Important Updates

Published January 2023

MVP Health Care® (MVP) is pleased to welcome Chiropractic and Acupuncture Providers to its network in the State of New York effective January 1, 2023. To provide our Members with the highest quality care, we believe all health care should be integrated and viewed as equal components of overall well-being.

MVP had contracted with eviCore healthcare MSI, previously known as Landmark for chiropractic and acupuncture services on behalf of MVP.

Register for an MVP Online Provider Account

To get started with MVP, visit mvphealthcare.com/ProviderRegister, to create an MVP Provider Online Account to check claim status, determine Member eligibility, and much more.

In 2022, MVP welcomed a new Chiropractic and Acupuncture network in the state of Vermont. We are thrilled with these partnerships.

Published January 2023

Online Resources for our new and existing Providers.

MVP has developed a dedicated MVP Provider Onboarding resource which outlines everything Participating Providers need to do to get started with MVP as well as to acclimate you to the many resources available on our website. Whether you’re brand new to our network, have added a new provider to your practice, or just need refresher, we encourage everyone to explore this information to maximize your partnership with MVP. This information can be found at mvphealthcare.com/onboarding.

Access Onboarding Resources

Our Provider Onboarding resources are broken down into three sections:

1. Getting Started
   Create an MVP Provider online account to check claim status, determine Member eligibility, and much more. You can also set up electronic claim submission and payments.


2. Required Training and Attestations 
   To make sure that all Providers are in good standing with state and federal regulations and guidelines, MVP has outlined all required attestations. Some of these trainings are required on an annual basis and some are a one-time requirement. 


3. MVP Resources 
   MVP has many resources available to help Providers stay informed and connected with us. Learn how to access our MVP Provider and Payment policies, Provider communications, forms, and more. You will also find educational materials for how to navigate your new MVP Provider Online Account and resources to help maintain your relationship with MVP.
   We hope that you find this information helpful no matter where you are on your journey with MVP, and that you bookmark this page as a resource for helpful information.

We hope that you find this information helpful no matter where you are on your journey with MVP, and that you bookmark this page as a resource for helpful information.

Published January 2023

MVP understands the increasing demands on Providers when it comes to meeting patient needs. Between the health crisis emergency we’re facing, where primary care practices do not have the ability to keep up with demand, and the over utilization of Emergency Rooms and Urgent Care facilities,the health care system is overwhelmed. To help ensure your patients get the care they need, we ask you to consider recommending Gia to MVP Members. Gia is a mobile app that allows Members to speak to doctors who can triage Members and help them get the care they need, either by answering questions, diagnosing when possible, or referring to in-person care from nearby doctors, specialists, labs, and pharmacies.

By meeting our Members’ needs, we are removing the barriers to care – so your patients stay more engaged with their health care.

Published January 2023

Effective January 1, 2023, MVP’s Managed Medicaid and HARP products will cover Gambling Disorder Treatment provided by Office of Addiction Services and Supports (OASAS) certified programs.

Published January 2023

In October 2022, MVP sponsored Rochester’s first annual Fall Fest, featuring family-friendly activities, games, inflatables, performers and fall treats. The free festival took place in the heart of downtown Rochester, bringing the “farm to the city of Rochester” and providing an inclusive opportunity for families from all parts of the community to get outside and enjoy the season. MVP is grateful for the longstanding partnership it has with the city of Rochester.

Published January 2023

On November 30, 2022, MVP Team Members gathered in Waterford, New York to support Toys For Tots. The team helped to organize and prepare toys that have been donated by various organizations and individuals. Our hope was to do our part in giving a better holiday to children in need in our community.

Published October 2022

The global coronavirus pandemic has played a significant role in complicating the management of chronic conditions. Balancing the need to protect people from COVID-19 while managing their chronic conditionshas been the challenge from the start.Heart disease, diabetes,COPD,obesity, and chronic kidney disease have emerged as important risk factors for severe illness from the COVID-19 infection. Althoughrapid innovationslike telehealth havegiven providers the ability to care forpatients virtually, many adults have simply delayed or foregonecare in fear of exposure to COVID-19.

