Clinical and revenue integrity for ABA practices

Every session. Clinically sound. Financially ready.

SageWorks ABA connects treatment, live session data, documentation, authorizations, billing, payroll and compliance in one continuous record — so care stays clinical and revenue stays defensible.

Purpose-built for ABA · Human-led clinical decisions · Intelligence with evidence

One session. One source of truth. Click a stage — it is the same session throughout. Everything shown is synthetic; no real record appears on this site.

1. Deliver careCapture what matters, in the home, with or without signal.
2. Verify integrityRules and evidence surface problems before they become denials.
3. Get paidClaims that carry the record which justifies them.
4. Run the practiceSee what is at risk while it can still be fixed.
Clinical integrity firstEvidence-linked AIPayer-rule aware Append-only auditHuman in the loopDesigned for HIPAA-aligned workflows
The problem

The gap is not between systems. It is between what was delivered, what was documented, and what was paid.

Care that cannot be evidenced

Hours are worked and paid. Weeks later the note is missing, the filing window has closed, and nobody can say when it stopped being recoverable.

Authorizations that run out quietly

Units are counted, not projected. The renewal is requested after the authorization is exhausted, and the choice is unpaid care or a gap in a child's treatment.

Documentation that does not survive a look

A narrative says no challenging behaviour occurred. The behaviour log for the same session says otherwise. Both are in the system, and nothing compares them.

None of these are software failures. They are what happens when clinical truth, operational truth and financial truth are three records that have to be brought into agreement by hand.

What makes it different

Six decisions, and each one shows up as behaviour you can check.

1

One session, one record

The claim is a view of the session, not a second copy of the work. Payroll reads the same ledger. Reconciliation is not a nightly job, because disagreement is structurally impossible.

A session cannot have two claims. Preparing twice yields one.
2

Notes assembled from the record, sentence by sentence

Every sentence carries the events it rests on. Click "independently on 4 of 6 trials" and the six trials are there. A sentence with no supporting record is not produced at all.

Absence is stated about the log, never about the session: "none was recorded" is evidenced, "none occurred" is not.
3

A core that works with the AI switched off

Trials, timers, visit verification, unit maths, entitlement and claim gating are deterministic rules. There is a kill switch, and turning it off changes nothing about whether the practice can operate.

If every language model on earth went dark tomorrow, the practice still runs.
4

Offline is a design, not a retry queue

A therapist pulls an entitlement lease while there is still signal and carries it into the home. Work recorded with no connection is never rejected on sync — the claim is held with a reason, and the record of care stands.

Device time is stored beside arrival time and the difference is measured. A clock is the one input the person being verified can change.
5

The gate judges the date of service

A credential lapsing next week does not stop today's session and does stop what is booked for next month. Caught at booking, not on the doorstep.

Checked again at the start of the visit, because things change in between.
6

Money stops. Care never does.

Every block in the system is administrative: a claim, a payroll export, a booking. Nothing can interrupt a clinical encounter, and no automated decision arrives without the records that produced it.

A flag a clinician cannot check is a flag they learn to dismiss.
AI governance

The assistant has a ceiling, and the ceiling is written down.

LevelWhat it permits
0 · ObserveAnalyses. Writes nothing anyone sees in the workflow.
1 · SuggestAppears in the rail. Dismissible without a reason.
2 · WarnPersists until acknowledged. May create a review task.
3 · ConfirmAn administrative action cannot proceed unattended. A named person confirms.
4 · BlockClaim release, payroll export, scheduling. Reserved for the rules engine — no model holds it.
A generative model producing a false positive in a living room, mid-escalation, with a child present, is a clinical safety event of its own making. Which is why nothing here can darken a session screen or halt a visit. It warns with evidence, notifies the supervisor, opens a review on the ledger — and holds the claim.

Every model output is recorded with who reviewed it and what happened next. The audit chain is hashed per practice and append-only: reads are recorded too, because in healthcare who looked is a finding of its own.

Where we actually are

Early, and specific about it.

We would rather tell you this now than have you find it out in a demo.

Built and verified

Eight domain services behind an edge and two separate front doors. The clinical ledger, the entitlement rules engine, claims with scrubbing and an 837P draft, workforce reconciliation, offline capture, intake and scheduling, the hash-chained audit, the practice console and an offline tablet client. The whole suite is checked by an automated verification run on every change.

Platform runningVerification green

Not yet

No practice is live on this. The payer rule graph holds one illustrative payer, and it is built payer by payer with someone who knows the companion guides. Clearinghouse transport is not connected, so an 837P is a structural draft and says so. HIPAA readiness is a programme — agreements, encryption, access reviews, retention, training — and the architecture supports it rather than constituting it.

No customers yetClearinghouse not connected
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