extensive experience in healthcare operations

WHERE PROCESS MEETS SOLUTION

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Best in Class Solutions

Process Mapping
provider data management
Successful Process Implementations
Solving Administrative Health Plan Headaches
Improving
Provider Data
Simplifying Compliance Regulation
Navigating Health Plan Data
about our company

Professional Healthcare Consulting Services

We use 45 years of experience in the development, improvement and implementation of operational processes to align with your strategic goals.

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our services

We Offer Solutions for

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Third Party Administrators

We use our years of experience to provide management solutions to working with health plan TPAs. We understand how to get the results you are looking for from external vendors.

Enrollment Processes

Quality enrollment processes start with our extensive knowledge reducing errors that cause processing delays.

Claims mapping, submissions + validation

Establishing clear processes is a critical step in any administrator's claim validation procedure. We are familiar with technology solutions and understand how to minimize confusion during claims data ingestion and processing.

Broker Commission mapping, submissions + validation

Develop custom broker payment processes for seamless integration allowing you to make timely broker payments.

Provider Data

Our quality control team can review and establish baseline procedures to minimize issues with provider data accuracy.

Regulatory system mapping, submissions + validation

Practical Process Consulting has comprehensive experience in developing Complaints, Appeals and Grievances workflows and data management that meet statewide measures.
testimonials

Review From Our Clients

"The entire team at Practical Process Consulting are the absolute best at what they do. We always recommend our clients use their services for healthcare projects. It gives us peace of mind knowing that our clients will receive the best level of service available."
G. RushingPresident, Creative Initiatives
“Practical Process Consulting (PPC) has been an exceptional Business Partner. PPC has significant health care knowledge and were critical to the success of the work completed by my team to help our company grow fifty times over in membership. Their projects ran the gambit from system conversion, new implementations to building products. This is something many consultants do not provide. PPC was respected and considered as another caring team member by all. In looking for a business partner on a payer project, PPC would be my first call. “
K. VetterVP of Health Plan Applications
“I had the pleasure of partnering closely with Terri and Brenda while working at a health insurance start-up. They truly have robust knowledge and some of the deepest experience in healthcare. Their mindful and empathetic approach makes them seem much less like consultants and more like amazing teammates. I’d highly recommend working PPC on any healthcare venture.”
S. WedwickProgram Manager
“With PPC you instantly gain an unprecedented level of experience, thoroughness, and efficiency. They know the questions to ask, they know how to identify and catch problems, and they have an incredible work ethic. If you want accurate, well thought out solutions delivered on time, go with PPC!”
B. EttenAVP Integrations
“I have had the pleasure of working with PPC for 5 years focusing, specifically on enrollment and eligibility. Their focus and dedication were an integral part of our success. If not for the commitment and perseverance, members would not have had a seamless experience. Working with Brenda and Terri was an experience I will never forget. They are so easygoing, yet professional and knowledgeable. The long hours were difficult, but their overall personalities made it feel like it wasn't work."
E. BrownMedicare Operations
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