Type of Concern

Member Complaint or Grievance:
Please select this option if you are a member who wants to file a complaint or grievance against a provider or Vaya Health (or if you are filing a complaint or grievance at the request of a member)

Other Concern (not filed by Member):
Please select this option if you are NOT a Vaya Health Plan member (or someone acting on his or her behalf) and want to report a concern about a provider or Vaya Health, including but not limited to potential fraud, quality of care issues, health or safety concern, or other issue.




Examples of concerns you can submit:

Billing or Documentation: Report concerns about accounting, billing, coding, or documentation for claims involving public healthcare funds.

Confidentiality: Report concerns about unlawful or inappropriate disclosure of sensitive information, including but not limited to protected health information, personally identifiable information or substance use treatment information.

Conflict of Interest: Report concerns about a potential conflict of interest involving another provider or a Vaya Health staff member, including but not limited to inappropriate gifts or donations.

Customer Service: Report a concern about the customer service provided by another provider or a Vaya Health staff member (for example, rudeness or inappropriate interaction).

Failure to Follow the Law: Report potential violation of laws, rules, regulations, policies, or standards that apply to the operations of Vaya Health or its providers.

Fraud or False Claims Act Violation: Report potential fraud (for example, billing for services not provided)

Health and Safety: Report a concern about member health, safety, or welfare.

Member Rights: Report a concern about potential violation of a member's rights, including but not limited to inappropriate use of restrictive intervention.

Misuse of Vaya Resources: Report unauthorized or fraudulent use of Vaya resources, facilities, equipment, or assets.

Quality of Care: Report concerns about the quality of care delivered by a Vaya Health contracted provider.

Other: Item that does not fit into any category above.

Report a Concern by Phone:

Dial toll-free, within the United States, Guam, Puerto Rico, and Canada:

866-916-4255

If you need help filing a complaint or grievance, please call Vaya Health’s toll-free, 24/7 Behavioral Health Crisis Line at 1-800-849-6127.