The first step to enrolling in the Vaya Health network is to submit an application. Federal law and our contracts with the N.C. Department of Health and Human Services (DHHS) allow us to limit participation in our closed provider network. At this time, we are accepting direct applications for participation from hospitals/health systems, prescribers and physician practices.

We are also actively seeking applications for network participation for specific services to ensure adequate access to care for our members. 

For information on hospital/health system applications, please visit our Hospital Enrollment page. All other providers, including prescribers, physician practices and existing network providers must apply by submitting a completed Provider Enrollment Form. 

Vaya determines eligibility for selection as a network provider in accordance with criteria set forth in our written selection and retention policy, as stated in our Provider Operations Manual and in our annual Community Mental Health, Substance Use and Developmental Disability Services Network Adequacy and Accessibility Analysis (Also known as the Gaps Analysis). Applicants will be notified of Vaya’s decision in writing. If the nomination is approved, you will be sent an application for credentialing and enrollment for the new site(s) and/or service(s) that will include detailed instructions and timelines for completion.

All requests for network enrollment must be sent to Vaya using the appropriate form below. Each form includes instructions for submission.

I WANT TO…Request nomination to become a Vaya network provider

I AM A(N)…	I SHOULD SUBMIT THE:
Provider not contracted with Vaya	Provider Enrollment Form (formerly Provider Nomination Form)
Out-of-network provider
Network licensed independent practitioner (LIP) seeking enrollment as or with a network agency

I WANT TO…Request to add a new site or new service to my existing contract with Vaya

I AM A(N)…	I SHOULD SUBMIT THE:
Network provider agency	Provider Enrollment Form (formerly Provider Nomination Form)
Network LIP
Contracted hospital/health system requesting to add enhanced outpatient services (e.g. SAIOP, partial hospitalization)

I WANT TO…Request to change site address or other address in my existing contract with Vaya

I AM A(N)…	I SHOULD SUBMIT THE:
Network provider agency	Provider Enrollment Form (formerly Provider Nomination Form)
Network LIP

Providers approved for network enrollment will be contacted by our Credentialing Team and provided with the appropriate credentialing application. Please note that network enrollment approval does not guarantee a provider will meet credentialing requirements and be offered a contract. Contracts are offered only if our Credentialing Committee approves a provider application.

Once a provider is enrolled, credentialed and contracted for network participation, contract renewal and re-enrollment is based on provider performance and other factors outlined in the selection and retention criteria in our Provider Operations Manual.

Letter of Support

The Letter of Support is to be used only for fulfilling the N.C. Division of Health Service Regulation requirement of securing a Letter of Support that is required to be submitted with an initial facility license application.

Out-of-network agreements

If you are not enrolled in our network but need to request an out-of-network (OON) agreement to provide care to a Vaya member who is unable to be served by a network provider, please follow the out-of-network process below.

I WANT TO…Request an out-of-network agreement

I AM A(N) …	I SHOULD …
Provider not contracted with Vaya Out-of-network provider	Submit the Out-of-Network Agreement Request
Hospital/health system (out-of-network or non-contracting)	Call Vaya’s Utilization Management Department 1-800-893-6246, ext. 1513

Vaya contracts with out-of-network providers only if we cannot meet the need for geographically accessible, appropriate or timely services for a specific member. Out-of-network providers are not listed in our Provider Directory and are not eligible for referrals.

Vaya will not pay for non-emergency services, including hospital inpatient stays, delivered by a provider who does not have a current network provider contract or OON agreement with Vaya.