Partners Health Management wants providers to be aware of the process for contacting Eligibility and Enrollment ahead of its pending merger with Vaya Health on Oct. 1, 2026.
Providers should use the designated Eligibility and Enrollment (E&E) support lines and contact information below, rather than calling E&E staff on their direct phone lines. This will ensure providers are connected to the appropriate staff for timely assistance.
What is happening?
Providers are being asked to call the E&E support lines, rather than calling E&E staff on their direct phone lines to ensure they are connected to the appropriate staff.
- For all member-related inquiries for dates of service on or after Oct. 1, 2026, contact Vaya Partners ACCESS Provider Services at 1-866-990-9712 or email EandE@VayaPartners.org.
- For inquiries regarding Partners members for dates of service before Oct. 1, 2026, continue using the Partners E&E State and Medicaid lines:
- Partners E&E State Line: 980-533-6196
- Partners E&E Medicaid Line: 980-533-6197
What is changing?
Upcoming State Enrollment Changes
Currently, Partners allows State enrollment requests to be processed up to seven calendar days after the date of service. Beginning Oct. 1, 2026, enrollment requests must be submitted within five business days after the date of service. Under the new process, weekends and holidays will not be counted when calculating the allowable backdating period.
Effective Oct. 1, 2026, Vaya Partners’ Conduent HSP claims system will allow Medicaid enhanced services to be processed for CDW without requiring a State enrollment layer. Providers will no longer be required to submit a request for a State layer solely for CDW tracking purposes. The Conduent HSP claims system (accessed via the Provider Portal, which will become ProviderCONNECT starting Oct. 1) will allow these services to be recognized without the additional State enrollment layer requirement.
Effective Oct. 1, 2026, State enrollment requests for members with active third-party insurance must include a service code from the NCDHHS bypass list. If a member has active third-party insurance and the service code is not included, the enrollment request will be returned to the provider with a note in the comments stating there is private insurance showing in NCTracks. The provider should follow up with the private insurance company for payment or provide the service code from the NCDHHS bypass list.
- Effective Oct. 1, 2026, providers will be able to post-date Target Populations up to 60 days in advance.
- Effective Oct. 1, 2026, all NC Support Needs Assessment Profile (NC-SNAP) assessments must be emailed to NCSnaps@VayaPartners.org.