From details on how to use our provider portal, to guides to MVP policies, MVP’s reference library offers quick access to a variety of helpful resources.

• Billing Procedures

  MVP’s Payor ID is 14165

  • Billing Edits Effective May 21, 2015 (PDF)

  Have a Transaction Account?

  Log in here if you have an existing account to submit 837 files or retrieve 835/999/277CA files. MVP is not currently accepting new applications for internet claim submissions.

  EDI Forms

  • Online EDI Enrollment
  • EDI Enrollment Form 835/ERA (PDF)

  EDI Guides

  • 5010 Secondary Payer and COB Rules (PDF)
  • EDI Error Codes (PDF)
  • Professional Implementation Guide—837 (PDF)
  • Testing & Implementation Guide—8371 (PDF)
  • Transaction Standard Companion Guide—270/271 (PDF)
  • Transaction Standard Companion Guide—276/277 (PDF)
  • Transaction Standard Companion Guide—835 (PDF)

  EDI Routine Maintenance Schedule

  • Upcoming Planned Downtime (PDF)

  Questions? Contact our EDI Service Department

  Call 1-877-461-4911 or email EDIServices@mvphealthcare.com

  
  

• Coding, Medical Record Documentation and Education

  Medical Coding and Training Resources

  • American Academy of Professional Coders (AAPC)
  • American Health Information Management Association (AHIMA)
  • Clinical Documentation ICD-10 (PDF)
  • Clinical Documentation Physician Tips (PDF)
  • HCC Training for Providers (PDF)
  • HEDIS 2017 Coding Reference Guide for OBGYN (PDF)
  • HEDIS 2017 Coding Reference Guide for Primary Care (PDF)
  • Medicare Learning Network

  If you feel your office would benefit from additional ICD-10-CM coding training, please contact our Medicare Risk Adjustment Team Trainers.

  West/Central Regions

  MaryEllen Reardon at (585) 279-8583 or mreardon@mvphealthcare.com

  East Regions

  Shannon Chase at (518) 386-7502 or schase@mvphealthcare.com

  Additional Resources

  • Durable Medical Equipment Prior Authorization List (PDF)
  • Medical Coding and Training Resources
  • Taxonomy Reference Site
  • Vermont Health Care Price and Quality CPT Codes (PDF)
  • Medical Records Requirements (PDF)

  Provider Education

  • Diagnosis Coding Principles (PDF)
  • Commandments of Coding (PDF)
  • Improving Clinical Documentation (PDF)

  Disease Specific Chapters

  1. Certain Infectious and Parasitic Diseases (PDF)
  2. Neoplasms (PDF)
  3. Diseases of the Blood and Blood-forming Organs and Certain Disorders Involving the Immune Mechanism (PDF)
  4. Endocrine, Nutritional and Metabolic Diseases (PDF)
  5. Mental, Behavior and Neurodevelopment Disorders (PDF)
  6. Diseases of the Nervous System (PDF)
  7. Diseases of the Eye and Adnexa (PDF)
  8. Diseases of the Ear and Mastoid Process (PDF)
  9. Diseases of the Circulatory System (PDF)
  10. Diseases of the Respiratory System (PDF)
  11. Diseases of the Digestive System (PDF)
  12. Diseases of the Skin and Subcutaneous Tissue (PDF)
  13. Diseases of the Musculoskeletal System and Connective Tissue (PDF)
  14. Diseases of the Genitourinary System (PDF)
  15. Pregnancy, Childbirth and the Puerperium (PDF)
  16. Certain Conditions Originating in the Perinatal Period (PDF)
  17. Congenital Malformations, Deformations and Chromosomal Abnormalities (PDF)
  18. Symptoms, Signs and Abnormal Clinical and Laboratory Findings (PDF)
  19. Injury, Poisoning and Certain Other Consequences of External Causes (PDF)
  20. External Causes of Morbidity (PDF)
  21. Factors Influencing Health Status and Contact with Health Services (PDF)

  
  

• ICD-10 Updates and FAQs

  The U.S. Department of Health and Human Services established a new set of standards for the electronic exchange of HIPAA transactions between providers and payers. Included in this new set of standards is support for ICD-10 (International Classification of Diseases, 10th Revision) codes, which provide a better definition of diagnoses and procedures. MVP will provide current news on ICD-10 information to help you move to ICD-10, and information on MVP’s implementation of ICD-10. Please check often for updates.

  ICD-10 Resources

  • 2016 ICD-10-CM Changes (PDF)
  • ICD-10 Issues: Questions and Answers (PDF)
  • ICD-10 Specialties Training Presentations

  
  

• Health Home

  • Health Home Upward Enrollment Referral Form (PDF)

  
  

• Guides to MVP Benefits & Plans

  • Harmonious Health Care Plan FAQs (PDF)
  • NY Marketplace Quick Reference Guide (PDF)
  • VT Marketplace Quick Reference Guide (PDF)

  
  

• Understanding MVP’s National Alliance with Cigna HealthCare

  • CIGNA Reference Guide (PDF)

  
  

• Learn about MVP Policies

  • Code of Ethics and Business Conduct Summary (PDF)
  • Corporate Code of Ethics and Business Conduct (PDF)
  • Detecting and Preventing Fraud, Waste and Abuse (PDF)
  • Independent Dispute Resolution Process for Emergency and Surprise Bills—Health Care Providers (PDF)
  • Medical & Pharmacy Policy Updates Archive
  • NPI Information

  
  

• Guides for Using Our Site

  • Authorization Look-up (PDF)
  • Electronic Claim Adjustment Request Form (CARF) (PDF)
  • Learn More About the New Menu Options (PDF)
  • Presentation: Setting Notification Preferences (PDF)
  • Summary of Provider Portal Enhancements (PDF)
  • Upcoming Planned Downtime (PDF)

  
  

Utilization Management

• Ambulatory Surgery List (Effective February 1, 2015) (PDF)
• Assistant Surgery List (Effective July, 2015) (PDF)
• Durable Medical Equipment Prior Authorization List (PDF)
• In-Office Procedure List (Effective January 1, 2017) (PDF)
• MVP Inpatient Surgical list (Effective August 1, 2017) (PDF)