MVP Health Care at a glance
| Legal name | MVP Health Care, Inc. |
|---|---|
| Also known as | MVP, MVP Health Plan |
| Category | Commercial |
| Parent organization | MVP Health Care, Inc. (nonprofit) |
| Claims payer ID | 14165 — registry reference; verify the member product, transaction and clearinghouse |
| Eligibility (270/271) payer ID | 14165 — registry reference; verify the member product, transaction and clearinghouse |
| ERA (835) payer ID | 14165 — registry reference; verify the member product, transaction and clearinghouse |
| NAIC company code | Not established in this registry |
| States covered | New York, Vermont |
| Members covered | ~700k members |
| Provider resource entry point | https://www.mvphealthcare.com/providers |
| Provider phone | 1-800-684-9286Provider Customer Care: 1-800-684-9286. The provider guidance directs claim-status inquiries to self-service rather than a live representative. |
Always verify claims-routing details against the member ID card and the payer's current EDI companion guide before submission.
Timely filing & appeals for MVP Health Care
MVP’s current public claims page states initial submission within 180 days of discharge or service. Corrected-claim and contractual adjustment instructions are separate. Product, participating/nonparticipating applicability and complete exceptions require the governing manual and provider agreement; no universal all-plan scalar is approved.
| Submission type | Window |
|---|---|
| Initial claim reference | Initial claims: 180 days from service or discharge; verify scope |
| Out-of-network initial claim | Verify the member's plan and applicable out-of-network rules |
| Secondary / coordination of benefits | Verify the allowed window and start event; a primary EOB does not automatically restart filing |
| Corrected claim | Verify correction instructions; do not substitute an appeal deadline |
| Reconsideration / appeal | Use the applicable denial or decision notice and the process below |
This registry has not established a payer-specific appeal ladder for MVP Health Care. Use the denial notice, plan document, provider agreement, or jurisdictional rule to assign the correct route and deadline. Missing registry evidence does not mean appeal rights are unavailable.
Source: MVP Health Care provider policy. Always confirm before disputing a TFL denial — payer policies are versioned and product-specific.
Prior authorization with MVP Health Care
Decision deadlines depend on the product, service and urgency. CMS-0057-F generally starts its decision-timeframe requirements in 2026 for Medicare Advantage, Medicaid and CHIP payers subject to the rule: seven calendar days for standard requests and 72 hours for expedited requests. Those requirements exclude drug authorizations and QHP issuers on the federally facilitated exchanges. Other plans, state rules and permitted extensions can differ. Check the applicable policy; a decision deadline is not a guarantee of approval.
CMS-0057-F decision-timeframe requirements and exclusions
Verify MVP Health Care electronic claims (837), eligibility (270/271), remittance (835) and authorization (278) separately for the member product and clearinghouse. Registry flags and routing references are not current transaction-complete approval. Confirm the companion guide, enrollment and applicable source findings below. A blank or unverified field does not establish that the transaction is unavailable. Authorization requirements and submission channels depend on the product, service and delegated reviewer. Verify the applicable policy before scheduling; a portal listing is not proof of X12 278 connectivity.
This registry does not provide a current prior-authorization code list for MVP Health Care. Start with the provider resources or the policy documents below, then confirm the applicable product, service and effective date. A resource link does not establish that a live code-lookup tool is available.
Top denial reasons for MVP Health Care
Per-payer denial benchmarks publish here once the QuickIntell anonymized ETL pipeline ingests sufficient MVP Health Care volume. Until then, see the broader CARC reference for industry-wide remediation guides.
Electronic claims, eligibility & ERA
| Transaction | Registry indication — not verification | Routing reference |
|---|---|---|
| 837P / 837I claims | Listed in registry; verify current scope | 14165 — registry reference; verify the member product, transaction and clearinghouse |
| 270 / 271 eligibility | Listed in registry; verify current scope | 14165 — registry reference; verify the member product, transaction and clearinghouse |
| 278 prior authorization | Listed in registry; verify current scope | Verify X12 278 routing separately |
| 835 ERA | Verify support and enrollment separately | 14165 — registry reference; verify the member product, transaction and clearinghouse |
Payer IDs vary by clearinghouse — confirm against your clearinghouse payer list (Availity, Change Healthcare/Optum, Waystar) before configuring submitter routing.
Source checks and remaining limits
The latest partial comparison is dated . Retained earlier findings keep their original dates below. This is a partial source check, not a whole-page, clinical or legal review. It does not refresh the legacy review date above.
provider_phone
Source comparison: 2026-09-26
Provider Customer Care uses 800-684-9286. Claim status is routed through self-service rather than a live representative.
