Claims Adjudication

Vaya Health’s Claims and Reimbursement Department reviews denied claims daily. We are able to access claims on the day following submission through the Provider Portal.

Vaya claims specialists work internally to correct any system errors that may have caused a denial. These denials are then re-adjudicated by Vaya without action required from the provider. Claims specialists may contact providers to alert them of any other denials the provider needs to correct and resubmit.

For further assistance, contact us at or at 1-800-893-6246, ext. 2455.

Claims specialists can answer questions related to topics such as:

  • Why a claim was denied
  • Meaning of denial codes
  • Denials due to no authorization when an authorization is present
  • Denials due to authorized units exceeded
  • Denials due to a combination of no coverage for patient/service/provider
  • How to replace (resubmit a corrected) claim
  • How to revert (void) a claim
  • Timeframe for resubmission of a denied claim
  • How to correct an incorrect unit amount
  • The appeal process
  • How to locate remittance advice (RA) in the Provider Portal
  • How to understand credit memos on RAs
  • Partial claim payments

To view our checkwrite schedule, visit our Rates and Checkwrite Schedules page.

For issues regarding overpayment and information on self-audits, please refer to our Provider Self-Audit Protocol for Paid Claims Audits and Provider Self-Audit Overpayment Summary.

Additional resources