The Affordable Health Care for America Act will certainly change the health landscape over the next several years. The law’s numerous provisions are effective at different times between now and 2020 and some provisions are phased in over a number of years. Click here for the full article.

While there are many unanswered questions that should be addressed in the regulations being written now, below is a brief summary of the law’s key provisions for health plans. Please click here to read further about the changes.

Claims with Drug Codes Require NDC Codes

(Effective July 1, 2017), Viva Health will begin requiring NDC codes on all claims submitted with drug codes. Omission of the NDC code may result in a delay in payment.

To ensure a smooth transition, Viva Health encourages all providers to begin adding NDC codes to their paper and electronic claims immediately. To see more information about this change, click here.


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 use this online form to send us the correct information. We will then update your information on our website.

Continued Affiliation Letters

Thank you for agreeing to participate in this outreach campaign. Please click here to access the secure submission site.

Injections Requiring Prior Authorization

(Effective 1/1/16) At Viva Health, we strive to keep our provider network informed of any changes. Most of you may currently obtain prior authorizations for administered injections.

Download list of injection, infusion, and supply codes
that require prior authorization.
Surgical Codes Requiring Prior Authorization

(Effective 1/1/16) Viva Health has added new surgical codes to our list of codes that require a prior authorization.

The codes listed in red are the codes that have recently been added. You will also find this change reflected on your Quick Reference Guide under “Most in office Surgeries”. This listing will also be updated and posted to our website at You may also receive a visit from your Provider Services Representative.

The procedure for obtaining a prior authorization remains the same. If you have any questions, concerns or issues please contact Provider Services via email at, by fax at 1-205-558-7477, or by phone at 1-800-294-7780.


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. You can also enroll online at

NEWLY COVERED PREVENTIVE SERVICES FOR MEDICARE RECIPIENTS Viva Medicare members and providers may access information on services (or benefits) that are now covered for Viva Medicare members at no cost to the member by clicking the applicable link below:

Members Click Here      Providers Click Here