You must complete all required fields on the form as indicated in red


Online Provider Account Registration

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.

Need technical support?

Contact us for assistance with the following:
  • Identifying current site administrator
  • Changing site administrator accounts
  • Any other registration or
    maintenance questions

1. Practice Information
     Complete this section for all requests.

Facility/Practice Name Facility/Practice Name is required and cannot contain any special characters
Tax ID Tax ID is required and must be in xxxxxxxxx format (ex.123450001)
(Please do not include hyphens. To request access to multiple Tax IDs, email esupport@mvphealthcare.com)
NPI for a Provider Associated with Above Tax ID NPI is required and must be in xxxxxxxxx format (ex.1234500001)
Office Site Administrator Name

2. User Information

Level of Access Select Level of Access
First Name First Name is required and cannot contain any special characters Last Name Last Name is required and cannot contain any special characters
Email Address Email is required and must be in xxx@xx.com format (ex.test@mvp.com)
User's Phone Phone must be in xxx-xxx-xxxx format (ex.123-456-7890) Ext.
plus minus

3. Submit Electronic Signature

I, the requester for this access, am authorized by the group / physicians associated with the Tax ID listed above to request access to their provider online account access protected health information (PHI) through the provider portal on their behalf.

First Name First Name is required and cannot contain any special characters Last Name Last Name is required and cannot contain any special characters
Phone Phone must be in xxx-xxx-xxxx format (ex.123-456-7890) Email Email is required and must be in xxx@xx.com format (ex.test@mvp.com)
   I understand that checking this box constitutes a legal signature and hereby confirms that the above statement is true and accurate. Please accept Terms and Conditions