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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Prevent
1
Patient access
- Benefits verified by phone with the carrier
- Authorizations obtained and tracked
- Office-specific patient journey, in build
2
Revenue integrity
- Documentation and coding guidance
- Chart audits by a certified auditor
- Provider and staff training
Detect
3
Claims and payment
- Claims scrubbed against payer edits
- Payments reconciled to what was expected
- Underpayments followed up, not written off
4
Denial intelligence
- Every denial sorted by what its code means
- Root cause traced to its source
- Patterns reported back to the practice
Recover
5
Appeals and recovery
- Appeals written in the payer's own policy language
- Underpayment and out-of-network recovery
- ERISA and state health benefit appeals
6
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 practicesSurgeons and surgical facilities
Operative-report coding for surgeons, ASC and outpatient hospital billing, and out-of-network payment disputes.
How we work with surgeonsAttorneys
Expert reports, arbitration and litigation files prepared for counsel, and an automated handoff between your office and ours.
How we work with counselBilling, 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.
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 worksWhat 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.

- 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.
A revenue assessment starts with a short form that goes to the founder. Business contact details only. Please do not send patient information through this site.
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