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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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Relevant Links:
New MNA Clinical Instructional Manual (Breakdown of all questions & other details): New MNA Medical Necessity Assessment Clinical Instructional Manual
White Paper AI: Rethink MNAMedical Necessity Assessment-AiDriven System Paper

Step 1:

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Instructions

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Details with images

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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

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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:

Assign Role 2 staff to their clients.

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From the Staff List:

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From the Client List:

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Default client access permissions for Role 2 is that staff can only access the clients they are assigned to.

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MNA Information and Documentation: Medical Necessity Assessment Information and Documentation

MNA Frequently Asked Questions: Medical Necessity Assessment FAQ

Step 1:

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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2:

Instructions

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Start the Assessment by Selecting "Create New Assessment"

Create New MNA.png

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3:

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).

image-20240603-220614.png

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4:

Instructions

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Good to Know

Completing an Assessment:

Respond to all questions in each area that helps to determine medical necessity criteria.  If additional comments are needed, use the comment field to add more information.





Client Record:

image-20240603-221350.png

Clinical Details:

image-20240603-221456.png

Provider Record:

image-20240603-221942.png

Provider Hours Requested:

image-20240603-222040.png

Treatment Plan Considerations:

image-20240603-222130.png

Assessments:

image-20240603-222219.png

Goal Considerations:

image-20240603-222315.png

Barriers to Treatment/Progress:

image-20240603-222524.png

Diagnostic Symptoms Considerations:

image-20240603-222622.png

MNA Navigation Wizard:

The Navigation Wizard at the top of the screen will show the user where they are in the assessment and how much more of the assessment remains.

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5:

Instructions

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Results Page

  • Upon finishing all prior pages and clicking either the next button or the results step at the top of the page, the user will see the results page

  • On this page, there will be a list of MNA recommendations, provider consideration flags, and an MNA summary

  • At the bottom of the page, there is an agreement section. Here, the user must answer the required questions to complete the assessment.

  • Once complete, the user can click the Summary Report, Detailed Report or Save to File Cabinet icons to save the report as a file, and the Finish button to save the report on Futures.

image-20240603-223710.pngMNA Agreement Page.png

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6:

Instructions

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Good to Know

Resuming, Reporting, and Deleting existing MNA reports:

  • On the main BH MNA page, the current assessment and previous assessments are listed.

  • On any assessment, the resume button can be used to modify the fields of the assessment.

  • The report button can be used to bring up a report containing information from the assessment.

  • Delete can be used to delete an existing assessment.

Resume Existing MNA.png

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.

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Rethink Behavior Health

Have questions? Contact us at Support@RethinkBH.com