Provider Operations Manual
Our Provider Operations Manual gives detailed information and technical assistance to Vaya Health network providers. The manual covers all requirements for network participation.
All requirements outlined in the manual are a binding part of every provider contract with Vaya. We encourage all providers to read it carefully and make sure that all employees and contractors are familiar with the requirements.
Vaya Health Provider Operations Manual 3.0
To request a printed copy, call our Provider Support Service Line at 1-866-990-9712, 7 a.m. to 6 p.m., Monday-Saturday, including holidays.
Vaya has published a draft updated version of our Provider Operations Manual for a 30-day comment period. For a list of revisions, see Appendix B. The updated manual is scheduled to take effect March 5, 2026, or upon approval by the North Carolina Department of Health and Human Services. Please submit comments to manuals@vayahealth.com.
Archived manuals are available online for reference.
Navitus Provider Manual
Vaya contracts with Navitus Health Solutions (Navitus) as our pharmacy benefit manager (PBM). Navitus’ Pharmacy Provider Manual is located on their website. The manual help pharmacies to process claims correctly and guides pharmacies on how to obtain authorizations, request pricing research, respond to audits, etc.
When you click to access Navitus’ Pharmacy Provider Manual, you will leave the Vaya Health website.