P PraxisNotes
03 · Data · from assessment to insight

The note expires when the claim pays. The data compounds for the life of the client.

The new PraxisNotes is data-first. Every fact starts in the assessment, is captured as structured rows in each session, is validated against the plan, and compounds into trends a note archive could never give. The note is a rendering of that data — the data is the asset.

Table and graph, per behavior

required at every 6-month reauthorization — Florida Medicaid.

Data no older than 60 days

quantitative currency rule for continued authorization — Cigna.

Baseline captured, never charted

today's PraxisNotes stores a baseline number and nothing plots it.

The data journey

One spine runs from the first assessment to the billed claim. Each stop below is a structured record, not a document in a drawer — and everything after this section walks the map.

Assessment

Vineland-3 · BASC-3 · CDE · referral

Client profile

DOB · diagnosis · guardians · insurance

Treatment plan v3

behaviors · programs · goals · mastery

Authorization

CPT · units granted · date window

Session capture

voice · tap · captured · asked

Measurement rows

value · type · source · plan target

Trends & analytics

per-behavior · caseload · org

Packets

reauth · QA · billing

Office Puzzle

via the extension · no retyping

The five stops in coral are where PraxisNotes lives; the rest it feeds. Scroll the row on a phone.

It starts with the assessment

A client is not a name. It's a spine of structured fields — every one of which a payer, a reauthorization, or a claim will eventually ask for. Intake captures them as data, not as a PDF nobody can query.

Demographics

DOB, preferred language, and guardians as linked people — never sharing the child's phone or email identity. Relationships are records, not free text.

Diagnosis

ICD-10 to the highest specificity, plus co-occurring conditions — the code that must support medical necessity on every claim line.

Insurance & authorizations

Payer, plan, member ID — and authorizations as first-class rows: auth number, CPT codes, units granted, date window.

Assessment instruments

Vineland-3 and BASC-3 scores — the exact instruments Florida requires in an authorization packet — held as scored values, not attachments.

Targeted behaviors

Each with an operational definition, a measurement type — frequency, percentage, or duration — and a baseline that is the first point on every chart.

Programs & goals

Replacement programs with mastery criteria, and goals tied to the plan — so a session can only record against something the plan actually authorizes.

Today's PraxisNotes gets halfway there.

The current app captures behaviors with baselines in a five-step wizard — good clinical instincts. But there's no DOB, no insurance, no diagnosis, no authorization field anywhere, and the baseline it collects is never charted. The data model exists; the data architecture doesn't. See the honest audit →

Intake is the agent's front door

Paste or upload the assessment report. The agent extracts the structured profile — diagnosis, scores, payer, behaviors, baselines — and a human confirms every field before it saves. Today's chat assistant already builds clients from a pasted treatment plan; we make that the way every client begins, with review over data entry.

Nothing is invented and nothing is silently trusted — the agent proposes, the human approves, and the audit trail remembers who confirmed what.

Extracted from Vineland-3 report confirm each field
Diagnosis (ICD-10)
F84.0 · Autism spectrum disorder
high
Vineland-3 · Adaptive Behavior Composite
71 · standard score
high
Payer
Sunshine Health · Medicaid
high
Elopement · baseline
6.8 / session · frequency
review
Nothing saves until a human confirms it.
J
Jordan M.
DOB 2019-03-11 · F84.0 · Sunshine Health · language: Spanish
Profile Plan Authorizations Data
Units ledger · the pre-session check that catches an expired or exhausted authorization before a session runs.
AuthorizationCPTUnits (granted · used · scheduled)Expires
SH-2026-04817
Sunshine Health
97153
96 · 47 used · 12 scheduled
37 units remaining
Sep 30

An authorization exceeded or a date outside the window is the top preventable denial — CARC 197/198. The ledger is live, so overbooking against the auth never reaches a claim.

Every session adds rows

The four ways in — captured, tapped, spoken, asked — all land in the same measurement rows, each validated against the plan. One data model, four ways in → The note renders from these rows; it never invents them.

Session · Apr 22 · 4:00–5:30pm · home 14 rows · 1 flag
Behavior / programValueTypeSourcePlan target
Elopement 3 frequency voice 4:47pm plan
Tacting program 76% percentage tap plan
Hair pulling 0 frequency confirmed zero plan
Spitting 2 frequency voice 5:02pm not in plan
A behavior that isn't in the plan doesn't fail silently — it flags the BCBA that the plan may need updating.
0 is an answer; empty is a question

We store a confirmed zero distinctly from not measured. Conflating the two is the exact bug that bites Office Puzzle users today — data reads as though a session was never held. Two states, never one default.

