Glossary

The language of behavioral health software.

Definitions for 35+ terms across clinical, compliance, operations, technology, and AI. Bookmark this; share it with new hires.

Clinical Compliance Operations Technology AI

10 terms

Clinical

ASAM Criteria: ASAM (American Society of Addiction Medicine) Criteria is the standard assessment framework for matching patients to the appropriate level of substance use treatment. The criteria evaluate six dimensions including withdrawal risk, biomedical conditions, emotional/behavioral conditions, readiness, relapse potential, and recovery environment to recommend a level of care from outpatient through medically managed inpatient. ASAM-aware EMRs like Navix automate parts of this assessment and flag mismatches between documented dimensions and the assigned level of care.
Biopsychosocial (BPS) Assessment: A biopsychosocial assessment is a comprehensive intake evaluation covering biological, psychological, and social factors affecting a client's mental health and substance use. It typically includes medical history, mental status exam, psychiatric history, substance use history, family history, social functioning, and treatment history. BPS assessments are usually required at intake and form the foundation for the treatment plan. Navix can auto-fill BPS forms from intake interviews using NavixScribe.
BIRP Note: BIRP stands for Behavior, Intervention, Response, Plan — a behavioral-health note format that emphasizes the clinician's intervention and the client's response. Common in therapy, group counseling, and case management settings.
DAP Note: DAP is a behavioral-health-specific clinical note format: Data (objective and subjective information combined), Assessment (clinical interpretation), and Plan (next steps). Common in counseling and case management. NavixScribe supports DAP alongside SOAP, BIRP, GIRP, and SIRP.
GIRP Note: GIRP is a goal-oriented note format: Goal, Intervention, Response, Plan. Each session note ties back to a specific treatment-plan goal. Common in long-term programs where progress against goals matters.
LOCUS: LOCUS (Level of Care Utilization System) is the assessment framework for matching adults to mental health levels of care. Like ASAM for addiction, LOCUS uses six dimensions to determine the appropriate care intensity, from outpatient through medically managed residential. LOCUS scores are commonly required by payers for behavioral health prior authorization and continued-stay reviews.
MAT (Medication-Assisted Treatment): MAT combines FDA-approved medications (methadone, buprenorphine, naltrexone) with counseling and behavioral therapies to treat substance use disorders. MAT is the evidence-based standard of care for opioid use disorder and is increasingly used for alcohol use disorder. EMRs supporting MAT must handle controlled-substance e-prescribing (EPCS) and integrate with state prescription drug monitoring programs.
SIRP Note: SIRP stands for Situation, Intervention, Response, Plan — a behavioral-health note format that begins with the situational context that brought the client to the session.
SOAP Note: SOAP is the most common clinical documentation format. It stands for Subjective (what the client reports), Objective (clinician observations), Assessment (clinical interpretation), and Plan (next steps). NavixScribe writes SOAP notes automatically from session audio.
Treatment Plan: A treatment plan is the formal clinical document specifying a client's goals, objectives, interventions, and timeframe for behavioral health treatment. Required for billing, accreditation, and continued-stay authorizations. Plans are typically reviewed every 30–90 days. Navix's Treatment Plan Generator drafts plans from chart context for clinician review and approval.

