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Policies
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Description
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| All current MVP Health Care regulatory provider policies | |
| Medical and Pharmacy Policies (Formerly BIM) | All Current MVP Health Care Medical and Pharmacy Policies |
| Complete list of all MVP medical policies | |
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UM Policy Guides |
Description
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| Utilization Management Guides explaining authorization requirements | |
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Resources
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Description
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| Letter Template: ER Use | Physicians may download and customize this letter to address their patients’ possible alternatives to the emergency room. |
| List of current claims edits | |
| Auditing of Professional Service Claims Frequently Asked Questions (FAQs) | Questions and answers for health care providers about the auditing of professional service claims via OrthoNet. |
| Quick reference guide for MVP Health Care and MVP's National Alliance with CIGNA Healthcare | |
| Educational resources related to ICD-9 CM coding | |
| Radiation Therapy Frequently Asked Questions (FAQs) | EviCore Radiation Therapy Management Program Frequently Asked Questions (FAQs) |
| Radiology/Radiation CPT Code/Billable Groupings/Substitution Rules | Effective January 1, 2021 |
| MVP/eviCore 2022 Procedure Code Additions, Deletions, and Description Changes | Effective January 1, 2022 |
| MVP/evicore Radiology/Radiation Prior Authorization List | Effective January 1, 2023 |
| 5010 updates and FAQs | |
| Behavioral Health Prior Authorization List | List of behavioral health services requiring prior authorization. |
| Durable Medical Equipment Prior Authorization List (Effective October 1, 2024) | List of HCPCS codes requiring prior authorization for DME, Prosthetics, Orthotics, and Medical Supplies effective October 1, 2024 |
| Durable Medical Equipment Prior Authorization List (Effective January 1, 2025) | List of HCPCS codes requiring prior authorization for DME, Prosthetics, Orthotics, and Medical Supplies effective January 1, 2025 |
| In-Office Procedure List (Effective June 1, 2021) | List of codes for covered procedures effective June 1, 2021 |
| MVP Inpatient Surgical Procedure List (Effective May 1, 2023) |
List of Inpatient Surgical codes effective May 1, 2023 |
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Ambulatory Surgery List (Ends 7/31/17) |
List of codes for covered procedures effective February 1, 2015 to July 31, 2017 |
| List of codes for covered procedures, effective July 2019 | |
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Provider FastFax
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Description
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| FastFax | Important changes that are sent to physicians via fax regarding policy and procedure updates |
| FastFax - West Region | |
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Healthy Practices Newsletter
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Description
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Quarter 3, 2023 Healthy Practices Newsletter - Summer 2023
Quarter 2, 2023 Healthy Practices Newsletter - Spring 2023
Quarter 1, 2023 Healthy Practices Newsletter - Winter 2023
Quarter 4, 2022 Healthy Practices Newsletter - Fall 2022
Quarter 3, 2022 Healthy Practices Newsletter - Summer 2022
Quarter 2, 2022 Healthy Practices Newsletter - Spring 2022
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Healthy Practices is a quarterly publication for MVP Health Care® Providers. |
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NPI (National Provider Identifier)
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Description
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| Links, instructions, and updates related to applying for NPIs and relaying NPI-related information to MVP | |
| MVP specialty codes to taxonomy codes | |
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Other
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Description
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| MVP Professional Relations Representative territory listing by ZIP code |
