The denial was written the day the appointment was booked.

So that is where we start. Precision Billing runs a practice's revenue cycle from the patient's first call to the last appeal, and sends what each denial teaches back to the front desk.

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Kelly Greco, CEO and founder of Precision Billing — Kelly Greco, CPC, COC, CPMA. CEO and Founder.

Prevent

Patient access

Benefits verified by phone with the carrier
Authorizations obtained and tracked
Office-specific patient journey, in build

Revenue integrity

Documentation and coding guidance
Chart audits by a certified auditor
Provider and staff training

Detect

Claims and payment

Claims scrubbed against payer edits
Payments reconciled to what was expected
Underpayments followed up, not written off

Denial intelligence

Every denial sorted by what its code means
Root cause traced to its source
Patterns reported back to the practice

Recover

Appeals and recovery

Appeals written in the payer's own policy language
Underpayment and out-of-network recovery
ERISA and state health benefit appeals

Dispute resolution

NJ PIP arbitration, and workers' compensation fee schedule disputes
Federal No Surprises Act IDR files, and files for the separate state process
RAC, UPIC and commercial audit response

LearnWhat each denial teaches goes back to the first call.

Arbitration, IDR and litigation support are provided in a non-attorney capacity, in coordination with the client's counsel.

Medical practices

The whole cycle, from the first call to the last appeal, run to an auditor's standard.

We bill for all medical providers, and for ancillary providers: rehabilitation (physical therapy and occupational therapy), acupuncture, nurse practitioners and chiropractors.

How we work with practices

Surgeons and surgical facilities

Operative-report coding for surgeons, ASC and outpatient hospital billing, and out-of-network payment disputes.

How we work with surgeons

Attorneys

Expert reports, arbitration and litigation files prepared for counsel, and an automated handoff between your office and ours.

How we work with counsel

Billing, RCM and EMR companies

Consulting on training, operations, coding and billing, for those companies and for practices that keep their billing in-house. We are also taking names for Rook's denial management, to run in your own environment.

What consulting covers Rook in your own environment

AI without expertise automates the mistake.

Rook is our own AI and automation workbench. It is local AI only: it runs on our own servers and inside our own Microsoft 365 environment, not on a public AI service. It spent a year being trained on the founder's audit, coding and appeal judgment, across all of our clients and all specialties. Today it is in full use at one practice, where every function runs through it.

Tyro, the apprentice, is being trained the same way.

How Rook works

What Rook does with a remittance

Receives each electronic remittance (835) and parses it line by line.
Triages each line and separates the denials from the adjustments.
Moves the routine next steps on its own, and sends the rest to a reviewer who decides.
For an appeal, pulls the authorized-representative form and the record, reads the record and drafts the argument: medical necessity or coding.
Sends it to the carrier by portal, mail or fax, without the work leaving the system.

The rules are added to and adjusted as payer policies change.

Three lines from one remittance.

Each one paid less than it billed. Only one of them is a denial.

It is the first rule Rook was taught. An appeal queue built on the paid column fills with claims that were never appealable, and the filing window runs while someone works them.

Line	Billed	Adjustment		Allowed	Patient resp.		Paid
1	3,200.00	CO-45	859.60	2,340.40		0.00	2,340.40
Paid at the contract rate. Nothing to appeal.
2	1,600.00	CO-45	370.00	1,230.00	PR-1	1,230.00	0.00
Paid zero, but adjudicated. The allowed amount went to the deductible. Not a denial.
3	4,100.00	CO-59	4,100.00	0.00		0.00	0.00
Allowed zero. This is the denial, and the reason code names the argument.
Total	8,900.00		5,329.60	3,570.40		1,230.00	2,340.40

Of 6,559.60 unpaid, 1,229.60 is contractual, 1,230.00 is the patient's, and 4,100.00 is the denial.

Illustrative figures. No patient or client data.

We are not adding AI to medical billing.

We are building one auditor's judgment into the system that works the claim. Kelly Greco founded the firm in 2003 while completing her degree in biomedical engineering, and has led it since.

Signature of Kelly J. Greco, CPC, COC, CPMA

CEO and Founder: Kelly Greco
Credentials: B.S. in Biomedical Engineering. CPC, COC and CPMA, issued by AAPC.
The firm: Established 2003 in Hackensack. More than 500 providers served.
Certification: Third-party billing service, certified by the State of New Jersey, Department of Banking and Insurance
Expert work: New Jersey PIP arbitration, workers' compensation and No Surprises Act disputes

Tell us what is not getting paid.

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