7 terms

Compliance

42 CFR Part 2: 42 CFR Part 2 is the federal regulation governing the confidentiality of substance use disorder patient records. Part 2 places stricter controls than HIPAA on disclosure of SUD records: written patient consent is generally required for any disclosure, and recipients are prohibited from re-disclosure. Behavioral health software handling addiction treatment records must implement Part 2 safeguards in addition to HIPAA.
CARF: CARF (Commission on Accreditation of Rehabilitation Facilities) is an international accreditation body widely used by behavioral health and rehabilitation programs. CARF emphasizes outcomes, quality, and consumer-focused services. Like JCAHO, accreditation is often required by payers and referral sources.
EPCS: EPCS (Electronic Prescribing of Controlled Substances) is the DEA-required certification for software that allows electronic prescribing of Schedule II–V controlled substances. Required in nearly all states. Navix EMR includes EPCS-certified e-prescribe.
HIPAA: HIPAA (Health Insurance Portability and Accountability Act) is the US federal law governing the privacy and security of Protected Health Information (PHI). The Privacy Rule restricts uses and disclosures of PHI; the Security Rule mandates administrative, technical, and physical safeguards; the Breach Notification Rule requires notification when unsecured PHI is compromised. Software vendors that process PHI must sign Business Associate Agreements with covered entities. Navix is HIPAA compliant.
JCAHO / Joint Commission: The Joint Commission (formerly JCAHO) is a US accrediting body for healthcare organizations including behavioral health programs. Accreditation is voluntary but commonly required by payers. Surveys evaluate documentation, patient safety, infection control, leadership, and other domains. Navix's Compliance Agent helps facilities maintain ongoing audit readiness.
SOC 2: SOC 2 (Service Organization Control 2) is an audit framework that verifies a service organization's controls relevant to security, availability, processing integrity, confidentiality, and privacy. SOC 2 Type II reports cover an extended audit period (typically 6–12 months). Many enterprise behavioral health customers require SOC 2 certification before signing. Navix is SOC 2 certified.
TCPA: The TCPA (Telephone Consumer Protection Act) regulates SMS and automated telephone communications in the United States. Compliant SMS programs require explicit opt-in with full disclosure language, disclosed message frequency, and clear opt-out instructions (e.g., reply STOP). Navix's SMS program follows full TCPA compliance.

6 terms

Operations

CPT Codes: CPT (Current Procedural Terminology) codes are the standard medical-procedure codes used for billing. Behavioral health uses a specific subset including 90837 (60-minute psychotherapy), 90832 (30-minute), 90847 (family therapy with patient), 90853 (group therapy), and many more. Navix's AI Coding Suggestions flags the right CPT codes from session content.
ERA (Electronic Remittance Advice): An ERA is the electronic version of a paper Explanation of Benefits (EOB) — payment information from a payer detailing how a claim was adjudicated. ERAs can be auto-posted into the EMR's accounts receivable, with discrepancies flagged for billing-team follow-up.
ICD-10: ICD-10 is the World Health Organization's classification of diseases used for diagnosis coding. F-codes cover mental, behavioral, and neurodevelopmental disorders. Navix's AI suggests ICD-10 diagnosis codes based on clinical documentation.
RCM (Revenue Cycle Management): RCM is the end-to-end process of getting paid for healthcare services: insurance verification, charge capture, claims building, claims submission, payment posting, denial management, and patient billing. RCM software automates these steps. Navix's RCM Automation Platform uses AI agents to build claims from EMR data and run rejection analysis with minimal manual touches.
UR (Utilization Review): UR is the process of justifying continued coverage of treatment to an insurance payer. UR reports include the client's clinical presentation, current treatment plan, level-of-care assessment (ASAM, LOCUS), progress since the last review, and clinical justification. Insurance companies use UR to authorize continued stay or step-down. Navix's Authorizations Assistant builds UR reports automatically from chart data.
VOB (Verification of Benefits): VOB is the process of confirming a prospective patient's insurance coverage before treatment begins. It establishes whether the payer covers the proposed service, in-network or out-of-network status, deductible and co-insurance amounts, prior authorization requirements, and any coverage limits. Manual VOB historically takes 2–4 hours per patient. Navix's VOB Agent automates the lookup across payer portals.

