| Policies |
Description |
|
MVP Provider Policies
|
All current Provider, Payment, Laboratory, Pharmaceutical and Medical Policies. |
| Medical and Pharmacy Policies (Formerly BIM) |
All Current MVP Health Care Medical and Pharmacy Policies |
|
Medical and Pharmacy Policy Update Summaries
|
Medical Policies and Pharmacy Policies with updates indicated |
| UM Policy Guides
|
Description |
|
New York (PDF) |
Utilization Management Guides explaining authorization requirements for New York State. |
|
Vermont (PDF) |
Utilization Management Guides explaining authorization requirements for Vermont. |
| Resources |
Description |
| Letter Template: ER Use (Doc) |
Physicians may download and customize this letter to address their patients’ possible alternatives to the emergency room. |
|
Custom Claim Edits (PDF)
|
List of current claims edits |
| Auditing of Professional Service Claims Frequently Asked Questions(PDF) |
Questions and answers for health care providers about the auditing of professional service claims via OrthoNet. |
|
CIGNA Reference Guide (PDF)
|
Quick reference guide for MVP Health Care and MVP's National Alliance with CIGNA Healthcare |
|
Medical Coding Training and Resources
|
Educational resources related to ICD-10-CM coding |
| Behavioral Health Prior Authorization List (PDF) |
List of behavioral health services requiring prior authorization. |
| Durable Medical Equipment Prior Authorization List (PDF) (Effective January 1, 2025) |
List of HCPCS codes requiring prior authorization for DME, Prosthetics, Orthotics, and Medical Supplies effective January 1, 2025 |
| Durable Medical Equipment Prior Authorization List (PDF) (Effective April 1, 2025) |
List of HCPCS codes requiring prior authorization for DME, Prosthetics, Orthotics, and Medical Supplies effective April 1, 2025 |
| In-Office Procedure List (PDF) (Effective June 1, 2021) |
List of codes for covered procedures effective June 1, 2021 |
| MVP Inpatient Surgical Procedure List (PDF)(Effective May 1, 2023) |
List of Inpatient Surgical codes effective May 1, 2023
|
| Provider FastFax |
Description |
| FastFax |
Important changes that are sent to physicians via fax regarding policy and procedure updates |
| Healthy Practices Newsletter |
Description |
|
Healthy Practices Newsletter - Winter 2025
|
Healthy Practices is a quarterly publication for MVP Health Care® Providers.
Sign up to recieve Healthy Practices via email.
|
| NPI (National Provider Identifier) |
Description |
|
Taxonomy Code Crosswalk
|
MVP specialty codes to taxonomy codes |
| Other |
Description |
|
Territory Lists and Contact Information
|
MVP Professional Relations Representative territory listing by ZIP code |
