You must complete all required fields on the form as indicated in red
MVP's secure provider account offers online access to member eligibility, benefits, claims, check authorizations,
policy information and more.
To receive access, your practice and / or site must:
- Be credentialed with MVP (Participating Providers), or
- Have a paid claim with MVP (Non-Participating Providers)
Note: To view information for Cigna patients, please go to This link takes you away from MVP’s website.
Office Site Administrator / Individual User Website Access
i To request access for Individual Users acting on behalf of the named provider entity, this form must be
completed by the Office Site Administrator.
1. Practice Information
Complete this section for all requests.
2. User Information
3. Submit Electronic Signature