Frequently Asked Questions

Typical onboarding takes 7–14 business days. We begin with a discovery call to understand your practice management system, payer contracts, and billing workflows. Next, we credential your providers with insurance payers (if needed), configure system integrations, and train your staff. Most practices submit their first claims within two weeks of signing.

We'll need access to your practice management or EHR system, a list of active payers and contract agreements, NPI and tax ID numbers for all providers, demographic templates, and any current billing reports. Our team provides a secure onboarding checklist during kickoff to streamline the process.

Yes. NELSON LAZARO integrates with all major PM and EHR platforms, including Epic, Cerner, Athenahealth, AdvancedMD, Kareo, and dozens more. If you use a niche or custom system, we'll work with your IT team to establish secure data exchange via HL7, API, or secure FTP.

Minimal disruption is our priority. Most practices continue charting and scheduling as usual. We adapt to your existing charge capture and superbill process. Our team handles claim scrubbing, submission, posting, and follow-up behind the scenes. You'll receive regular reports and have full visibility into every transaction.

Absolutely. NELSON LAZARO is fully HIPAA-compliant and maintains SOC 2 Type II certification. All data is encrypted in transit (TLS 1.3) and at rest (AES-256). We conduct annual third-party audits, enforce role-based access controls, and require multi-factor authentication for all team members. Your data never leaves our secure environment.

We follow strict protocols: signed Business Associate Agreements (BAAs) with every client, annual compliance training for staff, encrypted communication channels, audit logging of all PHI access, and regular risk assessments. Our infrastructure is hosted in HIPAA-compliant data centers with 24/7 monitoring and intrusion detection.

We maintain a comprehensive incident response plan. In the unlikely event of a breach, we immediately contain the incident, notify affected parties within 24 hours per HIPAA guidelines, coordinate with legal and compliance teams, and provide credit monitoring services if PHI is compromised. To date, we have maintained a zero-breach record.

NELSON LAZARO maintains a 98.6% first-pass clean claim rate—well above the industry standard of 85%. Our proprietary scrubbing engine checks every claim for coding errors, missing modifiers, authorization requirements, and payer-specific rules before submission. This means faster reimbursement and fewer denials.

Claims are typically submitted within 24–48 hours of charge entry. For urgent or high-value claims, we can expedite same-day submission. Our team monitors your charge lag daily and flags any delays in documentation or coding to keep your revenue cycle moving.

We categorize every denial by root cause and resolve them systematically. Technical denials (missing info, coding errors) are corrected and resubmitted within 48 hours. Clinical denials requiring additional documentation are escalated to your providers with a clear action list. We track denial trends and provide monthly reports with actionable recommendations to prevent recurrence.

Our appeals team achieves an 87% overturn rate on initial denials. We craft detailed, evidence-based appeals with supporting clinical documentation and cite payer policy when appropriate. Persistent denials are escalated through multiple levels, including peer-to-peer reviews and state insurance board complaints when warranted.

Yes. Our authorization specialists monitor upcoming procedures, submit requests proactively, and follow up with payers to secure approvals before the date of service. We track authorization expiration dates and notify your team of any extensions or re-authorizations needed.

You'll receive a comprehensive monthly dashboard covering key metrics: charges posted, claims submitted, payments collected, denial rate by payer and denial reason, days in A/R, collection rate, and year-over-year trends. Custom reports are available on request—we can slice data by provider, procedure code, payer, or location.

24/7. You have real-time portal access to view every claim, payment, adjustment, and outstanding balance. Automated alerts notify you of significant events—large denials, overdue A/R, or payer policy changes. Monthly business reviews with your dedicated account manager provide strategic insights and action plans.

Of course. Clean claim rate: percentage of claims accepted on first submission without errors. Days in A/R: average time from service date to payment. Collection rate: percentage of expected reimbursement actually collected. Denial rate: percentage of claims initially rejected by payers. We provide a full glossary and ongoing education to help you understand your revenue cycle.

We offer transparent percentage-based pricing: you pay only on collections, so our success is directly tied to yours. There are no hidden setup fees, long-term contracts, or charges for claim resubmissions. Visit our Pricing page for detailed tier information, or contact us for a custom quote based on your practice size and specialty.

No. We operate on 60-day rolling agreements. Either party can terminate with 60 days' written notice. We believe in earning your business every month through exceptional performance, not through contractual lock-in. Most clients stay with us for years because we deliver measurable results.

We take accountability seriously. If you're dissatisfied, we schedule an immediate escalation call with senior leadership to address concerns and develop a corrective action plan. If we can't resolve the issue within 30 days, we'll facilitate a smooth transition to another billing partner at no additional cost—including full data export and claims handoff.

Yes. Our credentialing team manages the entire enrollment process for new providers and practices. We complete applications, submit supporting documentation, follow up with payers, and track status until you're fully credentialed and can bill. Typical credentialing takes 60–120 days depending on the payer, and we keep you updated every step of the way.

We subscribe to payer bulletins, participate in professional billing associations, and maintain a centralized policy database updated weekly. When a payer changes LCD, billing rules, or authorization requirements, our compliance team alerts affected clients immediately and updates claim scrubbing logic to prevent denials.

While we don't provide contract negotiation as a standalone service, we can analyze your current reimbursement rates, benchmark them against regional and specialty averages, and provide a detailed rate analysis to support your internal negotiations. Many clients use our data to successfully negotiate higher rates with payers.