The Credentialing Process
Obtaining Your Billing Provider Numbers
YMG physicians must complete the Universal Credentialing Application in its entirety to receive a Yale billing number, Medicare provider number, and Medicaid provider number.
For questions or to check the status of your application, contact your Managed Care Coordinator
Click here to download the UCS.
In today's managed care environment, it is necessary for a provider to be credentialed in order to be correctly reimbursed for clinical services. YMG has developed a centralized credentialing process.
1. Obtain Medical License from the State of Connecticut
Contact the State of CT Department of Public Health at (860) 509-7563 to request a paper application or go to www.ct.gov/dph to download an application. Licenses are issued weekly and require annual renewal.
2. Obtain State of Connecticut Controlled Substance Registration (CSR) Certificate
Contact the Department of Consumer Protection Drug Control Division at (860) 713-6065 to request a paper application or go to www.ct.gov/dcp to download an application or online. You must have your CT state medical license in order to obtain this certificate. Processing time is two to three weeks and the certificate requires annual renewal.
3. Obtain a Federal DEA Certificate
Contact the local DEA Office at (860) 240-3700 to request a paper application or go to the DEA website, www.deadiversion.usdoj.gov, to download an application or apply online. You must have your state medical license and your state controlled substance registration certificate in order to obtain the DEA certificate. Your DEA certificate should have a CT address. Processing time is four -six weeks and certificates are valid for three years.
4. Obtain hospital privileges at Yale-New Haven Hospital
The Chairman of your department will initiate this process by sending forms regarding your arrival to the Medical Staff Office (MSO) of Yale- New Haven Hospital. The MSO then sends an application to you directly. Once your completed application is returned, the MSO will begin their verification process. Once verification is completed, the Chairman signs off on the delineation of clinical privileges. Application is then sent to the MSO's Credentialing Committee for official decision. This process takes two to four months to complete.
5. Obtain listing on the University's malpractice insurance roster
The Managed Care Coordinator in your department will contact the Legal Affairs office at Yale University prior to your arrival. They will advise Legal Affairs of your name and start date, and Legal Affairs will proceed to create an Advice of Insurance for you. This process takes three to four weeks to complete.
6. Apply for your National Provider Identification number
Apply for your National Provider Identification (NPI) number, as required by The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), at https://nppes.cms.hhs.gov/NPPES