How it runs for clinical laboratories
A second accountant reviews the package under Two-Tier Review, and you receive it with a note that explains what moved in revenue per accession, denials and margin by test line.
What is month-end close outsourcing?
Month-end close outsourcing means an external accounting team performs the steps that turn a month of transactions into finished financial statements: reconciling every account, posting accruals, prepaids and depreciation, checking cut-off, reviewing and locking the period. You keep your software and your accountant. The provider runs the checklist on an agreed calendar and hands you reviewed statements.
What we handle for clinical laboratories
- Charges, contractual adjustments, denials and cash posted from billing-system month-end reports
- Accessions resulted but not yet billed reviewed and accrued or listed as unbilled
- Reagent, send-out and courier costs accrued where the vendor invoice has not arrived
- Client-bill invoices issued and agreed to LIS volumes before the close is signed
- CloseTrack sign-off log showing each step, the preparer and the reviewer
The KPI that matters here
Close completed and reviewed within five business days of month-end with every reconciliation signed off.
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
- QuickBooks Online
- Sage Intacct
- Bill.com
- ADP
- LIS exports (Orchard, Sunquest, SCC Soft)
- XIFIN
- TELCOR
- All 50 platforms
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Frequently asked questions
What is different about a laboratory month-end close?
Revenue has to be recognized in the service month even though payment arrives weeks later and net of denials, so unbilled and denied accessions must be reviewed. Send-out and reagent invoices often lag the month they relate to and need accruing. And three revenue streams with different terms have to be aged separately. A generic close misses all three.
How are denials and write-offs treated at close?
Contractual adjustments are posted as a contra-revenue line from the billing-system adjustment report. Medical-necessity denials, timely-filing losses, client-bill credits and patient hardship write-offs each get their own account and appear on a list for your approval before posting. The P&L then shows where revenue is leaking rather than a single net figure.
Can you close faster than five business days?
Usually, after the first few closes clear the backlog and the billing-system and LIS reports are pulled on a fixed day. The main constraint is the arrival of send-out invoices and remittances, which is why accruals matter. The month-end close service page describes the CloseTrack calendar and how it is adapted to your systems.
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