Authorization & Billing

Vaya Health’s commitment to our network providers includes ensuring you have the information you need to fulfill our authorization and billing requirements both accurately and efficiently.

Service authorization, including authorization requests and clinical oversight, is managed by our Utilization Management Department. Billing issues, including claims submission and adjudication, are overseen by the Claims and Reimbursement Department. This section also includes information on topics including member eligibility and enrollment, member appeals, claims denial reconsideration requests, and Vaya’s rate and checkwrite schedules.

For additional authorization and billing resources, visit our Provider Learning Lab. The Forms page includes a comprehensive list of forms, worksheets and tools designed to serve you. Or, use our document search tool to quickly locate forms and other resources by entering one or more simple key words.

Visit individual pages within this section for additional information. Please check back frequently to make sure you have the most up-to-date information and documents you need as a network provider.