- 4009 Hackney Springs Ln, Sachse, TX 75048
TransLabs delivers comprehensive billing and revenue cycle management services designed exclusively for pathology laboratories performing surgical pathology, cytopathology, immunohistochemistry, molecular diagnostics, flow cytometry, and specialized anatomic pathology testing.
Clinical laboratory billing is fundamentally different from physician or hospital billing. The daily test volumes, the reflex testing protocols, the panel bundling rules, and the Medicare LCD complexity; these aren’t challenges a generalist billing company was designed to handle. And the revenue loss adds up quietly, month after month, until a full audit reveals the damage.
Increase in net collections
Increase in net collections
Increase in net collections
Increase in net collections
Clinical laboratory billing is fundamentally different from physician or hospital billing. The daily test volumes, the reflex testing protocols, the panel bundling rules, and the Medicare LCD complexity; these aren’t challenges a generalist billing company was designed to handle. And the revenue loss adds up quietly, month after month, until a full audit reveals the damage.
TransLabs’ specialized RCM services are built exclusively for labs, addressing the unique challenges that generalist billers miss. We provide end-to-end revenue cycle solutions designed specifically to turn laboratory complexity into profitability.
Complete payer enrollment, CLIA certification management, and network participation setup across all insurance carriers. TransLabs manages every credentialing detail so that your laboratory gets paid in-network from day one without any administrative delays.
Real-time insurance verification, benefits investigation, and prior auth completed before specimen processing begins. Confirming coverage upfront eliminates preventable denials and protects your lab from unexpected reimbursement failures.
Patient registration, appointment coordination, insurance verification, and customer service excellence managed by experienced laboratory billing professionals. A well-run front office reduces downstream billing errors and creates a better experience.
TransLabs provides expert RCM services to clinical laboratories in all 50 states, delivering the same exceptional results whether you’re a community hospital lab or a large reference facility. We bring specialized lab billing expertise to facilities nationwide, combining remote efficiency with hands-on partnership.
Clinical laboratory billing under Medicare Part B carries a compliance burden that catches many labs off guard and that generalist billing companies rarely have the expertise to manage.
The combination of Local Coverage Determinations, frequency limitations, Advance Beneficiary Notices, and the Clinical Laboratory Fee Schedule creates a regulatory environment that requires dedicated, proactive management.
Each of Medicare's 12 Administrative Contractors maintains its own LCD policies specifying which ICD-10 diagnosis codes support coverage for specific clinical lab tests. These policies differ by MAC, change without notice, and apply to thousands of test-diagnosis combinations. TransLabs maintains its LCD databases for every MAC and validates diagnosis code linkage on every Medicare claim before submission, not just the most common tests.
Medicare restricts how often certain tests can be covered for the same beneficiary within a defined period. HbA1c, lipid panels, PSA, TSH, and many other high-volume tests carry specific frequency limits that vary by MAC. TransLabs monitors each patient's claim history and alerts ordering providers before frequency limits are reached, preventing the automatic denials that are impossible to appeal after the fact.
When a Medicare beneficiary requests a test that may not meet medical necessity criteria under the applicable LCD, a valid ABN must be issued before the test is performed. Retroactive ABNs are not valid, and billing without a valid ABN when coverage is uncertain exposes the lab to recoupment liability. TransLabs implements ABN workflows into your front-end registration process so the documentation is always in place.
The CLFS sets Medicare payment rates for all lab tests and updates them annually based on market data reporting. TransLabs monitors CLFS changes, updates billing tables immediately to reflect new rates, and flags claims with charges that fall below CLFS rates, allowing proactive under-payment recovery before claim filing deadlines pass.
Labs meeting the applicable laboratory definition under the Protecting Access to Medicare Act (PAMA) carry mandatory private payer data collection and reporting obligations during designated data collection periods. Non-compliance carries civil monetary penalties. TransLabs tracks your lab's PAMA obligations throughout the year and ensures reporting requirements are met accurately and on time.
The Office of Inspector General publishes an annual Work Plan identifying billing areas under active audit and investigation. Clinical laboratory billing appears on the OIG Work Plan regularly, with carrier reviews, genetic testing, and toxicology receiving particular attention in recent cycles. TransLabs builds compliance protocols specifically around current OIG targets to reduce audit exposure before it becomes a problem.
Clinical laboratory billing is fundamentally different from physician or hospital billing. The daily test volumes, the reflex testing protocols, the panel bundling rules, and the Medicare LCD complexity; these aren’t challenges a generalist billing company was designed to handle. And the revenue loss adds up quietly, month after month, until a full audit reveals the damage.
Seamless integration with EPIC Beaker, Sunquest, and all major LIS systems. AI predicts denials and delivers insights.
We navigate complex lab regulations, OIG guidelines, and payer policies so you always stay compliant, protected, and audit-ready.
Schedule a call with our clinical lab billing specialist.
Schedule a call with our clinical lab billing specialist. We’ll review your panel optimization, reflex testing denials, LCD compliance, and A/R days
Dedicated billing specialist assigned to your lab
Dedicated billing specialist assigned to your lab
Dedicated billing specialist assigned to your lab
Dedicated billing specialist assigned to your lab
Dedicated billing specialist assigned to your lab
TransLabs exclusively serves laboratories. Our coders, technology, and processes are purpose-built for molecular, FISH, flow cytometry, AP, cytogenetics, and toxicology RCM.
TransLabs exclusively serves laboratories. Our coders, technology, and processes are purpose-built for molecular, FISH, flow cytometry, AP, cytogenetics, and toxicology RCM.
TransLabs exclusively serves laboratories. Our coders, technology, and processes are purpose-built for molecular, FISH, flow cytometry, AP, cytogenetics, and toxicology RCM.
TransLabs exclusively serves laboratories. Our coders, technology, and processes are purpose-built for molecular, FISH, flow cytometry, AP, cytogenetics, and toxicology RCM.
