Pat O'Sullivan, President
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.

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.

Machelle currently has 4 years experience as a Credentialing Specialist with O’Sullivan Consulting Group. Previously, she worked as a medical insurance biller 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.
• Sets up files with the corresponding insurance companies listed.
• Contacts the insurance companies and completes the required paperwork to begin the credentialing process.
• Sets up a credentialing spreadsheet; tracking the progress of obtaining provider numbers and effective dates of contracts.
• Applies for NPI and CLIA numbers. Applies for DME license if requested, registers for CAQH, queries the National Practitioner Data Bank.
• 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.
• 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.

Dorothy has more than 30 years experience in managing a growing practice:  Starting as  the Administrative Manager of a two physician practice clinic in 1970 and in 1999 assuming the role of Business Manager for the same practice, now with six physicians.

• Planning goals/objectives for office operations and identifying the resources (staff, equipment, funds) required to attain the end result.
• Coordinating and monitoring operations to insure requirements are sufficiently met on a daily basis.
• Human resources including orientation program for new employees, development of employee handbook, payroll, benefits administration, job descriptions, hiring and employee evaluations.
• Billing Operation including insurance processing, electronic billing, collections CPT and ICD9 coding, collections, accounts receivable and the researching of unpaid claims.
• Analyzing practice management computer systems. Choosing and implementing the software/hardware to computerize a medical practice.
• Reviewing contracts with managed care plans, meeting with provider relations representatives to review policy changes, performance reports and to resolve problems; monitoring their compliance with contractual obligations, fee schedules, analyzing profitability of insurance plans.

Dawn is a certified professional coder and a certified medical practice executive with more than 16 years of direct experience in all aspects of medical billing, revenue cycle management and practice operations. Ten of those years were spent in medical billing and the supervision of the accounts receivable function for various physician practices and hospital owned entities. Dawn’s expertise on the coding and billing side of the business, combined with her in-depth experience in practice management, translates to a value added service mix for clients. She has strong managerial skills and develops effective working relationships with clients and staff. Clients range from private physician practices to independent practice corporations, allied providers, self-insured employers and clinic facilities.

• Improve documentation with a direct impact on practice volume and revenue, through chart audits and coding analyses.
• Improve cash flow and efficiency for multiple-specialty MSO.
• Reduce days in accounts receivable from 247 to 90 days in four months.
• Improve performance of employees with a direct impact on cash, by creating a benchmarking program for employee productivity.
• Conduct seminars for physicians and staff on Evaluation and Management coding and documentation.
• Taught curriculum for classes in Physician Reimbursement and Payment Systems at Wayne College.
• Developed and implemented Employee Skill Assessment Examination for billing and coding personnel for assessing and improving staff knowledge.