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The Medical Necessity Assessment is an evidence-based tool designed and used by clinicians that provides clinical recommendations for appropriate level of care for individuals diagnosed with autism spectrum disorder based on available research for direct ABA services. Informed by client history, records review, learning considerations, and specific diagnostic considerations, medical necessity is determined and an ABA dosage for direct service hours per week is recommended.

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Instructions

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Good To Know

Role Permissions:

Make sure the permissions for the MNA are turned on in the Settings area for all roles that the MNA is needed.  It is recommended to turn on the MNA for Role 4 (Administrators) and Role 2 (BCBAs).  IF your BCBAs are set up under a different role, it's recommended to give them access as well.

Check off the following in Settings under each preferred role:

  • View Medical Necessity Assessment

  • Create Medical Necessity Assessment

Both Role 2 and 4 will be preselected in role permissions for any new accounts using the MNA

Assessments can be deleted if a user has the Role permission.

Settings Permissions:

  • By default the delete option with assessments will be turned off for all roles except role 4.

  • Role 4 Administrators can make the decision to check the delete assessment box for staff roles that need to have access to delete assessments.

Client Access:

Note default Role 2 is client assigned to user….link guide for pairing staff/clients.

Step 2:

Instruction

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Good to Know

  • Click on a client that you'd like to complete the MNA

  • Click on the Assessment tab

  • Click View Assessment on Medical Necessity

    • You will be redirected to the BH MNA page for the Medical Necessity Assessment

The status section of the tile will display the assessment’s status as well as the date the status changed on.

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Instructions

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Select Initial or Service Re-authorization for the assessment:

  • Initial Service Authorization: Use the initial service authorization for any new clients starting services with you (regardless of their past services with another organization). 

  • Service Reauthorization: Use the concurrent/on-going review for service reauthorization for any client that has been assessed and provided treatment at your organization within the last 6 month period (regardless of who the providing clinician was).

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Rethink Behavior Health

Have questions? Contact us at Support@RethinkBH.com