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Determining Medical Necessity: How Evidenced-based Protocols Can Support Proper Dosage and Clinical Outcomes

Join us on Thursday, April 22 when we will discuss preliminary data from over 6,000 completed assessments and how Rethink’s new Medical Necessity Assessment can help you:

  • Enhance care outcomes by ensuring accurate care plans and the correct level of prescribed hours
  • Align providers and payers on necessary dosage levels and facilitate pre-authorizations
  • Provide evidenced-based recommendations to new BCBAs and support their training process
  • Standardize levels of care across your organization
  • Increase parent satisfaction

There is no cost to attend and this webinar is not eligible for CEUs. The presentation will be posted on our blog within two weeks.

Dr. Diana Davis-Wilson, DBH, LBA, BCBA is a licensed behavior analyst, with several years of experience providing consultation and training to families, school districts, and organizational personnel nationwide. She holds a Doctorate of Behavior Health with an emphasis on integrated health care management and is currently the Chief Executive Advisor for Aspen Behavioral Consulting.

Mellanie Page, BCBA is the VP of Operations and Regional Director at ABS Kids. She is a BCBA who has worked in the field of ABA for several years, utilizing a variety of strategies to teach new skills to children, their caregivers, and providers. She has supported BCBA candidates through supervision and instruction at National University. She is certified in OBM practices and uses this experience to improve and enhance organizational operations.

parent training webinar

Enhancing Collaboration During Parent Training (Webinar)

Clinicians often struggle with parental nonadherence to treatment recommendations made during parent training activities.

Adherence may be improved by nurturing a collaborative relationship with family members. Collaboration requires specific relational responses of clinicians such as actively and empathically listening, compromising, and compassionately understanding each family’s unique circumstance.

This talk will review strategies to foster collaboration with parents, with the goal of improving adherence to treatment recommendations.

and more!

Our presenter is Bridget A. Taylor, PsyD, BCBA-D and Executive Director of Alpine Learning Group! She is also a Senior Clinical Advisor for Rethink. Dr. Taylor was recently recognized by the Association for Applied Behavior Analysis International for her outstanding contributions to behavior analysis, and was given ABAI’s Fellow designation. Dr. Taylor is considered a leading authority on effective, and innovative interventions for autism.

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ABA Business Insurance Overview: How Insurance Carriers View ABA Businesses (Webinar)

One of the most important aspects of having a business is protecting yourself and the business from legal backlash.

Join us as we walk through some action items to help mitigate risk while also explaining how insurance companies view ABA businesses.

Here are a few items we will discuss:

  • What Worker’s Comp Covers
  • Claims and Safety Tips
  • General Liability/Property/Auto
  • Claim Prevention and Prevention Programs
  • Cyber Liability and Employment Practice Liability

and more!

Our presenter is Jacob Kiley, Vice President at The Liberty Company Insurance Brokers who currently oversees their ABA program. Jacob has been enjoying the insurance industry for over 8 years. The passion comes from working with business owners every day to partner with them on how to mitigate risk. Starting in the claims department gave him a foundation of coverage analysis and how to work through the insurance process.

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Rethink announces first-ever protocol to ensure children with autism get the right level of treatment

Behavioral health providers now have access to an evidence-based standard to guide customized treatment plans.

New York—April 6, 2021—Rethink Behavioral Health, an industry leader in applying technology to support therapy providers in improving clinical outcomes, has developed the first-ever research-backed
protocol to help clinicians prescribe appropriate levels of Applied Behavior Analysis (ABA) therapy for children with autism.

The company’s Medical Necessity Assessment (MNA) analytic provides an objective standard to help practitioners of ABA therapy as they build individualized treatment plans. ABA has been proven to be
highly effective for children with autism and related developmental disorders. While ABA emerged as a promising treatment for autism in the late 1980’s, it is only within the past decade that health plans have been required to cover the cost of treatment. As a result, there are additional demands on practitioners to demonstrate a medical need for the treatment and prescribe a specific level of
intervention. Until now, the Board Certified Behavior Analysts (BCBAs) who deliver this therapy have had few resources to provide guidance in deciding how many hours or sessions of ABA an individual
patient should receive.

This lack of standardization may lead to under-or over-prescription of treatment hours, which can negatively impact outcomes for children. Standardizing the process for prescribing treatment hours can make health insurers more likely to approve treatment plans for reimbursement, and ensure that more patients are receiving a clinically appropriate level of care.

As a comprehensive electronic medical record and practice management platform solution to 600+ behavioral practice groups across the United States, Rethink became aware of the need for an evidence- based standard.

“There has never been a standard protocol available for determining how many hours of care should be delivered to a child based on their specific needs,” said Jamie Pagliaro, executive vice president and chief learning officer for Rethink Behavioral Health. “We designed an evidence-based assessment that may help reduce friction between providers and health plans, ensuring more children receive clinically appropriate levels of care.”

Developed with an expert panel and tested in more than 6,000 individual patient assessments with providers nationwide, the MNA solution allows a BCBA to plug in diagnostic factors for an individual
patient, then synthesizes that input with supporting evidence and research, to produce a suggested dosage range of treatment hours based on evidence.

In tests, clinicians agreed with Rethink’s MNA solution recommendations 70% of the time. Most instances of disagreement were due to functional issues, such as scheduling or transportation availability for families.

“Our clinicians really do like it. It balances them and helps keep emotions and bias from affecting the amount of services we are prescribing to a client on initial and reassessment,” said Karin Torsiello,
president of Behavior Basics, a Florida-based provider. Insurers have indicated to Rethink that they are receptive to the MNA solution and are eager to continue to work with Rethink and providers to ensure children with autism are getting clinically appropriate levels of care.

About Rethink Behavioral Health

Rethink Behavioral Health offers all-in-one, technology-based solutions to behavioral health practitioners, including video-based RBT training, ABA data collection tools and practice management solutions to meet market demands. It is a division of Rethink First, a global health technology company providing cloud-based treatment tools, training and clinical support to schools, employers, behavioral health professionals and payers. Rethink serves thousands of clients globally, including more than 25 of the Fortune 100 and many of the country’s largest public school systems and health plans. Rethink’s SaaS solutions are powered by proprietary, clinically validated content and best practices overseen by a renowned Scientific Advisory Board and include more than 2,000 evidenced-based training modules, extensive Social and Emotional Learning content and ground-breaking neurodiversity and inclusion training and education tools. Rethink is owned by K1 Capital, one of the premier private equity firms focused on high-growth, enterprise software solutions.

Media Contact:
Eric Masters