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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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4. Select Initial or Service Re-authorization for the assessment:

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

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9. View and/or save reports

Review the Research Paper
Print out the Summary Report or the Detailed Report
Save your Recommendation/Assessment to the File Cabinet

Deleting Assessments

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

Company Account 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.
If the permission to Edit an Assessment is checked, staff can Edit and Resume the Medical Necessity Assessment.

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Resuming, Editing and/or Deleting Assessments

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Resuming, Editing, Deleting an Assessment:

Resuming an assessment will be shown if an assessment has been started, but not all questions are answered. If an assessment has been started and staff members leave the assessment area, all questions answered will be saved (autosave). Previous Assessments that have not been finished will have the option to Resume (these assessments have started but there are no responses for questions)

Editing an assessment will be shown if an assessment has been started and all questions have been answered but the recommendation page has not been submitted. Staff can edit an assessment to make any changes needed before the assessment is submitted.

Delete an assessment by selecting delete. When attempting to delete an assessment, staff will receive a confirmation to delete or to cancel the request. The Delete function is only available once all areas of the assessment have been completed, including “agreeing or disagreeing” with the recommended hours on the final page.