File a Grievance
We hope Vaya serves you well. If you are unhappy or have a complaint, you may talk with your PCP. You may also call Member Services at 1-800-962-9003 or write to Vaya Health, Grievance Resolution & Incident team, 200 Ridgefield Court, Suite 218, Asheville, NC 28806, at any time.
A grievance and a complaint are the same thing. Contacting us with a grievance means that you are unhappy with your LME/MCO, provider, or your behavioral health services. Most problems like this can be solved right away. Whether we solve your problem right away or need to do some work, we will record your call, your problem, and our solution. We will inform you that we have received your grievance in writing. We will also send you a written notice when we have finished working on your grievance.
You can ask a family member, a friend, your provider, or a legal representative to help you with your complaint or complaint process. If you need our help because of a hearing or vision impairment, or if you need translation services or help filling out any forms, we can help you. We can also help you fill out the form and understand the steps of the grievance process.
You can contact us by phone or in writing at any time:
- MAIL: Write to us with your complaint at Vaya Health, Grievance Resolution & Incident Team, 200 Ridgefield Court, Suite 218, Asheville, NC 28806.
- PHONE: Call Member Services at 1-800-962-9003, 24 hours a day, 7 days a week. After business hours, you may leave a message and we will contact you during the next business day. You can also call Vaya’s Grievance Resolution & Incident Team at 828-586-5501, extension 1600, or report concerns anonymously through Vaya’s toll-free, 24/7 Compliance Hotline at 1-866-916-4255.
- ONLINE: Visit the Vaya EthicsPoint compliance portal at vayahealth.ethicspoint.com (also allows you to report anonymously).
- BY EMAIL: Send an email to firstname.lastname@example.org.
Resolving Your Grievance
We will let you know in writing that we got your grievance within 5 days of receiving it.
- We will review your complaint and tell you how we resolved it in writing within 30 days of receiving your complaint.
- If your grievance is about your request for an expedited (faster) appeal, we will tell you how we resolved it in writing within 5 days of getting your complaint.
If you are not satisfied with how Vaya resolved your complaint, you may appeal our decision in writing within 7 calendar days from the date of the resolution notice or escalate your grievance to the North Carolina Department of Health and Human Services, NC Medicaid (Division of Health Benefits.
Vaya will review your appeal within 15 calendar days from the date we receive your request. Once a decision is made, Vaya will send you a written Appeal Resolution Notice, which informs you of our final decision, within the following 15 days. There is no further appeal at Vaya beyond this review.
For more information about escalating your grievance or appeal to NC Medicaid, you can contact the NC Medicaid Ombudsman at us at 877-201-3750 from 8 a.m. to 5 p.m., every Monday through Friday except for State holidays.