How Refocus Partnered with Brellium to Decrease Payer Clawback Risk

“I've been doing the same job for three years and reading 40 notes a day takes time. It takes energy. It takes serious focus and taking that workload off of me has so significantly improved my life.”

Refocus Behavior Case Study: Automating ABA Chart Audits with Brellium

Background

Refocus Behavior is an ABA center in Hinesville, Georgia, providing early intervention and school-age services for children with developmental disorders, including:

• Autism spectrum disorder (ASD)
• Attention-deficit hyperactivity disorder (ADHD)

The organization historically prioritized strict compliance, especially with demanding payers like Tricare.

Challenge: Manually Reviewing 100% of Charts

Before Brellium, Refocus Behavior manually audited every single client note before billing. This process required staff to constantly toggle between:

• The EMR
• Payer and clinical requirement lists
• Error ledgers and tracking documents

This workflow was:

• Time-consuming – 60% of billing hours were spent on manual audits
• Exhausting – The billing lead experienced significant burnout
• Unsustainable – Time off was difficult because audits piled up, making returns from vacation stressful

Key pain points:

• 100% of charts manually reviewed before billing
• High audit volumes causing burnout
• Inability to step away without falling behind

Solution: Automated Chart Review with Brellium

To maintain both clinical quality and payer compliance, Refocus Behavior implemented Brellium’s automated chart review.

They built screening templates for key ABA session types:

• 97153 – Adaptive behavior treatment by protocol
• 97155 – Adaptive behavior treatment with protocol modification

Brellium was configured to automatically audit notes against:

• Custom clinical standards
• Payer-specific requirements (including Tricare)

Automated Auditing Workflow

1. Refocus Behavior entered their custom requirements into Brellium once.
2. Brellium’s team configured the AI to align with those requirements.
3. Patient charts were automatically analyzed after sessions.
4. Any errors were flagged, and providers received automated notifications with clear instructions for correction.

Key Benefits

• No more manual chart audits – Audits ran automatically in the background.
• Real-time feedback – Providers were notified of documentation errors and how to fix them.
• Proactive compliance – Full reporting enabled leadership to monitor trends and address issues before payer audits.

Results: 2X Productivity and 5X ROI

After implementing Brellium, Refocus Behavior saw measurable operational and human-impact outcomes.

Before Brellium:

• 60% of billing hours spent on manual audits
• Daily auditing led to burnout
• Constant struggle to keep up with audit volumes

With Brellium:

• 98% reduction in time spent manually auditing
• 2X increase in billing team productivity
• 0% of charts require manual pre-billing audits
• Significant improvement in job satisfaction and work-life balance

Net Benefit:

• 5X ROI on the investment in Brellium
• An entire workday’s worth of time freed up
• Billing staff gained the ability to take time off without returning to a backlog of audits

Client Feedback

"The fact that you guys get back to me within 10 to 15 minutes of an email is legitimately unheard of in the medical administration field."

"You guys have built a wonderful team that truly cares about the customer experience with the product. Every interaction has been so positive. The expertise has been invaluable in optimizing our audit process and ensuring smooth operations."

"Before using Brellium, I was on the brink of burnout. Taking time off was difficult, and every return from vacation was stressful. Adding Brellium significantly improved my work-life balance. I seriously cannot thank you guys enough."

— Aeriel Brenner, Billing & Compliance Manager, Refocus Behavior