⚙ Verified Deterministic Clinical Agent • Zero-Hallucination Primary Key Lock
dotMD-ClaimAudit v4.2
CMS Part B Specialist CPT Volume & GreatDoc™ Auditor
Handle: dotMD-ClaimAudit
Primary Registry: CMS Medicare Physician & Other Practitioners Part B Public Use Files
Core Role: Federal Physician CPT Procedure Volume Auditing, Hospital Rollup Filtering & Bedside Sentiment
Pipeline Architecture: v4.2 Deterministic
dotMD-ClaimAudit v4.2 powers the /doctors directory and GreatDoc™ scoring engine, ranking specialists by verified annual in-office procedure volume rather than paid directory sponsorships.
Live Federal Registry & Verification Endpoints:
Specification Box 1 • Data Provenance
1. Primary Federal Databases Queried
dotMD-ClaimAudit v4.2 queries official U.S. government clinical, pharmacological, and pricing tables directly without commercial sponsor feeds:
- ✓ CMS Medicare Physician & Other Practitioners Part B Public Use Files
- ✓ CMS National Plan and Provider Enumeration System (NPPES NPI)
- ✓ AMA CPT / HCPCS Procedure Code Utilization Tables
- ✓ Verified Patient Waiting-Room & Billing Sentiment Corpus
Specification Box 2 • Deterministic Equations
2. Locked Mathematical & Stoichiometry Formulas
Every quantitative claim, elemental yield percentage, and clinical risk reduction metric is computed via locked deterministic equations:
- GreatDoc™ Composite Score = 0.55 × (CMS State Specialty CPT Percentile) + 0.35 × (Bayesian-Weighted Patient Rating) + 0.10 × (Billing Transparency Index)
Specification Box 3 • Primary-Key Verification
3. Hallucination Firewall Rules
Zero-Hallucination Primary Key Lock: Every output string produced by
dotMD-ClaimAudit v4.2 must bind to a verified federal primary key (PMID, RxCUI, ICD-10-CM, DSLD ID, or NPI) before publication. Unbound claims are automatically rejected at build time.
- Excludes organizational rollup NPIs (>8,000 annual beneficiaries) and non-clinical pathology/radiology billing entities from patient triage feeds.
- Translates raw CPT codes into plain-English clinical capabilities (e.g., CPT 76536 = In-Office Neck Ultrasound).
- Enforces zero paid placement—physicians cannot pay to boost rankings or suppress billing complaints.
Specification Box 4 • Live Production Ledger
4. Recent Pages Audited by dotMD-ClaimAudit
Human Systems Oversight & Governance
Engineered & maintained by the dotMD Clinical Systems Architecture Team • Report a data discrepancy: audit@dotmd.com
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