Initial Appropriateness

Introduction

 

This article walks you through the process of submitting an Initial Appropriateness. When creating segments for enrolled, non-pended members, you are required to enter an Initial Appropriateness and Appropriateness Start Date.

 

Segments that were already created in FCM before August 1, 2025 will not require a date to be entered.

 

However, if a segment is dated prior to August 1, 2025 but created after that date, the system will prompt the user to enter an Appropriateness Start Date with the Initial Appropriateness. This date should reflect when you determined the member was appropriate for Health Home enrollment and must fall within the enrollment month.

 

Prerequisites

 

The Initial Appropriateness is available for enrolled, non-pended members.

 

All user types can enter an Initial Appropriateness when it is available on the member’s record. However, only HH Admins and DSP Admins can delete an assessment once it’s been created.

 

Note: If you don’t see the Initial Appropriateness Start Date option for a member, verify that the segment Outreach/Enrollment code is set to E-Enrolled .

 

 

Initial Appropriateness Codes and Criteria

 

When submitting an Initial Appropriateness, you will be required to select an appropriateness code. For full details on available codes and their criteria, please refer to the New York State Department of Mental Health’s Appropriateness Criteria Codes HHSA and HHSC.

 

 

Instructions

 

Review the instructions below to learn how to complete a Initial Appropriateness. Click the “Get Started” button to begin.

 

 

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