How COVID-19 can increase the risk of new or worsening chronic conditions

Diabetes: Delaying preventive and routine care visits has led to a rise in undiagnosed diabetesand an increase in uncontrolled blood sugar levels among those already diagnosed. A study published by the CDC showed that approximately 40% of more than 10,000 people who died of COVID-19 had diabetes, one of many conditions that can increase a person’s risk of severe illness tied to the disease. And though much focus has been on how COVID-19 impacts people who already have diabetes, there is evidence that suggestsCOVID-19 itself may fuel new diabetes cases.

Respiratory Diseases: COVID-19 makes people with asthma or COPD particularly vulnerable to complications such as blood clots, pneumonia, and acute respiratory distress syndrome. Pandemic practices such as wearing masks have brought people around to adhering to the same precautions that people inflicted with these conditions have followed for years. Improved messaging will be necessary for the public to adhere to social distancing and mask wearing as other airborne disease threats occur in the future.

Cancer:Decreases in cancer screenings have occurred during the pandemic. In many instances, healthfacilities have had to redeploy care personnel from their cancer centers to other areas to address hospital staff shortages.Other factors include national nursing shortages as well as the shut-down of in-person clinics.Such factors have led to a steep decline in the detection of new cancer cases, at least someof which may be found later at a more advanced stage.

Moving forward

COVID-19 has taught us important lessons that apply to chronic-disease care. We must remember that marginalized populations are particularly vulnerable, as they often lack optimal patient health care and are disproportionately impacted by both chronic conditions and COVID-19. Social Determinants of Health (SDOH), which are factors that influence health where people live, and can create challenges like overcrowded or unsafe housing, limited access to health care, lack of healthy food and other root causes. Consider collaborating with community partners to address SDOH that prevent good health. Continue to coach and educate patients in behavior changes and self-management. At the end of the day, they are the most important person in managing and preventing chronic illness.

Source: U.S. News A World Report How COVID Has Impacted Chronic Disease By Steven Ross Johnson, published March 10, 2022.

Published October 2022

MVP’s contracted Providers have an online resource for processing Medicare Part D Vaccine claims electronically. TransactRx Part D Vaccine Manager provides physicians with real time claims processing for in-office administered vaccines. This online resource helps to reduce the current challenges in providing Medicare Part D vaccines and vaccine administration reimbursement to our Members. Enrollment in TransactRx is available at no cost to physicians or patients. After completing a simple one-time online enrollment process at enroll.mytransactrx.com physician offices can:

• Verify Members’ eligibility and benefits in real-time.
• Advise Members of their appropriate out-of-pocket expense
• Submit vaccine claims electronically.
• Receive reimbursement information in real-time.

Physicians should select an authorized staff member who will be the primary user of the system to enroll the practice. This person should be prepared to provide the following information about the practice:

• Tax identification number
• National provider identifier(s) (NPI)
• Medicare ID number
• Drug Enforcement Administration (DEA) number
• State medical license number

When using TransactRx Part D Vaccine Manager to file a Medicare Part D Vaccine claim, physicians will be reimbursed according to MVP’s reimbursement schedule, less the Member’s co-pay. TransactRx cannot be used to bill the administration and cost of Medicare Part B covered vaccines (e.g., influenza vaccine, pneumococcal vaccine, or Hepatitis B vaccine for high or intermediate risk individuals).

Using TransactRx will ensure your patient pays the correct cost-share. If TransactRx is not used, there is a possibility that the Member may incur additional out-of-pocket costs that they will have to submit a reimbursement to recoup.

For questions related to enrollment and claims processing, call Dispensing Solutions’ customer support center at 1-866-522-3386 (EDVM). You can also contact the Professional Relations Service Center at 1-585-325-3114 or 1-800-999-3920 or email us at professionalrelations@mvphealthcare.com.

Published October 2022

MVP offers a Dual Special Needs Plan (D-SNP) for enrolled individuals dually eligible for Medicare and Medicaid in the Capital Region and the Hudson Valley. D-SNPs are a type of Medicare Advantage (MA) plan designed for individuals with special needs focusing on intensive care coordination.

