Cadence ABA

Cadence is the voice-first, agentic platform for ABA clinical work. A clinician runs the session out loud; Cadence captures each trial, structures it into clinical data, evaluates mastery, reads the trend, and drafts a billable, signable note. The tagline is the whole design brief: clinical presence, not data entry.

The problem we started with

ABA is one of the most data-intensive disciplines in healthcare. Every session generates trials, behaviors, graphs, notes, and billing — and most of it is still captured by hand, then reconciled after hours. The result is a quiet tax on the field: attention split between the child and the tablet during the session, and evenings spent on documentation instead of clients. We think that trade-off is a tooling failure, not a fact of the work.

How a session actually runs

1. Capture. Narrate naturally — "independent mand for break, then two prompted" — and the Capture agent resolves that speech into structured trials against the client's active targets, mid-session. Each resolved trial lands in a confirmation strip you can correct with one tap. Prefer not to talk? An eyes-up tap grid needs no AI and no network at all.
2. Understand. On commit, mastery is evaluated against a configurable rule, phase-change proposals surface carrying the exact evidence they rest on, and trend, variability, and level change are computed and narrated in plain language.
3. Document. A SOAP note is drafted from the session's committed data, with CPT codes mapped to what was actually delivered and the data attached. You review, adjust, and sign.

What's included

Session capture

• All eight ABA measurement systems natively — DTT, NET, task analysis, frequency, duration, interval, latency, and ABC
• Fully offline. Every tap is written to on-device storage and awaited before it shows as captured, then synced deterministically. Corrections made offline survive the sync
• Speech is transcribed on-device by default; BAA-covered medical ASR with speaker isolation is used only when explicitly configured
• Configurable prompt hierarchies, so prompted-trial scoring matches how your clinic actually codes prompts

Clinical reasoning

• Mastery evaluated against a configurable, data-driven rule — never hardcoded clinical logic
• Phase-change proposals surfaced the moment criteria are met, with their supporting evidence attached
• Trend, variability, level change, and stalled progress computed by least-squares regression, then narrated in plain language
• Equal-interval and cumulative graphs generated automatically from committed data
• Generalization and maintenance tracked distinctly from acquisition
• A caseload copilot that answers questions about your clients using read-only tools over committed data

Documentation & reporting

• SOAP notes auto-drafted from committed data, with the data attached and the full ABA CPT family (97151–97158) mapped to the procedures and time delivered
• Progress reports that assemble every target's graph, mastery status, and trend for the period, then draft the summary and recommendations
• A required-element checklist that blocks sign-off when a note is missing something a payer will ask for
• Every figure in a draft checked against committed measurements — a percentage that doesn't match is flagged before signature
• Signed notes amendable through tracked addenda, not edits, so the record stays defensible

Data quality & reliability

• Interobserver agreement in two methods — total count and exact agreement — against the field's conventional 80% acceptability threshold, stored with the session and target it belongs to
• Data-integrity checks that surface gaps and anomalies in a client's record rather than leaving them to be found at report time
• An explicit proposed → committed lifecycle for every clinical record; rejected and superseded records are retained, never deleted

Assessments & treatment plans

• Scored area-by-area against real instrument architecture: 16 VB-MAPP milestone areas and all 25 ABLLS-R areas (A–Y). Vineland-3, AFLS, PEAK, and FBA are supported with free-form area entry
• From a signed assessment, the Plan agent drafts the treatment plan — domains, targets, operational definitions, mastery criteria — for a BCBA to shape and activate

Scheduling, supervision & families

• A week-view clinical calendar scheduling clients with their assigned staff: recurrence rules, conflict detection, and cancellations and no-shows recorded distinctly so they vacate the slot for capacity math. A scheduled session starts directly into capture — the calendar and the clinical record are the same system
• Supervision that follows the caseload: committed data for every supervisee with pending proposals ranked, supervision hours tracked against the sessions they were delivered in, an org-wide cross-location view for multi-site operators, and a clinical sweep ranking what actually blocks clean billing
• Caregivers: a family-facing view written from committed data and never from an unreviewed draft; caregiver training tracked as its own program with implementation fidelity as the measure and mapped to 97156/97157; consents recorded per type

Authorizations & billing readiness

• Authorized units tracked against units delivered, with expiring and exhausted authorizations flagged before they lapse
• An Authorization agent that assembles the payer-facing continued-services packet ahead of a reauthorization window
• Pre-billing validation of CPT mapping, modifiers, and payer-specific rules before a claim draft leaves the clinic
• 837P export (ASC X12N 005010X222A1) for a biller to upload to their clearinghouse
• Audit packets bundling the note, the data behind it, and the audit trail for a single request

The invariant: agents propose, licensed humans sign

Cadence runs ten specialized clinical agents — capture, documentation, analysis, compliance, planning, reporting, authorization, caregiver, import, and program logic. Every one of them drafts or proposes. None of them can sign a note, decide a proposal, or submit a claim. Every promotion to the permanent record requires an explicit human confirmation and is written to an append-only audit log alongside the model and confidence that produced the draft. This isn't a setting — it's the architecture.

Security & compliance

• HIPAA-compliant and BAA-backed
• Client PHI encrypted at the field level with AES-256-GCM; model calls carry a de-identified token, never a client's name
• Role-based access for RBTs, BCBAs, directors, and auditors, with RBTs scoped to their assigned clients — plus custom roles that clone a base role and override individual permissions, and SAML single sign-on
• An append-only audit log of every PHI read and write and every agent proposal and commit, exportable for an audit

Bring your history, take your data

• CSV migration imports clients, targets, and past session data with column mapping and row-level validation
• A public REST API covering clients, sessions, notes, and authorizations — plus opt-in session and authorization writes — documented by an OpenAPI spec at /api/v1/openapi.json
• Retention and discharge workflows, so a client's record has a defined end state

What Cadence is not

• Not a full-service revenue-cycle system. There is no managed claim submission, ERA posting, or denial workflow. Cadence takes you to a validated 837P file; practices that need full RCM keep a dedicated billing solution alongside it. This is deliberate, not a roadmap gap.
• Assessment scoring is at the area level, not per individual milestone.
• We're early and founder-led — small on purpose right now, close to the clinicians we build for, and honest about where we are on the road.

Who it fits

Best for clinician-heavy practices where documentation load is the real bottleneck, teams that want clinical reasoning in the tool rather than another data-entry form, and multi-site operators who need cross-location supervision and authorization tracking. Less of a fit for practices looking for a single vendor to run revenue cycle end to end.

Pricing

Public and self-serve, priced per active client plus per clinical seat.

• Capture — $15/active client + $12/clinical seat per month. Voice and tap capture, auto-drafted signable notes, standard graphs. One location. 14-day free trial.
• Clinical — $99/mo platform + $25/active client + $18/seat. Adds mastery and phase-change logic, trend analysis, progress reports, and supervision. Up to three locations. 14-day free trial.
• Practice — $299/mo platform + $39/active client + $25/seat. Adds authorization and pre-billing compliance, org-wide cross-location supervision, SSO, custom roles, API access, and audit-log export. Unlimited locations, 15 active client minimum, sales-led.

Annual commitment gets two months free. Full detail at cadenceaba.com/pricing — nothing is quote-only except the Practice pilot.