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.
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.