Provider Compliance
To ensure compliance with state and federal regulations, as well as to enhance service to our communities, Providers are expected to meet specific requirements throughout the year. Please carefully review these obligations and diligently complete all tasks relevant to your practice.
Maintaining Provider Information with MVP
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Credentialed Providers
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Registered Providers
Credentialed Providers
Credentialed Providers should regularly update and attest to their demographic details in the CAQH Provider Data Portal, which automatically syncs with MVP systems. Information received includes practice address, contact info, specialties, panel status, and languages. Behavioral Health Providers are encouraged to complete all relevant CAQH sections to help MVP Members find care. For details, review the CAQH Frequently asked questions or review the Provider Participation Guide.
Exceptions: Providers must use the MVP Provider Change of Information form with supporting documents to submit changes in the following scenarios:
- Billing address change: (TIN-Remit)
- Provider name change, specialty, or category change (i.e. Primary Care Physician or Specialist)
- Adding a new plan such as Government Programs after obtaining an MMIS number
Credentialed Providers
Registered Providers must keep their MVP information updated, including demographics, hours, participation status, and panel changes. Notify MVP promptly about group moves, payment details, specialty/category changes, or new plans accepted.
Submit demographic updates online using the Provider Change of Information form, which supports uploads for group changes. Accurate Provider data ensures compliance with Health Access Standards and helps MVP Members find care efficiently.
Provider Demographic Change Forms (All Regions)
Attac Consulting Group
MVP works with Attac Consulting Group to verify the accuracy of Provider demographic details and appointment availability shown on the Find a Doctor tool. Some Providers may be contacted by phone or fax and are asked to confirm or return the requested information to help ensure members have reliable access to care.
Update Your Access & Availability (Required Quarterly)
As an MVP Participating Provider, you must meet regulatory Access and Availability standards. Providers can update their panel status to reflect whether they are accepting new patients by modifying the relevant field in the CAQH Provider Data Portal and re-attesting their demographic information. Each re-attestation sends updated information to MVP, ensuring Members have current details about your practice.
| Plan Type | Product |
|---|---|
| Commercial or Self-Funded |
HMO Commercial Small/Large Group HMO Commercial Individual Student Health Plan EPO, PPO, ASO |
| Government Programs |
Medicaid Managed Care Child Health Plus (CHP) Health and Recovery Plan (HARP)/MVP Harmonious Plan |
| Essential Plan | Essential Plan (Follows NY Medicaid Health Access Standards) |
| Medicare | Medicare Advantage |
Other Resources
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Access comprehensive medical coding tools and education including Risk Adjustment education, comprehensive ICD-10-CM coding documentation tools, tips on best documentation practices and condition specific ICD-10-CM coding guidance on our Medical Coding page.
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COVID-19 Public Health Emergency (PHE) Unwind Updates
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MVP is committed to keeping Providers informed of changes that impact their practice and patients. One such change is Vermont Bill H.766, signed into law as Act 111.
Didn’t Find What You’re Looking For?
Most routine provider tasks can be completed through Availity self‑service. Use Availity to submit and check prior authorizations, verify member eligibility and benefits, review claim status, and access payment and remittance information—all in one place.