Welcome Cardinal Providers

Welcome to Vaya Health! We are excited to have you join our network. Our goal is to provide resources that help you deliver high-quality health care services to Vaya members and recipients and make your experience with Vaya beneficial and successful. We value your efforts to provide quality care and ensure that Vaya members and recipients – your patients – have a positive healthcare experience.

This page is designed to help you and your staff get acquainted with our organization. The quick links below direct you to essential resources and information for doing business with Vaya. If you need additional assistance, our Provider Relations team is available by phone (1-866-990-9712) or email (provider.info@vayahealth.com) to answer any questions. 

The work you do is critical for our communities and the individuals we are privileged to serve. Together, we are making a positive impact on North Carolina today and for generations to come.

Sincerely, 

Brian Ingraham, President & CEO 

Getting Started

We encourage all network providers to join our mailing list so you can be included in all of Provider Communication Bulletins

Authorizations & Billing

We ensure you have the information you need to fulfill authorization and billing requirements accurately and efficiently

Learning Lab

We want to make it easy for our providers to do business with us and to continue their professional development

Get to Know Us

We strive for members to receive the right care, in the right amount, at the right time

 

AlphaMCS

Vaya uses the AlphaMCS Managed Care Information System (MCIS) for service authorization requests, claims submission, provider profiles, and enrollment of individuals receiving State-funded services.

Cardinal Innovations network providers need to complete the AlphaMCS Login Request FormAfter you have been set up as a provider in AlphaMCS, Vaya will contact you regarding your login information.  

 

Appointment Scheduling and Referral Management

To receive member referrals for Comprehensive Clinical Assessments from the Vaya Call Center, you will need to set up appointment slots in the Alpha system once you have access to AlphaMCS. You can review the instructions to schedule an appointment here.

 

Service Authorization Requests

All network providers who deliver services to members transitioning to Vaya will be required to utilize Vaya’s AlphaMCS platform to submit service authorization requests and claims for payment for dates of service on or after Jan. 1, 2022.  

 

EDI testing and submission   

If your organization has not previously submitted electronic claims to Vaya, please submit the Authorization process and submission EDI Enrollment Form to EDI@vayahealth.com. When submitting the form, add “Cardinal Network Provider” to the subject line of your email to make certain your request is properly routed. 

Please review the full list of Vaya Health-Tested Clearinghouses to confirm that your clearinghouse is successfully tested and approved for EDI transmissions.  

Please note that Vaya does not contract with the Change Health (formerly Emdeon clearinghouse). Provider organizations that use Change Health for claims submission and have an agreement to pay all fees may continue to submit claims to Vaya after Jan. 1, 2022.  

Claims involving a Cardinal member and dates of service prior to Jan. 1, 2022 may be submitted to Cardinal via the Change Healthcare during the Cardinal run-out period (through Mar. 31, 2022) under your current process. 

 

Coverage Information   

Our health plans cover a wide array of both Medicaid and non-Medicaid-funded behavioral healthcare and intellectual/developmental disability (IDD) services to members with mental health, substance use disorder and/or IDD healthcare needs. To review coverage information, please click here

 

Rate and Checkwrite Schedules  

Please review the Rate and Checkwrite Schedules here. A new uniform standard fee schedule for all contracted providers has been posted. 

 

More information can be found in this recent Provider Communication Bulletin and Provider Q&A Webinar

Our Provider Operations Manual provides detailed information and technical assistance to Vaya Health network providers. The manual covers all aspects and requirements of network participation. 

Provider Advisory Council 

The Vaya Health Provider Advisory Council (PAC) serves as an advisory body to Vaya on provider-related issues. The PAC is designed to facilitate an open exchanged of ideas, shared values, goals, and visions and bring forward concerns and solutions while promoting collaboration, ethical operations, mutual accountability and quality services. 

Provider Touchpoints 

You can view past Provider Touchpoints and resources shared here. 

Provider Events

Click here to view upcoming provider events, meetings, and trainings. 

Forms Library 

Looking for a form or document? You can view a list of forms and documents by clicking here or use the search in the upper right of this site. 

Contact Us

For general provider questions, please contact provider.info@vayahealth.com or call 828-225-2785, ext. 1512.