Vaya Health maintains a closed network for providers of certain behavioral health, intellectual/developmental disability (I/DD), and traumatic brain injury (TBI) services for the following health plans:
- Behavioral Health I/DD Tailored Plan Medicaid services/Vaya Total Care
- Tailored Plan State-funded services
- NC Medicaid Direct Prepaid Inpatient Health Plan (PIHP)
To meet North Carolina Department of Health and Human Services availability, accessibility, and quality goals and requirements, Vaya negotiates with any willing and qualified behavioral health, I/DD, or TBI services provider, except for services that are not available through Standard Plans and for which we maintain a closed network. For a list of closed network services, please see our Provider Operations Manual.
All Vaya network providers must be enrolled in NC Medicaid through NCTracks. For more information, visit our Provider Enrollment page.
Behavioral health, I/DD, and TBI services
For a full list of covered services, see Vaya’s Provider Operations Manual. For service definitions and other details, visit our Covered Services page.
Medicaid services
Benefits for Vaya’s Medicaid plans include all child and adult behavioral health, I/DD, and TBI services required by the North Carolina 1115 Demonstration Waiver and the NC State Plan for Medical Assistance (Medicaid State Plan). Service types include:
- Crisis and inpatient behavioral health services
- Outpatient mental health services
- Outpatient substance use disorder services
- I/DD services
- TBI services
- Residential services
- Respite services
- In lieu of services (ILOS)
Vaya Total Care also covers the following service types:
- NC Innovations Waiver services through the state’s Medicaid 1915(c) Home and Community-Based Services waiver for individuals with I/DD
- NC TBI Waiver services (upon program expansion to the Vaya region)
- Long-Term Services and Supports
State-funded services
State-funded behavioral health, I/DD, and TBI services available through the Tailored Plan are not an entitlement, and availability is dependent on funding from the state of North Carolina.
Additional behavioral health resources
For more information on network requirements for behavioral health, I/DD, and TBI providers, visit the following pages:
For more information about our specialty behavioral health programs please visit the following pages: