Review desk · case file

ReauthClear

ReauthClear — The ABA Reauthorization & Medical-Necessity Documentation Desk — AI-Native Service Business Blueprint Blueprint Contents Executive Summary Thesis Discovery Rationale Candidate Comparison CODE Validation Rubric Scorecard Target Buyer Jobs-to-be-Done Painful Problem The Outcome We Sell First One-Feature MVP Wedge Evidence Summary Claim Table Source-Claim Matrix Market & Demand Evidence Active Buyer Conversations Competitive Landscape Competitor & Budget Validation Pricing Evidence & Proposed Pricing Regulatory & Compliance Licensing Boundary AI-Native Advantage Internal AI Engine Architecture AI-vs-Human Operations Pipeline Dynasty Translation Layer Anti-Duplication Analysis Anti-Commoditization Analysis Service Delivery Workflow Operations as Product No-Holes Quality Engine What the Human Expert Does Minimum Viable Offer Fulfillment Process Tools & Systems Human-in-the-Loop

reauthclearabareauthorizationmedicalnecessitydocumentation

Who this is for

A precise operating owner, not a generic audience.

Responsible buyer

Target Buyer ICP: Independent or small-multi-site ABA therapy agencies with roughly 5–40 BCBAs and 30–300 active clients, billing a mix of commercial insurance and Medicaid managed-care organizations, without a dedicated in-house utilization-review/authorization specialist role. Beachhead excludes the largest PE-backed chains (top 13 for-profit chains already run ~892 facilities with in-house UR departments S4 ) and excludes solo practitioners below meaningful reauthorization volume.

Cost of the gap

Painful Problem Every 90 to 180 days, depending on the payer, every active ABA client requires a new authorization request: a clinical medical-necessity narrative referencing the treatment plan, quantified progress data (skills mastered, behaviors reduced, goals updated), and a justification for continued weekly hours, formatted to the specific payer's criteria. A 100-client practice manages 200–400 of these cycles a year Verified S5 . Practices without dedicated billing/UR infrastructure see denial rates of 15–25%, roughly double to quintuple the 5–10% healthcare-wide average Verified S5 .

Outcome

The Outcome We Sell Not software the clinic operates. We sell: (1) authorized hours that never lapse — packets land complete, on time, and payer-formatted before expiration; (2) hours retained after a reduction — evidence-backed appeals filed within days of a denial, not weeks; (3) BCBA time returned to billable clinical work, measured and reported monthly.

Decision rule

Proceed only when the source record, service boundary, responsible reviewer, and release criteria can be named before work begins.

Method

The work moves through visible states.

  1. ScopeService Delivery Workflow Client agency signs BAA and connects/exports practice-management data for clients approaching authorization expiration.
  2. CollectIntake queue flags clients within a 21-day expiration window.
  3. NormalizeAI engine drafts the packet against the correct payer's criteria.
  4. ValidateDeterministic checks run (completeness, state caps, unit math).
  5. ResolveAssigned BCBA reviewer receives the draft, edits, signs.
  6. ReviewPacket is transmitted via the payer's required channel; confirmation logged and shared with the client.
  7. ReleaseOutcome (approved/reduced/denied) is logged; reduced/denied cases trigger the appeal workflow automatically.

Engagement

Buy the reviewed outcome, with boundaries written down.

Pricing Evidence and Proposed Pricing Market pricing observed: full RCM outsourcing at 5–8% of collections or $4–8 per claim S5 .

Release package

  • The Outcome We Sell Not software the clinic operates.
  • We sell: (1) authorized hours that never lapse
  • packets land complete, on time, and payer-formatted before expiration; (2) hours retained after a reduction
  • evidence-backed appeals filed within days of a denial, not weeks; (3) BCBA time returned to billable clinical work, measured and reported monthly.

Proof standard

Operating evidence: No verified cycle-time result is published yet. The first result will be calculated from accepted intake through qualified-human release.

Client evidence: No client identity or case narrative is published. A reference may appear only after written permission and factual review.

Volume evidence: No completed-client count is claimed. Counts will be published only after the delivery ledger and provider records reconcile.

Evidence room

Authority comes from traceable sources, not decorative claims.

Open the full canonical blueprint dossier

  • bacb.com/bacb-certificant-dataSource identified in the canonical blueprint; verify currency before client reliance.
  • bacb.com/bcbaSource identified in the canonical blueprint; verify currency before client reliance.
  • businesswire.comSource identified in the canonical blueprint; verify currency before client reliance.
  • blog.marketresearch.comSource identified in the canonical blueprint; verify currency before client reliance.
  • breakingnewsaba.comSource identified in the canonical blueprint; verify currency before client reliance.
  • npr.orgSource identified in the canonical blueprint; verify currency before client reliance.
  • bhbusiness.comSource identified in the canonical blueprint; verify currency before client reliance.
  • pestakeholder.orgSource identified in the canonical blueprint; verify currency before client reliance.

Service boundary

Automation prepares. A qualified human releases.

ReauthClear is an operational documentation and processing service operated by Your Deputy, Obuke LLC. It is not a law firm and does not provide legal, tax, medical, financial, or other licensed professional advice. Consumer and personal debt matters are not accepted. The client retains its licensed professionals and decision authority. Automation may organize and check records, but a qualified human must review and release every client deliverable. Minimum-necessary data handling and professional review apply.

  • Unsupported facts remain unresolved, never inferred into a client deliverable.
  • Jurisdiction-specific or licensed questions are routed to the client's professional.
  • Every correction retains the source, reviewer, version, and reason for change.

Questions

Know the limits before intake.

Is this legal or professional advice?

No. This is bounded operational documentation and processing support. Licensed judgment remains with the client and its professionals.

Does automation make the final decision?

No. It can organize records, run declared checks, and prepare an exception queue. A qualified human reviews and releases every deliverable.

Is a client portal or CRM already active?

This public site does not claim an active portal integration. Portal access is provisioned only after the relevant backend is configured and independently verified.

What happens when evidence conflicts?

The item is placed in an exception state with its sources and owner. It is not silently resolved or presented as verified.

Fit diagnostic

Send enough context to scope the next conversation—no sensitive files.

Do not submit protected health information, personal financial data, credentials, or confidential client records through this public page.