Credentialing

Vaya Health maintains a Uniform Provider Credentialing and Recredentialing Policy that applies to individual and organizational providers of acute, primary, behavioral health, substance use disorder, long-term services and supports, and NC Division of State Operated Healthcare Facilities services. The policy outlines provider selection and retention policies and procedures for initial credentialing, re- credentialing, recertification, and reappointment. 

Vaya’s Provider Network Participation Committee is responsible for making recommendations regarding network contracting decisions. Vaya operates a closed network for behavioral health, I/DD, and TBI providers, which means Vaya does not have to accept new providers into the plan. We operate an open network for all other provider types, including physical health, pharmacy, LTSS, and Non-Emergency Medical Transportation (NEMT) providers, which means Vaya must enroll and contract with all willing and qualified providers that wish to participate in the Vaya Health Plan.

Vaya’s focus is on ensuring access to quality care. We accept applications from new providers for the closed network if it will help address unmet needs.