Patient Assignment and
Enrollment
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Health Home Network Provider List
Upon designation as a Lead Health Home, Health
Homes were asked to update a list containing their
network partners’ NPIs.
Network partner NPIs were used in conjunction with
HH eligible members’ claim data to match each
eligible member to the Health Home with which the
member had the most connectivity.
The DOH assignment algorithm depends on accurate
network partner NPIs.
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Health Home Assignment-FFS
• Quarterly, DOH will release to each HH a list of FFS
individuals assigned to the HH based on members’
connectivity to the Health Home’s partner network.
• Individuals with no service utilization were randomly
assigned to a regional Health Home.
• The HH patient tracking assignment files are
transmitted through the OHIP Datamart Portal housed
in the Health Commerce System (HCS).
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Health Home Assignment-MC
• Quarterly, DOH will release to each Managed Care
Plan a list of Health Home eligible members
• The HH patient tracking assignment files are
transmitted through the OHIP Datamart Portal housed
in the Health Commerce System (HCS).
• Managed Care Plans will evaluate HH eligible
members and assign selected members to Health
Homes that best serve the individuals’ needs.
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HH Assignment-Converting Case
Management Programs
• Converting programs will assign their members to
Health Homes that best meet members’ needs.
• Converting programs will contact the Health Homes
they are assigning members to directly and will supply
the HH with required patient information.
• Upon DOH acceptance of the HH DEAA, HH must
compile required member information from converting
programs and send the information to upstream
providers (DOH for FFS and MCP for Managed Care
members) prior to DOH releasing assignment lists.
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New Referrals
• New referrals (identified by HRA, county, SPOA or LGU, care
management agency, practitioners, hospital, prisons, BHO, etc)
meeting Health Home criteria (see Health Home Medicaid
Update) will be enrolled in HH using the monthly tracking
system submitted to DOH.
• DOH will facilitate HH assignment for Fee for Service (FFS)
recipients and MC Plans will facilitate HH assignment for their MC
members.
• Specific guidance regarding the referral process is being finalized
in collaboration with OMH, AIDS Institute, OASAS, Health Homes
and MCP.
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