NYS Licensure /Insurance Enrollments

Making Sense of the Process

New York State Medical License

Licensure process– NYS Application– FCVS (if applicable)

A physician must have a New York State Medical License in order to apply for and obtain:– Malpractice Coverage– DEA Certificate

Web Sites NYS Education Department www.op.nysed.gov

(Licensure requirements, applications) Federation Credentials Verification Services:

www.fsmb.org - click on FCVS / FSMB Credentials Verification Service Home Page / Physicians. Information and applications available.

Health Professional Shortage Areas http://hpsafind.hrsa.gov

NYS Department of Health www.highered.nysed.gov/kiap/scholarships/precoll/ Loan forgiveness applications and sites provided that meet the requirements.

DEA Diversion Control Program (on-line application) http://www.deadiversion.usdoj.gov/

NYS Medical Licensure

U.S. Medical Graduates

M.D./D.O./D.P.M. Degree from an accredited program by the Liaison Committee on Medical Education (LCME)

M.D. and D.O.’s: Application accepted after completion of one year of an Accredited Graduate Medical Education program (Internship / Residency)

USMLE Steps 1, 2, & 3 (www.fsmb.org – Examination Services) OR

NBOME Parts I, II, & III (www.nbome.org)

NYS Medical LicensureInternational Medical Graduates

Completion of an acceptable educational program for physicians by the appropriate civil authorities of the country in which the school is located and receipt of the degree of Doctor of Medicine, or the equivalent as determined by the NYS Department of Education.

Educational Commission for Foreign Medical Graduates (ECFMG) certification.

The FCVS application process should be started at the beginning of your residency. A copy of the completed FCVS packet needs to be sent to the Medical Board of the State you will be seeking employment in.

NYS Medical Licensure

International Medical Graduates

Completion of three (3) years Residency in an Accredited Graduate Medical Education program. NYS license application may be submitted any time in last year of training.

Verification of residency accepted by NYS 30 days prior to completion of training.

FCVS

FCVS packet now accepted in 48 out of 50 states– Not accepted in Nebraska and Arkansas

Mandatory* in 13 states:– Kentucky; Louisiana; New Hampshire; Ohio;

Maine; Nevada (Osteopath only); New York; North Carolina; Rhode Island; South Carolina; Wyoming; Utah; Virgin Islands

* FCVS profile required from applicants who completed their Medical Education at a non-LCME or AOA accredited or board approved facility.

Physician Applications

Hospital Medical Staff application(s)

Malpractice and Personnel Packets

Third Party Payors:

Any insurance company that the employer participates with, i.e., Excellus, MVP, etc.

Enrollments

Begins upon receipt of signed Physician contract.

Applications are filled out and sent to physician/provider for completion of confidential/personal information, signature and date.

Request made for all mandatory documents to be returned with applications.

Return envelopes provided.

Mandatory Documents

The following documents must be obtained and submitted with third party payor applications:– NYS Medical License– DEA Certificate– Curriculum Vitae (month / year format)– Malpractice Certificate– Medical School / Graduate Education

Diploma

Completion of Residency Certificate(s)Completion of Fellowship Certificate(s)Board Certificate(s) - if applicableProof of past malpractice coverage (if applicable)

ECFMG (if an International Medical Graduate)

Social Security CardNPI notification letter (if available, user ID &

password)

CAQH ID number (if available, user ID & password)

Malpractice Insurance

Claims Made– Coverage for any incident is provided only

while you are insured under this policy. Once this policy is no longer in force, “tail coverage” should be purchased by either you or your employer to protect you for claims that may come about during the policy period.

Occurrence– This policy protects you no matter when a

claim is brought against you.

Application Enrollment

Applications returned from the physician/provider are copied for our files.

Only when a complete packet of Mandatory documents are obtained, can the applications be submitted.

Third party payors can take up to three months to process once all documentation has been received in the insurance credentialing office.

Potential “Road Blocks”

NYS LicenseResidency CertificateMalpractice CertificateProfessional ReferencesMCO’s Committee Meetings

Moonlighting Residents

Malpractice and Personnel Packets

Third Party Payors

Minimal participation for residents (i.e., Medicare, Medicaid, PA Medicaid)