Vaya Health is a public managed care organization (MCO) contracted with the North Carolina Department of Health and Human Services to manage mental health, substance use disorder and intellectual/ developmental disability services paid with federal, state, and local funding, including Medicaid fund. Think of us as part government agency and part insurance company. All the money we manage is for serving the health care needs of you and others in your community. The better we manage that money, the more services and programs we can provide.
NAVEX is a third-party vendor Vaya Health uses to manage risk and compliance. They provide a unified view of across our business, giving us the power to gain organizational insight, increase operational efficiencies, and make informed decisions with confidence.
Vaya is committed to the highest values of integrity, ethics and caring. Our goal is to ensure high quality care and accountable financial stewardship through ethical, responsive, transparent and consistent leadership and business operations. Medicaid fraud is a serious problem that costs taxpayers billions of dollars every year. Vaya is dedicated to preventing Medicaid fraud and identifying potential fraud whenever it occurs.
Pursuant to our Non-Discrimination policy, Vaya has zero tolerance for unlawful discrimination or harassment of any kind. Vaya does not discriminate against members, recipients, providers, employees, or applicants in the provision of services or administration of any Vaya Health Plan, including but not limited to any clinical, marketing, and care management programs offered by Vaya or its network providers to our members.
In situations where you prefer to place an anonymous report in confidence, you are encouraged to use this hotline, hosted by a third-party hotline provider, EthicsPoint. The information you provide will be sent to us by EthicsPoint on a totally confidential and anonymous basis if you should choose. You have our guarantee that your comments will be heard.
FOR OUR MEMBERS, PROVIDERS AND COMMUNITY PARTNERS: We want you to let us know if you have any concerns about fraud, waste or abuse of public funds, inappropriate or questionable billing practices, member rights violations, health and safety issues, quality of care, poor customer service, provider behavior, or any other concern, complaint or grievance about Vaya Health or about our contracted providers. You can also ask for guidance related to compliance issues and share positive suggestions and stories. We also make sure that anyone who reports a concern, complaint or grievance does not experience harassment or retaliation of any kind.
While you can always call our Provider Line at 828-225-2785 ext.1512., we encourage you to use this hotline, which is hosted by a third-party vendor, EthicsPoint. This hotline allows you to place an anonymous report in confidence if you wish. The information you provide will be sent to us by EthicsPoint on a totally confidential and anonymous basis if you should choose. You have our guarantee that your comments will be promptly addressed.
FOR OUR EMPLOYEES AND CONTRACTED VENDORS: Vaya is committed to an environment where there are no barriers to open, honest communications. We maintain an Employee Handbook and Code of Ethics that outlines general guidelines for conducting business with the highest ethical standards, including how to avoid and report potential conflicts of interest. We want you to feel comfortable in approaching your supervisor or management in instances where you believe violations of policies or the code of conduct have occurred. Vaya’s non-retaliation policy ensures that employees who report potential violation(s) in good faith will not be disciplined or otherwise retaliated against.