Online Resources for Providers

Policies
Description

Provider Resource Manual

All current MVP Health Care regulatory provider policies
BIM Benefits Interpretation Manual

Medical Policies and Policy Summary Updates

Complete list of all MVP medical policies

UM Policy Guides

Description

New York

Vermont

Utilization Management Guides explaining authorization requirements
Resources
Description
Letter Template: ER Use Physicians may download and customize this letter to address their patients’ possible alternatives to the emergency room.

Custom Claim Edits

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.

CIGNA Reference Guide

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-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 Central

5010 updates and FAQs
Behavioral Health Prior Authorization List List of behavioral health services requiring prior authorization.
Durable Medical Equipment Prior Authorization List (Effective April 1, 2024) List of HCPCS codes requiring prior authorization for DME, Prosthetics, Orthotics, and Medical Supplies effective April 1, 2024
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

Ambulatory Surgery List (Ends 7/31/17)

List of codes for covered procedures effective February 1, 2015 to July 31, 2017

Assistant Surgery List

List of codes for covered procedures, effective July 2019
Provider FastFax
Description
FastFax Important changes that are sent to physicians via fax regarding policy and procedure updates
FastFax - West Region
Healthy Practices Newsletter
Description

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

 

Healthy Practices is a quarterly publication for MVP Health Care® Providers.

Sign up to recieve Healthy Practices via email.

NPI (National Provider Identifier)
Description

NPI Resource Center

Links, instructions, and updates related to applying for NPIs and relaying NPI-related information to MVP

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