Lab Client Onboarding Checklist

The gap between a signed contract and a new client's first clean, correctly-billed requisition is where a lot of avoidable friction happens — not because any single step is hard, but because the steps span sales, billing, compliance, and the bench, and nobody owns the handoff between them by default. This checklist lays out what actually needs to happen, in order.

1. Confirm the approved test menu

Before anything else, lock down exactly which tests this client is approved to order, at what pricing, with what turnaround expectations. This should reference the lab's live, current test menu — not a static list copied into the contract that can silently drift out of sync as the menu evolves.

2. Set up billing and payer information

• Confirm billing model (client bill, insurance bill, patient bill, or a mix by test)
• Collect and verify payer information if insurance billing applies
• Confirm any special pricing, contract terms, or volume-based arrangements agreed to in the contract
• Set up the account in billing systems before the first specimen arrives — retroactively fixing billing setup after specimens are already flowing is where billing errors concentrate

3. Configure requisition and specimen requirements

• Provide (or configure, if using an electronic requisition) the correct requisition form reflecting the approved test menu
• Confirm specimen collection, labeling, and transport requirements are communicated clearly — mismatched expectations here are the single most common source of early specimen rejections from a new client
• If integrating electronically (HL7, API, or portal-based ordering), complete and test that integration before go-live, not after the first live order

4. Train the client's front-desk and clinical staff

• Walk through correct specimen labeling and collection for the tests they'll be ordering most
• Confirm who at the client site is the point of contact for questions, results delivery issues, or specimen problems
• Set expectations on turnaround time by test — a client who doesn't know a send-out test takes five days will call it a service failure at day three

5. Set up results delivery

• Confirm delivery method (portal, fax, interface, courier for paper reports) and test it with a sample result before go-live
• Confirm who receives critical/panic value calls and how that's documented on the client's side
• Set up any custom report formatting the client's EHR or workflow requires

6. Assign an internal owner for the first 30–60 days

New client accounts have a higher early failure rate than established ones — first orders are where labeling mismatches, missing requisition fields, and billing setup gaps actually surface. Assigning a specific person (typically client services) to actively monitor the first weeks of orders — not just wait for the client to complain — catches these early rather than letting a rough start define the relationship.

7. Close the loop with sales

Once onboarding is functionally complete (test menu live, billing configured, first clean specimens processed without issue), the account should formally hand off from onboarding to steady-state client services and account management — with the CRM record reflecting that transition, not left showing an open "in progress" status indefinitely.

Where onboarding typically breaks

Sales closes the deal and client services finds out at the same time the first specimen arrives. Without a defined handoff step, there's no guarantee billing, requisition setup, or front-desk training happened before go-live — the first sign of a gap is often a rejected or incorrectly billed specimen.

Test menu and contract drift apart. The list in the signed contract and the list actually configured for ordering diverge over time as the menu changes, with no process keeping them in sync.

No one owns the early-days monitoring. New accounts get treated the same as established ones from day one, missing the window where early friction is easiest to catch and fix before it becomes the client's lasting impression of the relationship.

The through-line

Every step above is really the same principle applied to a different function: the contract, the test menu, billing, and the CRM record all need to reference the same underlying facts about this client, updated in one place — not four separate documents that each start accurate and drift apart the moment reality changes.