A robot that never tires of the hold music
Somewhere in America, right now, a person in a medical billing office is listening to a recording tell them their call is very important. It is the eleventh call of the morning. It is about a claim that should have been paid two months ago. The hold music loops. This is the sound Steven Greene decided to silence.
Greene is the co-founder and CEO of Standard Practice, a New York company that builds voice AI for the people who keep medical practices solvent: revenue cycle teams, billing staff, the folks who chase down what insurance companies owe. The product does something almost comically unglamorous and almost universally hated. It picks up the phone, dials the insurance payor, navigates the menu, waits on hold, and has the conversation. Claim follow-ups. Benefits checks. Prior authorizations. Pharmacy calls. The work that eats a clinic alive.
The numbers behind the idea are the kind that stop you. Roughly a million healthcare workers spend something like four and a half hours of every workday on the telephone. Nine in ten practice leaders say they're short on billing staff. The American healthcare system, for all its software and dashboards, still runs on a person holding a handset and waiting. Greene looked at that and saw not a nuisance but a category.
The pivot hidden inside the origin story
Standard Practice did not start as Standard Practice. It started in 2021 as Nibble Health, a company Greene built with his co-founder Phil Markunas, a product and engineering leader who serves as the technical other half of the operation. The first idea was about money directly: no-cost healthcare financing and employee benefits, a fintech-flavored attempt to ease the crush of medical bills on ordinary Americans. The seed for it, by Greene's own telling, was personal - a healthcare emergency and a surprise bill of around $8,000 that made the system's financial plumbing feel less like a policy abstraction and more like a punch.
But founders who actually talk to their customers tend to learn things that ruin their original plan in the best possible way. As Greene and Markunas spent time inside medical practices, the conversation kept drifting away from patient financing and toward a more primal pain: the phone. The endless, grinding, soul-flattening phone calls to insurers. In April 2024 they did the brave and slightly terrifying thing. They relaunched. Nibble Health became Standard Practice, and the company pointed its technology straight at the busy signal.
What the AI actually does all day
- Calls insurance payors to follow up on unpaid claims
- Verifies patient benefits before the appointment
- Handles prior authorizations and doctor credentialing
- Confirms medications with pharmacies
- Runs EDI enrollment and other back-office plumbing
The platform is HIPAA and SOC 2 compliant, which in healthcare is the difference between a product and a liability. It works across specialties that have nothing in common except paperwork: gastroenterology, dermatology, cardiology, orthopedics, behavioral health. The voice is built to sound human, which raises a quietly funny truth about the whole enterprise. On one end of the line is an insurance company's phone tree. On the other is an AI. Two machines, negotiating the fate of a doctor's payment, while the humans get on with their day.
From the deal room to the dial tone
Greene did not arrive at healthcare's least sexy corner by accident. He took the scenic route through some of the most polished rooms in American business and then walked out of them. He studied at Cornell, earned an MBA from Harvard Business School, and spent the better part of a decade at Goldman Sachs on the Healthcare M&A team, advising big biopharma, healthcare services, and healthcare IT clients on the kind of deals that move in nine and ten figures. He describes himself, with a banker's dry honesty, as "reformed."
In 2017 he stepped briefly into civic life as a Fellow and Advisor to the Mayor of Boston, working on digital services designed around what the city's residents actually needed - an early sign that he was more interested in how systems serve people than in the systems themselves. Then he joined Thirty Madison, the telemedicine startup, where he led strategy and business development and served as chief of staff, learning the texture of healthcare from the inside rather than the spreadsheet. By the time he started his own company, he had seen the industry from the boardroom, from city hall, and from the operator's chair.
The bet, and the believers
The $8.5 million behind Standard Practice came from a roster that pays attention: Wing, Tiger Global, A* Capital, and Expa. The company has shown up in Forbes, Bloomberg, and Politico, which is a respectable amount of ink for a startup whose core innovation is patience at scale. From its base at 33 Irving Place in New York's Gramercy district, the thirteen-or-so person team is building toward something larger than call automation.
Greene's stated ambition is to turn Standard Practice into a genuine operating system for healthcare - the connective software that helps practices get paid faster and, eventually, helps patients make better decisions and navigate a system designed, it sometimes seems, to be un-navigable. It is a big vision dressed in the most unassuming clothes. The revolution will not be televised. It will be on hold, and then, finally, it will be picked up.
There is something fitting about a person who once optimized billion-dollar transactions deciding that the most valuable thing he could give back to medicine was time. Four and a half hours a day, multiplied by a million people. That is the math Steven Greene is trying to bend. Not with a grand theory of healthcare, but with a machine that does the one thing humans hate, and does it without ever once sighing into the receiver.