Remote controller review for clinical laboratories

An outsourced controller for clinical laboratories gives an owner or lab director an experienced reviewer above the monthly bookkeeping without hiring a full-time controller. LedgerBPO's controller review examines each close, challenges unbilled accession estimates and send-out accruals, checks that billing-system AR agrees to the ledger by stream, watches margin by test line against fee-schedule and reagent pricing changes, and maintains the thirteen-week cash forecast that decides when an analyzer purchase or a new draw site can proceed.

  • Since 2020
  • US · UK · CA · AU
  • Named accountant plus backup
  • Your software, no lock-in

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How it runs for clinical laboratories

The controller also prepares lender and investor packages, answers your CPA's year-end questions and documents the accounting policies your team follows. Decisions remain yours; the numbers behind them hold up.

What are outsourced controller services?

Outsourced controller services provide the review layer that sits between bookkeeping and the owner: a senior accountant who checks the close, owns the accounting policies, tests the controls around cash and spending, and explains the financial statements. The controller does not do daily posting. They make sure what was posted is right and documented before anyone relies on it.

What we handle for clinical laboratories

  • Monthly close review with written variance commentary on revenue per accession, margin and AR
  • Unbilled accessions, send-out accruals and denial reserves challenged each month
  • Thirteen-week cash forecast including expected remittances, reagent commitments and capital purchases
  • Lender, investor and CPA packages prepared and their questions answered on your behalf
  • Accounting policy notes for revenue, adjustments, reagent agreements and analyzer capitalization

The KPI that matters here

Controller review and variance commentary delivered with every close, and a cash forecast updated weekly.

Clinical labs compliance notes

CLIA

Every lab that tests human specimens must hold a CLIA certificate matched to the complexity of its testing, renewed on a two-year cycle with fees based on test volume. We record certificate fees, proficiency-testing subscriptions and inspection-related costs as compliance expenses and keep renewal dates on the close calendar. Certification and inspection readiness stay with your lab director.

Payer rules and PAMA

Medicare pays lab tests from the Clinical Laboratory Fee Schedule, commercial payers pay contract rates, and both apply medical-necessity and frequency rules that produce denials. PAMA private-payer rate reporting also falls on applicable labs in reporting years. We keep revenue, adjustments and denials in separate accounts so your billing team and CPA can see each effect.

HIPAA

Remittances, client invoices and LIS exports carry patient identifiers and test names. Our staff are HIPAA-trained, we sign a BAA, all access is logged with MFA, and exports are handled inside your systems and our portal rather than on local drives.

Anti-kickback and EKRA

The federal Anti-Kickback Statute and the Eliminating Kickbacks in Recovery Act restrict how labs pay marketers and how they price or discount services for referral sources. We record sales compensation and client discounts exactly as your compliance counsel has approved them, and flag any arrangement that looks volume-based so it can be reviewed. We do not give legal advice.

Clinical labs software we work in

More for clinical laboratories

Frequently asked questions

What does a controller review add for a laboratory?

Judgment and forecasting. Bookkeeping records what happened; the controller review tests whether unbilled, denial and accrual estimates are reasonable, explains why margin or revenue per accession moved, keeps a rolling cash forecast and prepares the packages lenders and CPAs want. For a lab it means fee-schedule, reagent pricing and payer-mix effects are examined monthly rather than discovered at year end.

Can the controller help with a bank line or an analyzer financing application?

Yes. The controller prepares the statements, AR schedules by stream, equipment and lease schedules, debt schedules and trailing-twelve-month figures lenders request and answers their follow-up questions plainly. We do not give financing advice or guarantee an outcome; we make sure the figures presented are reconciled and consistent with your tax returns.

Is an outsourced controller enough for a multi-site lab?

For most owner-led labs with several draw sites and one core facility, yes, provided bookkeeping and close run on a fixed calendar. The controller review covers consolidated and site-level results, allocations and the cash forecast. Labs preparing for audited statements, a sale or a hospital joint venture may also need a CPA firm, and we work alongside them.

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Next step

Books closed. Invoices paid. Every month.

Tell us what is going on with your books or billing. You will hear from a named person within 1 business day, with a custom quote and a plan for the first close.

  • Reply from a named person within 1 business day
  • No setup fee, month-to-month
  • Your software, your data, no lock-in

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