya members and recipients.
View FormsProvider Communication Bulletins
Stay on top of the latest news, updates, and announcements for Vaya network providers.
Communication Bulletins ArchiveProvider Touchpoint
Catch up on the latest informational webinars for Vaya network providers.
Provider TouchpointProvider Operations Manual
Reference our Provider Operations Manual for network participation requirements.
Provider Operations Manual
Claims
Submit claims and review claims status through our secure Provider Portal. Vaya also accepts claims submissions via secure file transfer protocol (SFTP), electronic data interchange (EDI) files, or paper submission (in limited circumstances only).
ClaimsPrior Authorization
Providers are responsible for requesting service authorization, supplying required documentation, and demonstrating medical necessity. To request prior authorization, submit a service authorization request (SAR) through our Provider Portal. If you do not have access to the portal, visit our Prior Authorization webpage for alternate submission methods.
Prior Authorization
Authorization Guidelines
Familiarize yourself with the authorization guidelines for services covered under Vaya’s Medicaid and State-funded benefit plans. Authorization decisions are based on medical necessity and made in accordance with individual needs, Medicaid waiver and clinical coverage policy requirements, federal regulations, clinical practice guidelines, and applicable federal and state rules and regulations. Not all services require prior authorization.
Authorization GuidelinesWhole-Person Care in North Carolina
We know many things can affect health – from medical conditions or mental health concerns to housing, food, and transportation. Our care managers work with physical and behavioral health care providers and link our members and recipients to community resources to help them get or stay well. Learn more about Vaya Total Care, our approach to whole-person care.
Contact Us
Provider Support Service Line:
1-866-990-9712
Pharmacy Service Line:
1-800-540-6083
Monday-Saturday, 7 a.m.-6 p.m., including holidays
provider.info@vayahealth.com
Sign Up for Communication Bulletins
Subscribe to our weekly Provider Communication Bulletins for the latest announcements.
Report Fraud, Waste, or Abuse
Call our 24-hour Confidential Compliance hotline.
