CLIA on every claim
Your CLIA number goes on the claim, and the certificate type limits which tests can be paid. A test outside your certificate, or a lapsed certificate, gets denied no matter how clean the rest of the claim is.
Lab claims start with CLIA and the requisition
An independent lab bills on what the ordering clinician wrote, what your CLIA certificate allows, and when the specimen was collected. Get those three right and most of the downstream work gets easier.
Book a demoWhat makes lab billing its own discipline
Medicare treats an independent laboratory as its own provider type, with its own fee schedule and certification checks on every claim.
Fee schedule and assignment
Most clinical diagnostic tests are paid under the Clinical Laboratory Fee Schedule, which CMS sets from private payer rates reported under PAMA. Medicare lab tests are paid on assignment, and the fee schedule carries no deductible or coinsurance.
Referred tests and collection
When you send a specimen to a reference lab, the rules on who bills shift. Specimen collection fees and travel allowances have their own coding and conditions, so they need their own check.
Split the bench from the billing
Lab billing depends on data your team never creates: diagnoses and orders from outside clinicians. Settle who chases it.
What the lab keeps
Test performance, CLIA compliance, and accreditation stay with your lab director and staff. So do client contracts and any PAMA data reporting your lab owes CMS.
What Taiga takes on
Taiga's billing team handles claim submission and scrubbing, eligibility checks, every denial and appeal including small balances, and patient statements and follow-up.
Where a decision is needed
Missing diagnosis codes or ordering clinician details on requisitions are the classic lab problem. Decide who goes back to the ordering office, and how fast.
Questions for a lab fit call
Bring a de-identified requisition, a paid claim, and a denied claim. Do not include patient details in the booking form.
How do you bill today?
Separate insurance-billed tests, client-billed accounts, and patient self-pay, with rough volume for each.
What does your certificate cover?
Share your CLIA certificate type and accreditation, plus any tests you refer out or receive as a reference lab.
Where do orders arrive?
Name your LIS, any interfaces with ordering practices, and how paper requisitions get entered.
For labs that want follow-through on every claim
Relevant to an independent lab owner whose denials pile up on medical necessity, missing order data, or small balances nobody has time to work.
Fit comes before any promise
Lab billing sits on its own claim and payment rules, and Taiga has not published lab support. This page does not interpret coverage policies or frequency limits for specific tests.
Questions about clinical laboratories billing
Is lab billing something Taiga already does?
Taiga has not listed independent labs among its supported specialties. Bring your service mix and Taiga will tell you whether it fits before anything moves.
Why do Medicare lab claims deny for CLIA reasons?
Medicare checks the CLIA number on lab claims against the certificate on file and the test's complexity. A missing number, an expired certificate, or a test outside your certificate type can each trigger a denial.
What is the date of service for a lab test?
Generally it is the date the specimen was collected. CMS has exceptions, including a 14-day rule for certain specimens collected during a hospital stay and tested after discharge.
Can you work with our current LIS?
Taiga works alongside existing clinical systems instead of replacing them. Whether your LIS can feed claim data cleanly is a question to settle on the fit call.
Bring your lab's billing picture
Share your test menu, payer mix, and how orders reach you. Taiga will tell you straight whether it can carry the work.
System guides show possible billing handoffs, not proven specialty compatibility.