YMG Credentialing

The Credentialing department of the Yale Medical Group is responsible for review and verification of information collected from a health care provider who is intere sted in peer review and acceptance into the YMG Clinical Practice and in participating with managed care organizations. The YMG credentialing program supports the development and maintenance of credentialing and re-credentialing standards in accordance with the National Committee for Quality Assurance (NCQA) requirements, and ensures that members who seek care from the Yale Medical Group have adequate access to a qualified provider. 

The Credentialing staff collects required documentation and completes provider files, including but not limited to: obtaining primary source verifications of medical and professional licenses, medical education, residency, hospital privileges, board certification or eligibility, professional liability policy history and any applicable disciplinary actions. Secondary source verifications include obtaining copies of the provider's medical and/or professional license(s), DEA/State Controlled Substance certificates, professional liability coverage certificate and Curriculum Vitae and Work History (if applicable). Each provider must also submit a completed Universal Credentialing Application (UCA) and supportive documentation.



Physicians must be credentialed to be reimbursed for services.

Several plans have “delegated” the duties of credentialing to the YMG. To be reimbursed for services through these plans, you must complete the UCA.