Learn how Rethink can streamline utilization review and standardize the decision making process while monitoring member progress on an individual level.
Applied Behavior Analysis as a covered benefit is a relatively new venture for Behavior Analysts.
Combining the large discrepancies between provider treatment plans, the array of severity of symptoms and treatment methods, unclear documentation and specific health plan requirements with complex medical necessity criteria, utilization managers are being set up with a subjective, inconsistent decision-making process.
The purpose of Applied Behavior Analysis for children with Autism is to increase quality of life by decreasing symptomology.
This goal is agreed upon by providers, families, and payors alike. The trouble achieving best outcomes stems from inconsistency in the monitoring of individualized progress over time. By comparing previous and current treatment records, all involved are better able to determine clinically significant progress and potential barriers to treatment, thereby ensuring quality of care is provided. Taking that data a step further, synthesizing and benchmarking it, allows for the potential to meet quality of care standards and can lead to value based care initiatives.