From Trust to Proof: Verifiable, Privacy-Preserving Session Records and In-Room Clinical Intelligence as Emerging Infrastructure for Applied Behavior Analysis

Applied behavior analysis (ABA) is among the most heavily billed services in behavioral health. It is delivered one to one, frequently inside a family's home, and documented after the fact by the same party that bills for it. This structure leaves payers, families, and honest providers without an independent way to confirm that a billed session occurred as described. Recent audits by the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) have found that large shares of sampled ABA payments were improper or potentially improper, with deficiencies concentrated in session documentation rather than in the care itself. This perspective argues that the field's central problem is structural and evidentiary rather than moral, and that ABA needs a new layer of infrastructure: verifiable, privacy-preserving session records paired with real-time, in-room clinical intelligence. It describes a proposed approach, Proof of Session, and a complementary clinical layer, SessionAssist, and discloses that the author is developing both as TrueSession, Inc.