Aureum, the audit that never stops.
auro’s constantly auditing architecture. Every assertion the practice makes is re-checked against what the practice can actually prove, all the time, so the answer to “can you show me” is already true rather than assembled three weeks later.
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An audit is not an event. It is a state. Most software can be audited: someone asks, a team stops what it is doing, and three weeks later the evidence is assembled. Aureum inverts that, and holds every assertion against its evidence continuously.
The clinical chain
The claim against the note, the note against the visit, and the code against the rule that was actually in force.
The claim against the signed note
Every line on a claim is held against the note it was coded from. A code with no signed note under it is a finding, not a rounding error, and it is raised before the claim is filed rather than after it is paid.
The note against the visit
The note is held against the visit that produced it: the consent stamped on the recording, the time the visit actually took, the clinician who was in the room. A note that drifts from its visit stops being evidence.
The code against the rule in force
Not today’s rule. The payer rule as it stood on the date of service, which is the only version that decides whether the line was right. Rules move; the date of service does not.
The money and the shelf
The order against the acceptance, the three-way match, and the ledger against the bank.
The order against the vendor acceptance
An order placed and never acknowledged is a hole in the supply chain. Aureum names it while it can still be fixed, rather than when the shelf is empty on a Monday.
The three-way match
The receiving record against the invoice against the purchase order. Received short and invoiced full is caught on the shelf, not discovered in the close six weeks later.
The ledger against the bank
Every line on the books is held against the settlement behind it. A number with no document under it is a question, and it is asked before the month can be locked.
What the model asserted
The benefit Lana read back, and the authority Savoir acted under.
The recording against the benefit
The benefit a claim asserts is held against the recording and the reference number Lana captured on the line. A claim claiming coverage the call never established is stopped before it leaves.
The authority against what was done
Every action Savoir takes is checked against the limit it was given, by something that is not Savoir. Acting past the limit is a defect, and the action is put back.
Every action carries its receipt.
Not a log line. A document: what arrived, what Aureum saw, what was chosen, under whose authority, and what the world answered. An action without a receipt is a defect in Aureum, not a missing nicety.
Receipt
One claim line, filed the night of the visit.
- What arrived
- A signed note for a follow-up nutrition visit. Consent stamped on the recording, the time spent written into the note, read and signed by the dietitian before anything was billed.
- What it saw
- That signed note. The benefit read back by a payer representative on a recorded call the night before, with a reference number against it. The payer rule as it stood on the date of service, not the one in force this morning.
- What it chose
- 97803, four units, filed to the plan that was active on that date, under the rendering provider named on the note.
- Why
- The note records the time spent, and the benefit read back still had hours against it. Both are attached to the row rather than summarised into it, so the reason can be opened, not taken on trust.
- Under whose authority
- A standing limit the practice wrote: file when the note is signed and the benefit is established. Outside that limit Savoir stops and asks a person, and the asking is on the receipt too.
- What the world answered
- Accepted by the clearinghouse, then paid on the first pass. The remittance is attached to the same row as the claim, which is what makes the pair worth learning from.
- the claimagainstthe signed note it was coded fromholds
- the noteagainstthe visit that produced itholds
- the codeagainstthe payer rule in force on the date of serviceholds
- the benefit assertedagainstthe recording and the reference number behind itholds
- the paymentagainstthe bank line that settled itholds
- the actionagainstthe authority it was taken underholds
If any one of these stops agreeing, the row is flagged and a person is told, with what Aureum saw. Nothing is quietly corrected, and nothing waits for someone to ask.
What the pilot practice can prove
37
checks run against the books before the month can be locked
12 of 12
billed visits with a signed note under them in the September close
0
answers asserted without evidence behind them; where it cannot prove, it flags
Aureum assumes auro is wrong, and goes looking for the disagreement.
A code with no note under it
A line on a claim whose note is not signed, or is not there at all. The claim is held against the note it was coded from, and a code with nothing under it never becomes a bill.
A benefit the call never established
A claim asserting coverage the recording and the reference number do not support. The call is the evidence. If the evidence does not say it, the claim does not say it either.
An order against a vendor that never accepted
A purchase order placed and never acknowledged, or received short and invoiced in full. The receiving record, the invoice and the order are held against each other until all three agree.
A ledger line with no document behind it
Every number on the books is held against the settlement, the remittance or the invoice that produced it. A line with nothing behind it is raised before the owner is asked to lock the month.
A model that acted past its authority
Every action is checked against the limit it was taken under, by something that is not the model that took it. Acting outside the limit is a finding, the action is put back, and the finding is kept.
A line on a claim whose note is not signed, or is not there at all. The claim is held against the note it was coded from, and a code with nothing under it never becomes a bill.
The name
Aureum is Latin for golden, and the assay is the test a thing is put to before anyone is allowed to call it gold.
The boundary, watched rather than promised
Nothing about a patient leaves the practice’s boundary. The model interprets and never holds the record. Authority limits hold, and every live action stays revertable. Aureum watches all four the way it watches a claim, and where it cannot prove something it flags it instead of asserting it, which is the law Lana works under on the phone applied to the whole system.
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