Months after a session is finished and paid, a payer can reach back and take the money for it. Sometimes over something as small as a missing signature, or a note that never quite said what the session was for. Nobody in ABA wants to spend their day on documentation. Clinicians dread it, owners worry about it, and QA teams are drowning in notes they could never fully read. And all the while, that paperwork quietly decides whether you keep the reimbursement, and sometimes whether a clinician keeps their job.

My guest today is Mitchell Mom, head of product at Brellium, an AI compliance platform that audits session notes against payer, regulatory, and quality requirements. Mitchell says they have reviewed close to seven million ABA session notes, which gives them a clear view of where documentation tends to break down and what it costs a practice when it does.

Here is what we get into:

• Why no team can manually review more than a fraction of its notes, and what changes when you can check all of them instead of spot-checking.
• The patterns that show up again and again. Notes that do not tie clearly to ABA, sessions that look double-billed, and signatures that do not line up with the actual session time.
• Why the same note can pass in one state or with one payer and fail with another, and how to think about a moving target.
• How to coach clinicians without the gotcha. A six-month trend lands better than catching one note from last Tuesday.
• The link between specific notes and better care. "Mastered X with 80 percent accuracy across three trials" tells a story. "Client did great today" tells you nothing.
• Why good documentation can even help keep families in care, because parents can finally see the progress for themselves.
• Moving from reactive to proactive, and treating documentation as protection before an audit instead of a scramble after one.
• A fair reminder that a documentation error is not always fraud. Sometimes a good clinician simply forgot to sign once.

One thing Mitchell is careful about. Brellium is not there to second-guess clinical judgment or replace your QA team. It handles the consistency at scale that no tired human can, and flags the few notes that actually need a real set of eyes, so your people can spend their judgment where it counts. The goal is never to tell a clinician they failed. It is to point out the few things worth fixing, and show them how.

Learn more about Brellium at https://www.brellium.com

This is Brellium's first time at ABA C.A.R.E.S., and they will have a booth in Boston this August. If documentation is eating your QA team alive, or you keep getting flagged and are not sure why, that is exactly the conversation to have with them. Register here: https://behaviorlive.com/conferences/abacares2026/registration

We will see you in Boston August 4th through 7th, or live streaming from the other side of the screen.