Clinical Pathology CLIA Billing Auditor
185.00 in illegal clinical laboratory claims exceeding CLIA certificate complexity level identified across across 2 items.
Lab holds Certificate of Waiver only. Billed High Complexity PCR test (CPT 87635). Illegal under CLIA Regulation 2. Severe False Claims Act liability.
Method1Audited billed CPT diagnostic procedure codes against FDA/CDC CLIA Test Categorization database.
2Isolated non-waived test lines to halt false claims enforcement and execute voluntary self-disclosure.
| Reference | Description | Illegal_Billing_Exposure |
|---|---|---|
| LAB-903 | High Complexity Molecular PCR Test (Waived Lab) | 120.00 |
| LAB-901 | Moderate Complexity Chemistry Panel (Waived Lab) | 65.00 |
Clinical laboratory billing claim logs, plus CDC/FDA CLIA test categorization database and lab CLIA certificate
CLIA certification level mismatch risk schedule and voluntary billing compliance refund report (Resolution Dossier, Findings Schedule)
Open Clinical Pathology CLIA Billing Auditor on sample data now with no sign-up, then run your own files free for 14 days. $3,000 a month after that, cancel any time. 30% goes to the referring partner.
Read in memory for the session, never stored, never used to train a model.
Not medical, clinical, coding or regulatory advice. A qualified healthcare, coding or regulatory professional must review every result.
14 days on your own files, then $3,000 a month.
Open Clinical Pathology CLIA Billing Auditor on sample data now with no sign-up, then run your own files free for 14 days. $3,000 a month after that, cancel any time.
On a sample file: 185.00 in illegal clinical laboratory claims exceeding CLIA certificate complexity level identified across across 2 items.
Why not just use ChatGPT?
Rules that stay current: the rate cards, tariffs, code sets and regulations it checks against are kept up to date for you; a one-off prompt starts from nothing each time. Evidence that stands up: every finding cites the line, the file and the rule, so it holds up with a vendor, a payer or an auditor. The same answer every time: the checks are written rules, not a fresh guess, so this month's result can be compared with last month's. Nobody has to own it: no one inside has to build, test and maintain a home-made tool, and files are not pasted into a public chatbot.
Start on your own files
If you would rather talk it through, write to dev.sathya@baseloom.app; that reaches Dev Sathya, founder.