Frequently Asked Questions
Browse the selection of frequently asked questions to learn more about our Provider services!
Call Provider Relations at 408.885.2221 if you have any questions or if you need help with any other health plan matter. For the hearing and speech impaired, call the California Relay Service (CRS) by simply dialing 711 or the 800 CRS number of your modality. You can also submit any question or concerns electronically to Provider Relations by using our online form.
Valley Health Plan works with Office Ally for electronic data exchange (EDI). Please contact Office Ally at 866.575.4120.
For electronic payments, please complete the EFT form and fax a copy along with a voided check to Provider Relations at 408.793.6648.
Please notify the VHP in writing whenever a change in any of the following occurs:
- Addition or deletion of clinic site
- Billing address or practice location change
- Board certification or eligibility status change
- Change in Tax Identification Number (TIN)
- Hospital affiliation
- Languages spoken in practice
- Name change
- New physicians or mid-level practitioners added to current practice
- Office hours
- Privileges and licensure status
- Professional malpractice or premise liability insurance
- Termination from employment
You can fax your submissions to Provider Relations at 408.793.6648 or submit your changes in writing to:
Valley Health Plan
Attn: Provider Relations
2480 N. First Street, Suite 200
San Jose, CA 95131
For questions regarding claim status or Remittance Advice (RA), please contact the Claims Department at 408.885.4563.
A Provider Dispute is a contracted or non-contracted provider’s written notice to the Plan challenging, appealing or requesting reconsideration of a claim that has been denied, adjusted, contested or seeking resolution. Please submit your written notice along with supporting documentation to:
Valley Health Plan
Attn: Provider Disputes
P.O. Box 28387
San Jose, CA 95159
You can verify eligibility online through Valley Express or you can contact Member Services at 408.885.4760 or 888.421.8444 (toll-free) for assistance.
The Provider Manual in the Provider area of the website. If you would like us to send you a hard copy, please request through Provider Relations at 408.885.2221 or use the Provider Contact form.
Valley Express is available to contracted Primary Care Physicians and selected specialists. To obtain the Valley Express log-in form, contact Provider Relations at 408.885.2221.
Any contracted Primary Care Physician you can utilize our on-line system, Valley Express. Complete a Treatment Authorization (TAR) form and fax your request to the VHP Utilization Management Department at 408.885.4875. If you need help accessing Valley Express, call Provider Relations at 408.885.2221.