Application

The Universal Credentialing Application

YMG contracts with over 25 managed care organizations (MCOs). All MCOs utilize a credentialing process before allowing providers to receive patient referrals and payment. Several plans have “delegated” the duties of credentialing to the YMG. To be reimbursed for services through these plans, you must complete the UCA.

With your completed UCA, you must also provide one clean and current copy of the following items:

  • State of Connecticut medical license
  • State of Connecticut Controlled Substance Registration
  • Federal DEA certificate with CT address 
  • Board certificates OR two letters of reference if NOT certified
  • Curriculum Vitae in month/year format
  • Malpractice insurance face sheet
  • Yale-New Haven Hospital privilege letter
  • Medical School diploma
  • NPI notification letter

The New Physician Practice Guide

The New Physician Practice Guide contains information essential to a smooth and complete entry process, and startup tips on how to build a clinical practice. Download the PDF.

CT DSS Provider Agreement

The CT DSS Provider Agreement is provided as INFORMATIONAL ONLY and will be submitted electronically on behalf of YMG physicians and non-physicians unless advised otherwise in writing to ymg.info@yale.edu.