MODULE 2: XACTIMATE FOR MOLD

Billing Red Flags

Lesson 2.4 - The Billing Blueprint: Mold Edition

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The Billing Blueprint

Why Mold Claims Get Extra Scrutiny

High dollar amounts ($10K-$40K+)
Industry history of inflated claims (early 2000s)
Coverage limits create pressure on every dollar
Adjusters are trained to question mold
Third-party auditors review large claims

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Red Flag #1: Outside Protocol

Billing for work NOT in the protocol

Protocol says: Remediate bathroom
You bill: Bathroom AND closet

Result: Instant reduction. "It wasn't in the protocol."

Adjusters compare your estimate to the protocol line by line.

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Equipment Red Flags

Air scrubbers exceeding CFM needed - 4,000 CFM for 600 CFM space?
Equipment days beyond clearance - Clearance day 4, billing day 6?
Duplicate equipment without justification - Two negative air in small space?

Fix: Know the calculation. Document why quantities are appropriate.

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PPE Red Flags

PPE doesn't match labor hours - 40 labor hours but 5 days of PPE?
Excessive suit quantities - 20 suits for 2-day, 2-worker job?
Respirators for wrong crew size - 4 respirators but only 2 workers?

Fix: Make PPE, labor hours, and crew size tell the same story.

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Containment Red Flags

Containment SF larger than affected area - 10x10 bathroom = 500 SF containment?
Multiple zones when one would work - Adjacent areas, separate containments?

Fix: Document containment with photos showing actual dimensions.

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Clearance Documentation Red Flags

Billing complete without clearance letter - Did you actually finish?
Charges after clearance date - Why equipment running after pass?
Multiple re-tests without explanation - Problems with your work?

                Timeline should be logical: Work → Clearance test → Pass → Containment down
            

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Pricing Red Flags

Prices far above Xactimate guidelines - $8/SF when guideline says $5?
Excessive material markups - 50% markup vs standard 10-20%?
Custom line items with high prices - $2,000 custom item, no description?

Fix: If pricing deviates, explain why in estimate notes.

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How to Avoid Red Flags

Match estimate to protocol exactly
Document everything with photos
Calculate equipment and PPE properly
Include clearance documentation
Keep pricing reasonable
Make estimate tell a consistent story

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Consistency is Key

Labor, equipment, PPE, and timeline
should all align.

Inconsistencies trigger questions.

When something is unusual, explain it.

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Explain the Unusual

            A note on the estimate explaining

            why you needed extra equipment or

            why the job took longer

            prevents questions later.

            Proactive explanation > Reactive defense

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Key Takeaways

Mold claims get heavy scrutiny - build estimates to withstand it
Major red flags: outside protocol, excessive equipment, mismatched PPE
Always include clearance letter
Keep pricing reasonable or explain deviations
Make your estimate tell a consistent story

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Coming Up Next

Module 3: Protocols & Estimates

How to read a protocol
Translating protocol to estimate
Working within coverage limits
Building and submitting estimates

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MODULE 2: XACTIMATE FOR MOLD

End of Module 2

Xactimate for Mold Complete

Action Item: Download the Red Flags Checklist. Review before submitting.

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