Managed Care

O'Sullivan Consulting Group has developed relationships with insurance carriers which have benefited our clients. Contracting and Provider Relations staff have come to expect fair and professional communication from our team of experts. Managed Care compliance and revenue management is the core of a successful medical practice.

• Referral process training
• Contract negotiations
• Development of MCO fee schedule maintenance
• Development of managed care strategies
• Development of managed care "tools" for staff
• Reimbursement analysis
• Summary of practice contracts
• Training of staff on procedures regarding MCO issues (i.e., front desk)
• Site visits/audit coordination

         Credentialing

• Compilation of the providers' required documents for credentialing process
• Apply for NPI Individual and group numbers
• Maintenance of credentialing files
• Contact insurance carriers to request applications for credentialing
• Complete all sections of the applications, copy, mail and file for reference
• Continuous status updates with carriers
• Site visit coordination
• Track the progression of obtaining the executed contract and fee schedule per the providers' request
• Review the contract reimbursement rates
• Notify the providers' medical billing department of the providers' numbers, effective dates and reimbursement rates