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Pat O'Sullivan,
President
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Throughout
her career in health care, Pat O'Sullivan has
had a dream. The start to the fulfillment of that dream
began in 1996. The accumulation of over 25 years of experience
in coding, revenue enhancement, human resources and a straight
forward approach to practice management was the beginning of O'Sullivan
Consulting Group, Inc.
Pat's
special aptitude for dealing with the many personnel issues facing
providers, teaching and empowering staff, helping healthcare organizations
identify, plan for and implement operational and perpetuation
issues, and increasing reimbursement rations has helped
her organization continue to grow. Pat's long term relationships
with MCO's have directly impacted her clients contract negotiations.
Her company now consists of a team of specialists
that combine their individual talents to form one of the premier
health care consulting groups to be found anywhere. Pat
conducts workshops and seminars for healthcare professionals and
is a member of many related professional organizations.
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Denise
Nimon – Operations Manager |
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Operations
Manager, Denise Nimon, has more than 7 years experience
in management, and a financial background of 10+ years in
billing, personnel management, bookkeeping,
accounts payable, accounts receivable, and payroll.
Denise's previous
management skills come from managing a busy four physician
family practice/urgent care facility. Her extensive knowledge
with revenue and expenses has enabled her to operate a profitable
practice and develop a strong and trusting relationship
with her staff, which in turn has increased revenue for
clients.
Denise
is the Membership Director of the Professional Association
of Healthcare Office Management (PAHCOM). Her affiliation
with this organization keeps her updated with the constant
changes in the healthcare field through educational seminars
and networking. |
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Machelle
Giordon – Credentialing Specialist |
Machelle
currently has 4 years experience as a Credentialing
Specialist with O’Sullivan Consulting Group.
Previously, she worked as a medical insurance billers with
Premier Billing Network, (also owned by Pat O’Sullivan).
Therefore, Machelle thoroughly understands the unique correlation
between the billing of insurance claims and how credentialing
reduces the probability of interrupted insurance payments.
Credentialing
is no longer a part time assignment; it requires the full
time attention of a trained credentialing specialist.
Machelle
has developed the following process for our clients in-house:
- Enters
ODI information and catalogs the required documents.
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Sets up files with the corresponding insurance companies
listed.
- Contacts
the insurance companies and completes the required paperwork
to begin the credentialing process.
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Sets up a credentialing spreadsheet; tracking the progress
of obtaining provider numbers and effective dates of contracts.
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Applies for NPI and CLIA numbers. Applies for DME license
if requested, registers for CAQH, queries the National
Practitioner Data Bank.
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Tracks the progression of obtaining a copy of the executed
contract once all is final. Reviews the contract reimbursement
amount and notifies the billing department of this significant
payment information.
- Notifies
carriers if there is a change of the “Tax ID Number"
or change in the address and/or billing location.
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Machelle has developed a credentialing process for
- Nurse
Practitioners
- Physician
Assistants
- Occupational
and Physical Therapists
- Nurse
Midwifes
- All
types of physician practices
- Machelle
has developed very good relationships with the carriers
which impacts the timeliness of the progress of credentialing.
There is a continuous follow-up with the insurance carriers
until provider numbers are obtained.
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