As of November 1, 2022, to participate in MVP’s Dual Access network, Providers must participate in both the MVP Medicare Advantage and MVP Medicaid networks. Some exceptions exist for providers who offer Medicaid-only services.

As a reminder:

• Providers cannot collect any cost share from these patients
• Participating Providers are asked to complete an annual course to learn about their important role in the care team of D-SNP Members. Access it at mvphealthcare.com/DSNPeducation.
• Be sure to bill and send prescriptions to the pharmacy using the Member Medicare ID card.
• Be sure to submit prior authorization requests using the Member Medicare ID card.
• Follow Medicare billing and coverage practices, including billing for immunizations through the Part D benefit where applicable.

If you have any questions, please contact your MVP Professional Relations Representative.

Published July 2022

MVP Health Care® (MVP) offers a variety of classes and workshops at all activity levels for the people in the communities we serve. Living Well means being informed about the best ways for them to take care of themselves —physically, emotionally, financially, or otherwise.We recognize that your patients may need extra support these days, and we encourage you to make them aware of the many virtual classes and workshops available from MVP.

To learn more about MVP’s Living Well Programs, visit mvphealthcare.com/calendar and please encourage your patients to participate throughout the year.

Published July 2022

To continue the theme of good health for all, MVP has partnered with the National Fitness Campaign (NFC)to bring outdoor fitness courts to cities within New York. Thirteen new free fitness courts (and counting!) are opening starting as early as this summer in communities across MVP service areas. MVP is also actively working to develop future sites in Vermont.

The fitness courts are for people of all ages and abilities and no extra equipment is necessary. Participants will get a great workout using their own body weight and will have access to a free fitness court app that will coach them along the way. 

We encourage you to tell your patients about these new courts opening within the areas they live and work. The new fitness courts will beginappearing in the following locations from now through September2022:

• Haverstraw, NY
• Brockport, NY
• Greece, NY
• Schenectady Community College, NY
• City of Schenectady, NY
• City of Troy, NY (4 Fitness Courts)
• Amsterdam, NY
• Town of Union, NY
• City of Rochester, NY
• West Seneca, NY
• Rosendale, NY
• Albany College of Pharmacy, NY
• Depew, NY
• Sardinia, NY
• Monticello, NY

National Fitness Campaign (NFC) is a wellness consulting firm – founded in San Francisco, California in 1979 – that offers grant funding, project management and master planning services to cities, schools, and sponsors to build healthy communities.

For more information about the MVP Fitness Courts visit, nationalfitnesscampaign.com/newyork.

Published July 2022

Most people recognize that physical activity plays a role in their overall health, but they are not always committed to making meaningful changes to be more physically active. Evidence proves that physical activity is an extension of medical health and can help prevent serious health conditions such as heart disease, obesity, diabetes, and stroke. So how do you sell exercise to patients that are not convinced they want to buy it?

Providing Motivation for your Patients

Providers must consider what motivates or contributes to the overall happiness of the patient. When it comes to the discussion of exercise, studies show that providers must promote the idea of choice for their patients to impact long term success.

“Framing” allows you to narrow and pinpoint what problem you are solving. Better framing leads to better solutions.For example, studies have shown that if you recommend that your patients walk for fun versus walk for exercise, the likelihood of sustaining the activity and having better health outcomes may increase. By “marketing” exercise for pleasure or as quality time with friends and family you can potentially net better results.

Additionally, patients need evidence that they are making progress. If they have to wait for “proof” (weight loss, lower blood pressure or improved cholesterol) you run the risk that they might quit. By promoting the value of feeling better, or lifted mood through exercise, you are providing them with positive results that can be immediately recognized.

The American College of Sports Medicine published an article containing six evidence-based issues to help clinicians understand how to make physical activity more motivating for patients to sustain. The article titled From a Vital Sign to Vitality: Selling Exercise So Patients Want to Buy It can be found at acsm-csmr.org.

