Hospital Enrollment

All requests for network enrollment by a hospital/health system for inpatient and/or basic outpatient services must be sent to Vaya Health’s Provider Network Operations Department.

• Providers of emergency department and/or related ED physician services can be enrolled with the information provided on the paper claim submitted for behavioral health when accompanied by a copy of the billing facility or physician group entity’s Federal W-9 form. For more information, visit our Billing for Emergency Services page.
• To apply to contract for psychiatric inpatient facility and associated psychiatric group services, or to enroll for payment of behavioral health-related emergency department facility and/or emergency physician group services, complete the Hospital Data Form (Excel). This form can also be used to add or remove affiliated licensed practitioners from a previously enrolled hospital health system or emergency department physician group’s roster.

If emergency behavioral health services resulted in a psychiatric inpatient admission, contact Vaya’s Utilization Management (UM) Department at 1-800-893-6246, ext. 1513, to request authorization and initiate the inpatient out-of-network agreement process.

To add enhanced outpatient services to your contract at a new or existing contracted location, see our Provider Enrollment page for more information. 

To decrease the administrative burden on hospitals directly enrolled with NC Medicaid, we are permitted (but not required) to accept and rely upon NC Medicaid’s credentialing of North Carolina-licensed hospitals. This may include all facilities and sites affiliated with the hospital seeking to be enrolled, to the extent such facilities and sites are enrolled with NC Medicaid and affiliated with the hospital in NCTracks.

Any required information not submitted to or verified by NC Medicaid must be submitted to Vaya for verification. This includes, but is not limited to, Social Security numbers and dates of birth for all owners, directors, members of the Board of Directors and managing employees.

Federal statutory law and regulations expressly prohibit us from making any payment for Medicaid services to anyone other than the contracted provider of services, except in certain limited circumstances.