Vaya Health Tailored Plan: Behavioral Health Billing Guide
Vaya Health is an LME/MCO that manages behavioral health, I/DD, and TBI services, and it runs one of North Carolina's four Tailored Plans. Its process is built around the service authorization request, and it continues to require prior authorization for behavioral health, I/DD, and TBI services listed in its guidelines.
Short answer
Vaya Health operates an NC Medicaid Behavioral Health and I/DD Tailored Plan. Providers request prior authorization by submitting a service authorization request through the Vaya Provider Portal, which also handles claims and user management. Vaya requires prior authorization for behavioral health, I/DD, and TBI services as listed on the Authorization Guidelines page of its Provider Central site. The Provider Support Service Line is 1-866-990-9712.
Where Vaya fits
Vaya Health is one of North Carolina's Behavioral Health and I/DD Tailored Plans, which launched July 1, 2024 for members with significant behavioral health, substance use, I/DD, or TBI needs, and which manage the enhanced behavioral health services Standard Plans do not. Tailored Plans serve defined counties, so confirm both the member's plan and your contract with it.
Authorizations
Vaya's prior authorization process is the service authorization request (SAR), submitted through the Provider Portal. Vaya continues to require prior authorization for behavioral health, I/DD, and TBI services as indicated on its Authorization Guidelines page, so check that page for the specific service before scheduling.
The Provider Portal
The Vaya Provider Portal is where providers submit and review authorization requests and claims, manage users, and find resources.
| Contact | Detail |
|---|---|
| Provider Support Service Line | 1-866-990-9712, 7 a.m. to 6 p.m., Monday to Saturday, including holidays |
As of October 2026.
Where behavioral health claims go wrong
- Service delivered before the SAR is approved. Services that require authorization started without it.
- Guidelines not checked. Assuming a service is exempt without checking the Authorization Guidelines page.
- Member is in a Standard Plan. Behavioral health billed to Vaya for a member who is not in its Tailored Plan.
Related: verifying NC Medicaid eligibility in NCTracks, associate-level clinician billing in NC, and the NC Medicaid behavioral health billing guide.
Sources, checked October 2026: Vaya Health Provider Central quick reference guide. Confirm current details on the plan's provider site.
Frequently asked questions
How do I request prior authorization from Vaya Health?
Submit a service authorization request (SAR) through the Vaya Provider Portal.
Does Vaya Health require prior authorization for behavioral health?
Vaya continues to require prior authorization for behavioral health, I/DD, and TBI services as listed on the Authorization Guidelines page of its Provider Central site.
What is Vaya Health's provider support number?
1-866-990-9712, 7 a.m. to 6 p.m., Monday to Saturday, including holidays, as of October 2026.
Is Vaya Health a Tailored Plan?
Yes. Vaya is an LME/MCO operating a Behavioral Health and I/DD Tailored Plan for members with significant behavioral health, substance use, I/DD, or TBI needs.
Authorizations in before the first session.
See Stable track Vaya service authorization requests and hold claims that would bill ahead of approval.
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