How it works
Agents do the work. Every step has an owner, and the record shows who.
A governed case moves through six links. Code checks the facts, an agent drafts, a named person approves, and only then does anything happen. The receipt stays on file.
Six links, and who owns each one
| Link | Owner | What happens |
|---|---|---|
| Evidence | Records | The case points at the session notes, authorization, payer letter or claim it rests on. It does not copy them into a summary no one can check. |
| Rule | Code | Deterministic checks decide what is true: units left, days left, whether a note is signed, which payer rule applies. A model never calculates, validates or decides these. |
| Proposal | An agent | An agent drafts the next step and cites its sources. It is drawn as unaccepted machine output until a person accepts it. |
| Approval | A named person | A clinician or biller approves, edits or returns the draft. The seal records who, when, which rule version, and what they changed. |
| Action | The system | The side effect happens only after a sealed approval, or inside an action class that has earned autonomy and says so. |
| Audit | The record | The case closes with a receipt, so the decision can be reconstructed from what was written at the time. |
What the agent is never allowed to do
- Sign or attest a clinical note. Texas requires practitioner review of AI-generated records, so this action stays with a clinician at any accuracy.
- Release a weekly update to a family before the child's BCBA has approved it.
- Present a draft as final. Machine output keeps its own look until a person accepts it.
- Calculate a unit balance, a deadline or a payer rule. Code does that, and the code is tested.
Autonomy is earned per action, and the owner sets it
The owner sets a level for each workflow the dial governs: suggest, draft, prepare and queue, or act with receipt. The top two have to be earned from reviewed runs, measured by how often a person accepted the work unedited. A bad stretch of recent runs demotes a level, and the change is written to an append-only log. Payer-facing, parent-facing and Texas SB 1188 workflows are capped in code and can never act on their own. Every governed run gets a receipt: what it did, the evidence, the level, when, and how to undo it.
What goes on the receipt
- The evidence the case rested on, by link, never by copy.
- The rule that applied and the pack it came from, with its sources and review status.
- The machine's draft, kept beside the signed version so the difference can be measured.
- Who sealed it and when, with a hash that binds the signature to the exact content signed.
- For a claim submitted through a payer portal, a plain statement that ABACare did not transmit it.
Video evidence keeps observation apart from meaning
Where session video is used, the same discipline applies. What is seen, what the model suggests it is, and what it means are three separate layers, and only a clinician writes the last one.