Coordination of Benefits (COB)
For help with coordination of benefits, call 1-800-556-2477.
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, call 1-800-452-6966 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
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
|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.
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 Essential Plan||1-888-723-7967|