About Us

Your trusted partner in time saving medical practice management.

Time is really the only capital that any human being has, and the only thing we can’t afford to lose.

Thomas Edison

Incorporated in 1998, Grey Ledge Medical has developed long-standing, trusted partnerships with providers for over 20 years.

Throughout the past 2 decades, Grey Ledge Medical has evolved from a third-party medical billing company into a full scale revenue cycle management company. Grey Ledge Medical offers our clients access to a suite of innovative software technology, coding and billing education, and detailed reporting. With these services, our clients are more equipped than ever to understand and react to the ever-changing requirements of their medical practice.

Each member of Grey Ledge Medical’s leadership team has worked within a large variety of medical facilities throughout their careers. This technical intelligence and dedication brings a unique benefit to Grey Ledge Medical and our clients, as we understand the daily administrative challenges each medical office and client faces.

Whether your facility is located in RI, MA, CT or beyond, Grey Ledge Medical can be your trusted partner for all of your revenue cycle management needs.

Understanding these challenges allows us to better customize our services in order to minimize workflow burdens and allow providers more of an opportunity to concentrate on patient care.

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Senior Management Team




Julie Sylvestre, FACMPE

President and Owner

Working in the healthcare management industry since 1986, Julie joined Comprehensive Practice Management in 2002 as Director of Operations and expanded to take on co-ownership of the company.

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Karen Marcoux, CPC

Director of Operations

Starting her career as a medical assistant in 1997, Karen performed both clinical duties and administrative tasks, giving her the unique perspective and understanding of the myriad of responsibilities required to run a successful medical practice.

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Sharon Parayno, CPC

Sharon joined CPM in May 2014 as our Intergy Practice Management, Electronic Health Record (EHR) Trainer and MACRA/MIPS/Meaningful Use liaison. Sharon is a Certified Professional Coder (CPC).

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Bonnie Marcoux

Bonnie started with CPM in 2002 as a Medical Billing Specialist. Since her time at Grey Ledge, she has worked in many different roles and is a member of the Senior Management Team.

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Grey Ledge Medical's highly experienced management team will review your financial patterns over a give period of time and highlight areas in which additional research may be warranted.