Important MVP Policies for Providers
MVP Provider Policies, Payment Policies, Laboratory Policies, Medical Policies, and Pharmacy Policies
MVP Provider Policies, Payment Policies, and Laboratory Policies include revisions on operational procedures, plan type offerings, and clinical programs. The policies are designed to serve as a reference tool for Providers and facilities. Its purpose is to enhance and reinforce the understanding of the roles and responsibilities of MVP Participating Providers. In turn, this will help ensure that patients’ needs are met within the health care coverage provided by their MVP Health Benefits contract.
Current Provider, Payment, and Laboratory Policies
Provider Policies, Payment Policies, and Laboratory Policies are most compatible with the Chrome browser. For help viewing .PDF files in your browser, visit Adobe’s website.
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(Policies effective April 1, 2025)
| Contacting MVP Health Care (PDF) |
Updated 1/1/2025 |
| MVP Plan Type Information (PDF) |
Updated 1/1/2024 |
| Credentialing (PDF) | Updated 1/1/2025 |
| Provider Responsibilities (PDF) |
Updated 10/1/2024 |
| Inpatient and Outpatient Service Program (PDF) |
Updated 10/1/2024 |
| Pharmacy Benefits (PDF) |
Updated 10/1/2024 |
| Behavioral Health (PDF) |
Updated 4/1/2025 |
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New York State Government Programs (PDF) |
Updated 4/1/2025 |
| MVP’s Medicare Advantage Plans (PDF) |
Updated 1/1/2025 |
| Utilization and Case Management (PDF) | Updated 4/1/2025 |
| Claims (PDF) |
Updated 10/1/2024 |
| Quality Improvement (PDF) |
Updated 7/1/2024 |
| Appeals Process (PDF) |
Updated 4/1/2025 |
| National Vendors (PDF) |
Updated 1/1/2023 |
| Payment Policies (PDF) |
Updated 4/1/2025 |
| Laboratory Policies (PDF) |
Effective 4/1/2025 |
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Archive
- Laboratory Policies, Effective February 1, 2025 (PDF)
- Provider Policies, Effective January 1, 2025 (PDF)
- Payment Policies, Effective January 1, 2025 (PDF)
- Laboratory Policies, Effective September 15, 2024 (PDF)
- Provider Policies, Effective October 1, 2024 (PDF)
- Payment Policies, Effective October 1, 2024 (PDF)
- Provider Policies, Effective July 1, 2024 (PDF)
- Payment Policies, Effective July 1, 2024 (PDF)
- Laboratory Policies, Effective August 15, 2024 (PDF)
- Provider Policies, Effective April 1, 2024 (PDF)
- Payment Policies, Effective April 1, 2024 (PDF)
- Provider Policies, Effective January 1, 2024 (PDF)
- Payment Policies, Effective January 1, 2024 (PDF)
- Provider Policies, Effective October 1, 2023 (PDF)
- Payment Policies, Effective October 1, 2023 (PDF)
- Provider Policies, Effective July 1, 2023 (PDF)
- Payment Policies, Effective July 1, 2023 (PDF)
- Provider Policies, Effective April 1, 2023 (PDF)
- Payment Policies, Effective April 1, 2023 (PDF)
- Provider Policies, Effective January 1, 2023 (PDF)
- Payment Policies, Effective January 1, 2023 (PDF)
- Provider Policies, Effective October 1, 2022 (PDF)
- Payment Policies, Effective October 1, 2022 (PDF)
- Provider Policies, Effective July 1, 2022 (PDF)
- Payment Policies, Effective July 1, 2022 (PDF)
- Provider Policies, Effective April 1, 2022 (PDF)
- Payment Policies, Effective April 1, 2022 (PDF)
- Provider Policies, Effective January 1, 2022 (PDF)
- Payment Policies, Effective January 1, 2022 (PDF)
- Provider Policies, Effective October 1, 2021 (PDF)
- Payment Policies, Effective October 1, 2021 (PDF)
- Provider Policies, Effective July 1, 2021 (PDF)
- Payment Policies, Effective July 1, 2021 (PDF)
- Provider Policies, Effective April 1, 2021 (PDF)
- Payment Policies, Effective April 1, 2021 (PDF)
- Provider Policies, Effective January 1, 2021 (PDF)
- Payment Policies, Effective January 1, 2021 (PDF)