Vaya Health will not require prior authorization for physical health services until Oct. 1, 2024, as part of Behavioral Health and I/DD Tailored Plan launch. Click here for more information and additional authorization flexibilities.
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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 Health. 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 2024-2025 (July 1, 2024)

To request a written copy, call our Provider Support Service Line at 1-866-990-9712, Monday-Saturday, 7 a.m.-6 p.m., including holidays.

All 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.

Need Help?

For information or technical assistance, call Vaya Health’s Provider Support Service Line at
1-866-990-9712
(Monday-Saturday, 7 a.m.- 6 p.m.).