6 terms

Technology

API: An API (Application Programming Interface) is a defined way for software systems to talk to each other. Modern healthcare APIs are typically REST-based (HTTP + JSON) and use OAuth 2.0 for authentication. Navix's public API at api.navixhealth.com lets developers read and write charts, manage clients, fire automations, and subscribe to webhooks.
EMR vs EHR: An EMR (Electronic Medical Record) is the digital chart maintained by a single practice or facility — used internally for that organization's patients. An EHR (Electronic Health Record) is broader: designed to share patient records across multiple providers, hospitals, and care settings. The terms are often used interchangeably; in behavioral health, most platforms (including Navix) function as an EMR for the host organization with EHR-style structured data exchange where needed.
FHIR: FHIR (Fast Healthcare Interoperability Resources) is the modern standard for exchanging healthcare data between systems. FHIR is RESTful, JSON-based, and built on web standards. Resources include Patient, Encounter, Observation, MedicationRequest, ServiceRequest, DiagnosticReport, and many more. FHIR is the foundation for modern lab integrations, EHR-to-EHR data exchange, and patient apps. Navix supports FHIR R4 across its lab and integration surface.
HL7 v2: HL7 v2 is the older but still ubiquitous healthcare data exchange standard. It uses pipe-delimited segments (ORM for orders, ORU for results, ADT for admit-discharge-transfer) over MLLP or file-based transport. While FHIR is the future, most US labs and many older systems still operate on HL7 v2. Navix supports both.
PHI (Protected Health Information): PHI is any individually identifiable health information that is created, received, or transmitted by a HIPAA-covered entity. PHI includes names, addresses, dates, medical record numbers, email addresses, biometric identifiers, photographs, and any other identifier when combined with health information. Software handling PHI must implement HIPAA's required safeguards.
Webhook: A webhook is an HTTP callback — when an event happens in one system, that system pushes a payload to a configured URL. Navix supports webhooks for chart events, status changes, automation fires, and more. Webhooks enable real-time integration without polling.

6 terms

AI

Agentic AI: Agentic AI refers to AI systems that don't just answer questions or generate content — they autonomously execute multi-step workflows. Where traditional AI features are reactive, agentic AI is proactive: a VOB Agent verifies benefits across payer portals, an alumni follow-up agent reaches out post-discharge, an authorizations assistant builds UR reports from chart data. Each agent is a specific named capability rather than a generic chat interface.
AI Scribe: An AI scribe is an AI-powered tool that listens to a clinical session — either in real time or from an uploaded audio file — and automatically produces a structured clinical note. Modern AI scribes go beyond raw transcription: they identify section structure (subjective, objective, assessment, plan), generate notes in chosen formats, and integrate directly into the EMR. NavixScribe is a behavioral-health-specific AI scribe.
De-identification: De-identification is the process of removing identifiers from health data so it cannot be linked back to a specific individual. HIPAA's Safe Harbor standard (45 CFR 164.514(b)(2)) lists 18 identifier categories that must be removed (names, dates, account numbers, biometrics, etc.). De-identified data is no longer PHI and can be used for research, analytics, and AI training without HIPAA restrictions. Navix's AI training uses de-identified data only.
LLM (Large Language Model): An LLM is a foundation AI model trained on massive text data, capable of understanding and generating human language. GPT-4, Claude, Gemini, and Llama are LLMs. In healthcare, LLMs power AI scribes, chart summarization, and agentic workflows. The leading clinical AI platforms tune general-purpose LLMs against clinical data to improve accuracy in medical contexts.
MCP (Model Context Protocol): MCP is the emerging open standard for connecting AI agents to systems and data sources. Created by Anthropic, MCP is being adopted by Claude, ChatGPT, Cursor, and other AI tools. An MCP server exposes capabilities (read data, take actions) to any compatible AI client. Navix exposes its capabilities as MCP servers — meaning any AI agent can read Navix data and execute Navix actions through a single secure protocol.
RAG (Retrieval-Augmented Generation): RAG is an AI architecture pattern where a language model retrieves relevant data from a knowledge base before generating a response. In healthcare, RAG lets AI answer questions grounded in the actual chart rather than hallucinating. Navix Intelligence (chart-chat) uses RAG over Navix data so answers reference real clinical content.

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