Coordination of Benefits (COB) 

For help with coordination of benefits, call 1-800-556-2477

Credentialing 

Providers who would like to become an MVP Participating Provider can learn more on our Provider Credentialing page.

Customer Care Center for Members 

To find the appropriate Customer Care Center phone number for a Member, please refer to the back of their Member ID card. Providers can verify Member eligibility and benefits in their Provider online account, or by calling the MVP Customer Care Center for Provider Services at 1-800-684-9286.

Durable Medical Equipment (DME) 

For all MVP plan types, email authorizationrequest@mvphealthcare.com or fax 1-888-452-5947.

Hospital Billing Questions

Call MVP’s Provider Services at 1-800-684-9286, or contact us via mail at: 

MVP Health Care 
Hospital Billing Coordinator 
PO Box 2207 
Schenectady, NY 12301-2207

Pharmacy

MVP Formularies for all products are available on our Provider Pharmacy page

For formulary exception and prior authorization requests, a Medication Prior Authorization Request form should be submitted. This, and all medication request forms, can be found on our Provider Forms page

If you are submitting the form for a non-Medicare Member, please fax it to 1-800-376-6373. For Medicare, MVP Managed Medicaid, and Child Health Plus Members please fax the form to 1-800-401-0915.

Updating Your Online Demographics

Providers who wish to update their demographic or payment information with MVP should complete the Online Demographic Change Form.

For other matters, please email MVP Professional Relations

Utilization and Case Management

For Case Management, call 1-866-942-7966

Providers may call the MVP Customer Care Center for Provider Services at 1-800-684-9286, or fax utilization management (UM) requests to the appropriate number below.

Type of Request 
 Fax Number 
 Prior Authorization Request Forms or Out-of-Network Requests  1-800-280-7346  
 Acute Inpatient Concurrent Review  1-888-207-2889 
 SNF or Acute Rehabilitation  1-866-942-7826
 Commercial, ASO, and Medicaid Plans  1-866-942-7826
 Medicare, please contact naviHealth, Inc  1-844-411-2883

 

Please reference the Utilization and Case Management section of the Provider Policies for all other numbers related to Utilization and Case Management.

 

Services That Require a Referral for MVP Medicaid Managed Care 

Referrals are required to all specialties for Members who have a physician restriction. Providers should verify eligibility by calling MVP Customer Care Center for Provider Services at 1-800-684-9286

 

Behavioral Health

For behavioral health inquiries related to provider relations, contracting or credentialing, please call 1-800-684-9286

For behavioral health authorization requests, please refer to the table below: 

 

Plan Type Phone Number
MVP Child Health Plus 1-800-684-9286
MVP Harmonious Health Care Plan 1-800-684-9286
MVP Managed Medicaid 1-800-684-9286
NY Commercial 1-888-687-6277
NY Essential Plan 1-888-723-7967
NY Medicare 1-800-665-7924
NY Self-Funded 1-888-687-6277
VT Commercial 1-800-684-9286
VT Medicare 1-800-684-9286
VT Self-Funded 1-800-684-9286


Questions?

Call MVP Customer Care Center for Provider Services at 1-800-684-9286