Medical Necessity Assessment

1. Make sure the permissions for the MNA are turned on the company account 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 the company account under each preferred role

• View Medical Necessity Assessment

• Create Medical Necessity Assessment

2. Navigate to the assessment

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

• Click on their Assessment tab

• Click View Assessment on Medical Necessity

3. Start the Assessment by Selecting "Create New Assessment"

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).

5. Complete the assessment by responding to all questions in different areas that help to determine medical necessity criteria.  If additional comments are needed, use the comment field to add more information.

Treatment Model Identification:

Planning Considerations

Learning Considerations

Environmental Considerations

Dosage Considerations

6. Review the assessment results and click on finish.  

To review your responses, you can click on the "Prev" button on the bottom left hand corner to look at your previous responses before pressing finish and finalizing the assessment.

7. Press the Blue Finish Button at bottom right hand corner to view the assessment results and recommendations.

8. Review the recommendations and agree/disagree. The recommendations include:

• Type of Treatment package recommended based on the responses given

• Total Recommend Direct Service Hours (+ / - 5)

• How the total direct services hours were determined by responses on the assessment (left hand side)

  • If Not Applicable was given as a response, it will note 0 hours

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

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.

• User needs to have the Role permission of “delete assessments” to be able to complete this task

Resume

Edit

Delete