Published July 2022

On July 16, the National Suicide Prevention Lifeline (NSPL) will launch 988 as the new three-digit dialing code available toeveryone across the U.S. “988” will route callers directly to theNSPL and will provide free and confidential emotional supportto people in suicidal crisis or emotional distress 24 hours a day,7 days a week. Every year, more people die by suicide than incar accidents, and suicide is the second-leading cause of deathamong young people in the U.S. By promoting this resource toyour patients, you will assist in connecting them to mental healthresources in their time of need. Find out more about The Lifelineand 988 by visiting suicidepreventionlifeline.org/currentevents/the-lifeline-and-988.

Published April 2022

MVP Health Care® (MVP) is collaborating with BioReference Laboratories, Inc. to offer MVP Members medically necessary COVID-19 PCR testing, bloodwork, and other diagnostic tests in the comfort of their homes. MVP is utilizing Scarlet Health®, BioReference’s on-demand, fully integrated digital solution that offers specimen collection at a convenient location of your patients’ choosing such as their home or workplace.

As we learned in the recent MVP podcast: Exploring the Virtual-to-Physical Care Continuum, patients desire availability, which is a component of access, convenience, and value. Scarlet gives patients an easy option to stay current with their laboratory testing which may not only lower costs but may also lead to improved health outcomes and happier patients. When you tell your patients about Scarlet, you not only give them the choice of convenience and peace of mind, you may also reduce the unfilled lab test gap.

Providers who want to make this part of their regular workflow may email hello@scarlethealth.com for more information. However, patients can still take advantage of this service even if you’re not contracted with Scarlet Health. Just be sure to click the print button instead of automatically sending the order to a lab. Give the printed lab order to the Member so they can share it with Scarlet.

After the test is complete, lab results will be sent to the ordering provider via fax or secure email. Patients may access their test results via the secure, HIPAA-compliant BioReference Patient Portal.

Learn more about Scarlet.

Exploring the Virtual-To-Physical-Care Continuum

Published April 2022

Last quarter, MVP launched Part 1 of our podcast with Dr. Kim Kilby, Vice President, Medical Director for Health and Well-Being at MVP, and Dr. Tucker Slingerland, CEO of Hudson Headwaters Health Network in upstate New York. Together, they discussed telehealth in general, and how we can all work together to achieve an optimal virtual-to-physical care continuum in the future.

We are proud to present Part 2. In the conclusion of their conversation, we’ll hear about how in person visits and virtual care can work together for the best patient care. The doctors also discussed other challenges and foreseeable changes as health care continues to adapt to our ever-changing environment. Access both podcasts at mvphealthcare.com/providers/podcast.

Published April 2022

As part of your agreement with MVP, Providers that are enabled to submit claims electronically must do so. To ensure the claims submission and remittance process is as easy for Providers as possible, MVP is reviewing and enhancing its digital strategy and capabilities related to these processes. Providers are encouraged to take advantage of the many digital options available which helps to streamline the process – through our online claims keying tool, direct 837 submission to MVP, or through a billing service or clearinghouse of your choice.

As a result of this review, we are updating our list of preferred clearinghouses to ensure our Providers receive the highest quality service from these vendors. Over the next few months, you may receive a notification from your clearinghouse stating MVP has ended its relationship with them. However, this will not impact your ability to submit claims to MVP. Providers can use any claims clearinghouse vendor and the claims will be submitted to MVP. Regardless of if MVP is contracted with a specific clearinghouse, your submission process does not need to change, and the service, including response times, should not be impacted.

There are many ways to submit claims to MVP – the use of a clearinghouse is just one way. MVP also encourages providers to receive remittance electronically, which helps to expedite payment. Learn more about how to submit claims and receive remittance electronically at mvphealthcare.com/providers/education.

Published April 2022

Effective immediately, please call the MVP Customer Care Center for Provider Services at 800-684-9286 for calls related to Durable Medical Equipment (DME) inquiries. MVP has discontinued the use of the former DME phone number, 800 452 6966, as of April 1, 2022.