Every row remembers its source

Tap, voice at 4:47pm, an answered escalation, an edit before signing — the provenance travels with the number. Every point on every chart is auditable down to the voice note that produced it.

See the trajectory

Rows over weeks become a picture. This is the client's Data tab — the thing a note archive can never render, and the exact graphs Florida wants in the reauthorization packet.

Jordan M. · Data
30d 90d Auth period
Behaviors: Elopement Tacting Hair pulling Manding
Elopement
4.2/session
↓ 38% vs baseline 6.8 · improving
Tacting program
76%correct
↑ 4 pts to 80% mastery · improving
Data completeness
96%sessions
with full measurement rows
Auth runway
37units left
~5 weeks at current pace
Elopement · frequency per session
last 90 days · down is progress
8 6 4 2 0 baseline (assessment) · 6.8 Jan 31 Feb 21 Mar 14 Apr 11 Apr 29
Apr 22 · 4.1 / session
voice-sourced · 4:47pm

This exact graph is what Florida wants in the reauth packet — it renders itself from the rows, no chart-building.

Tacting · % correct
last 90 days · up is progress
100 75 50 25 0 mastery criterion · 80% Jan 31 Feb 21 Mar 14 Apr 11 Apr 29
Apr 29 · 76% correct
tap-sourced · 30 trials

A flat line here is the signal Aetna documents: no improvement means the BCBA must modify the protocol — and record that they did.

The whole behavior set, at a glance
one behavior per panel — no spaghetti chart, always
Elopement ↓ improving
Hair pulling ↓ improving
Tacting ↑ improving
Manding ↑ improving
The packet assembles itself

Reauthorization is per-behavior table + graph + a 60-day data-currency check, one click — the shape Florida and Cigna require. The same rows feed QA (data-vs-note consistency) and the billing packet. One source, three destinations, zero re-charting.

Dr. Chen · caseload
Which clients trend the wrong way this month
Jordan M.↑ improving
Priya S.↑ improving
Marcus T.↓ worsening
Ava L.flat · review
Owner · org health
96%
data complete
98%
notes signed
95%
first-pass
Completeness, signatures, and first-pass clean-claim rate across the whole clinic.

Validated, always

A trend is only trustworthy if every point is anchored. The golden thread runs from the plan to the graph, and survives the plan changing underneath it.

Every row maps to a target

A measurement can only record against a behavior or program that lives in the client's plan. No orphan data on any chart.

The plan is versioned

Trends survive plan revisions: each measurement references the plan version it was recorded under, so a Feb goal change never rewrites Jan history.

Off-plan flags the BCBA

A behavior the plan doesn't have becomes a plan-update suggestion, never a silent drop — the BCBA decides whether to add it.

Source stamps make it auditable

Every chart drills down to the tap, the voice note, or the answered escalation that produced the point. Defensible to the source.

The same data feeds Office Puzzle

Billing runs through Office Puzzle today, and its Event Modal expects the session data too — data-collection values, the note, signatures, and claim fields, all on one event. Today that's a double-entry tax: capture here, retype there — or capture only in Office Puzzle and lose the analytics entirely.

PraxisNotes · one source of truth
Measurement rows
Note text
Times & place of service
Claim fields
extension no retyping
no transcription drift
Office Puzzle · Event Modal tabs
Data collection
Documents
Event details
Claims
EVV

EVV is never auto-filled — visit verification must originate in the EVV flow, a permanent design invariant. Office Puzzle's Imported Data tab takes only historical DATE;VALUE;TYPE numbers — fine for backfilling old data, useless for the live loop. The extension is the live path.

Extensible by schema

Each CPT code's capture is a versioned schema, not code. 97153 carries ABC and program data today; 97155 protocol modification, 97156 caregiver training, and 97151 assessment writing come next. A new code is a new schema paired with a new rule pack — no redeploys.

And the spine isn't ABA-specific. Assessment → plan → structured sessions → trends is the shape of speech and OT too — the same brain, pointed at a different discipline.

See the data model
Capture schemas
97153 · ABC + programs · today
97155 · protocol modification
97156 · caregiver training
97151 · assessment writing

New schemas ship as data, versioned and reviewable — the same pattern the plan and payer rules already use.

The data outlives the note. It's the clinic's compounding asset — and the client's story, told in evidence.

A note is spent the moment the claim pays. The rows behind it become baselines, trends, reauth packets, and proof — for the whole life of the client.

Meet the team that works this data