Primary source for provider_phonetimely_filing_days
Source comparison: 2026-09-26
Current claims page states 180 days from discharge or service, rather than the stored 120. Corrected-claim and contractual adjustment rules are separate.
Primary source for timely_filing_daysportal_url
Source comparison: 2026-09-26
Official provider resources route routine claims, eligibility, authorization and remittance tasks to Availity. Authenticated transactions were not tested.
Primary source for portal_url
Not checked in this pass: Whole-record approval, legal identity, ownership and complete product coverage; Authenticated transactions and QuickIntell integrations; payer_ids.claims: No universal medical claims identifier established; preserve clearinghouse and product verification.; payer_ids.eligibility / payer_ids.era / era_payer_id: No transaction-specific universal eligibility/ERA identifier established; do not copy a claims ID.; electronic_claims_supported / supports_279_271 / supports_278: No blanket transaction-capability or QuickIntell connectivity certification; unauthenticated resources do not establish all stored flags.; appeal_levels / prior_auth_required_codes_sample / qi_module_coverage: No new approval of appeals, code-specific authorization or product integrations in this bounded pass..
Sources used for this guide
State coverage
MVP Health Care operates in the following states. Each link opens state-level Medicaid program details, dominant commercial payers, and state-specific RCM regulations.
Evaluate QuickIntell workflow fit for MVP Health Care
These module references are evaluation starting points, not evidence of a validated connection, supported transaction or customer deployment. Confirm the actual member plan, data access and product scope first.
- QuickRCM
Evaluate claim preparation, follow-up and denial worklists for MVP Health Care; verify the actual plan rules and available connections before implementation.
- QuickAuth
Assess authorization-packet and status workflows for MVP Health Care; confirm product, service, delegated reviewer and permitted submission channels.
- QuickERA
Verify the actual 835 files, posting exceptions and reconciliation requirements for MVP Health Care before evaluating automation. An ERA identifier alone does not establish supported ingestion or posting.
Frequently asked questions about MVP Health Care
Where is the MVP Health Care provider portal?
Use https://www.mvphealthcare.com/providers as a starting point for MVP Health Care provider resources. This link may open a directory or contact page rather than a transaction portal. Select the applicable product and administrator, then verify the available functions, enrollment and access requirements. QuickIntell is not the official payer portal.
What is the timely filing limit for MVP Health Care?
MVP’s current public claims page states initial submission within 180 days of discharge or service. Corrected-claim and contractual adjustment instructions are separate. Product, participating/nonparticipating applicability and complete exceptions require the governing manual and provider agreement; no universal all-plan scalar is approved.
What is the MVP Health Care payer ID?
Claims: 14165 — registry reference; verify the member product, transaction and clearinghouse. Eligibility (270/271): 14165 — registry reference; verify the member product, transaction and clearinghouse. ERA (835): 14165 — registry reference; verify the member product, transaction and clearinghouse. Do not substitute a claims ID for an unverified transaction ID. Check current source findings and the member ID card before submitting.
Does MVP Health Care accept electronic claims?
Verify MVP Health Care electronic claims (837), eligibility (270/271), remittance (835) and authorization (278) separately for the member product and clearinghouse. Registry flags and routing references are not current transaction-complete approval. Confirm the companion guide, enrollment and applicable source findings below. A blank or unverified field does not establish that the transaction is unavailable.
How do I appeal a MVP Health Care denial?
This registry has not established a payer-specific appeal ladder for MVP Health Care. Use the denial notice, plan document, provider agreement, or jurisdictional rule to assign the correct route and deadline. Missing registry evidence does not mean appeal rights are unavailable.
How long do MVP Health Care prior authorization approvals take?
Decision deadlines depend on the product, service and urgency. CMS-0057-F generally starts its decision-timeframe requirements in 2026 for Medicare Advantage, Medicaid and CHIP payers subject to the rule: seven calendar days for standard requests and 72 hours for expedited requests. Those requirements exclude drug authorizations and QHP issuers on the federally facilitated exchanges. Other plans, state rules and permitted extensions can differ. Check the applicable policy; a decision deadline is not a guarantee of approval.
What is the MVP Health Care provider phone number?
This registry lists 1-800-684-9286 as a contact reference for MVP Health Care. Provider Customer Care: 1-800-684-9286. The provider guidance directs claim-status inquiries to self-service rather than a live representative.
Automate workflows around MVP Health Care requirements
Connect eligibility, prior authorization, pre-submission claim checks, and remittance routing in one governed workflow. Payer and plan configuration is confirmed during implementation.
Disclaimer
This page is operational reference for medical-billing professionals. It is not legal, clinical, or contractual advice. Payer policies change without notice — always verify against MVP Health Care's current published documents before submission. CPT® is a registered trademark of the American Medical Association.