Vaya’s Utilization Management (UM) program helps us make good decisions about your health care and spend limited taxpayer dollars responsibly. Our UM clinicians evaluate the medical necessity of requested services and help ensure services are appropriate and effective.
Vaya’s UM program complies with North Carolina Department of Health and Human Services requirements. Our UM Policy and Program Description describes the program’s goals, how we review and make decisions about requests for services, UM staff requirements, the appeals process, and more.
If you have questions, please call our Member and Recipient Service Line at 1-800-962-9003.
