Applied Behavioral Analysis (ABA) Prior Authorizations
ATTENTION: Viva Health will no longer provide retrospective authorizations for Applied Behavioral Analysis (ABA) therapy for Viva Health members.
Effective 09/01/2022, Viva Health will require a prior authorization for Applied Behavioral Analysis (ABA) therapy for Viva Health Members. Initial prior authorization requests can be obtained via phone or fax. For more information click here.
Real-Time Prescription Benefits
Providers treating Viva Medicare patients can use the real-time prescription benefit tool to see drug coverage information, patient cost, up to five alternatives specific to the patient’s plan, and other restriction such as prior authorizations and quantity limits.
For more information, click the links below.
Viva Health has selected Change Healthcare (formerly Emdeon) as its electronic payment and remittance reporting provider. Change Healthcare ePayment replaces paper-based claims payments with electronic (EFT) payments that are directly deposited into your bank account. To learn more about this service and how you can sign up, download this [PDF] document.
Change Healthcare (formerly Emdeon) is Viva Health's electronic payment and remittance administrator. There is no fee to use Change Healthcare (formerly Emdeon) ePayment. Enrollment is simple and free.
By enrolling with Change Healthcare, you can accelerate your reimbursement cycle, eliminate paper based claims payments, sorting mail, and making trips to the bank. In addition to receiving payments electronically, Change Healthcare ePayment users can search, view, and print electronic remittance advices (ERAs).
To get started, contact Change Healthcare: Phone: 1.866.506.2830 Fax: 615.238.9615 Online: www.changehealthcare.com Mail: Attention – Electronic Payment Service Enrollment P.O. Box 148850 Nashville, TN 37214 NOTE: If you have signed up for EFT please expect a return email from Change Healthcare verifying your bank account information. Please respond accordingly.
Medical Preferred Drug Program with Step Therapy
Effective January 1, 2022, Viva Health is adding a Medical Preferred Drug Program with Step Therapy requirements for our Medicare Advantage members. This program is already in place for our commercial members and applies to drugs administered by medical providers such as doctors and hospitals (not retail pharmacies). Click here for information about the program.
Pain Management Referrals Removed
Effective 7/1/20 Viva Medicare members will no longer be required to have a Primary Care Physician referral in order to see a Pain Management physician. Here is an updated copy of our 2020 Provider Reference Guide listing the services that require a prior authorization. Click here to view.
Participating Lab Usage
Viva Health is dedicated to working with you to ensure quality care is provided at the lowest cost possible to our members. We need help from you to continue this effort. According to your provider contract, you should only refer patients to participating providers, including lab services. If you use a non-par lab, look for communication from Viva Health regarding a change in our policy that may negatively impact your fee schedule. Our participating laboratories are listed in this document.
Provider Network Information
Recent changes to section 100.4 of the Medicare Marketing Guidelines now require Health Plans to contact network providers quarterly to verify the information listed in the Health Plan's provider directory.
You should have received a letter from us with the information we have on record for you.
If you have any changes, please email firstname.lastname@example.org or call Viva Health Customer Service at (205) 558-7474 or 800-294-7780. We will then update your information on our website.
Coordination of Benefits Update
Viva Health is proud to announce secondary HCFA and UB claims can now be filed electronically for all Commercial, Medicare, and Drummond lines of business. If you have any questions, please feel free to contact our Provider Customer Service department directly at (205) 558-7474.