AGENCY: Department of Health and Human Services. Healthcare Administration. Division of Integrated Healthcare. Office of Medicaid Operations.

SERIES: 7914
TITLE: Nursing home claim exception
DATES: 1977-
ARRANGEMENT: None

DESCRIPTION: This is a list of claims from nursing homes that exceed the norm established for this group. This is part of COM 68015E, MMIS Claims Exception Reports. It includes run and report dates, the category of service, the location code, the clerk's identification number, the name of the employee entering the data, the medical records number, the provider type, the transaction control number, the recipient's name, age, sex, identification number, and date of birth, the period covered by the statement, the dates admitted to and discharged from the nursing home, the level of care code, the medicaid admission date, the prior approval code number, the admitting diagnosis code number, the total charge, the amount deducted for family income, other income, aid in assistance, and third party payments, and the net charges, the billing date, the amount allowed charges, the committed exceptions, and if there is an error, the error code, a description of the error, and the status.

RETENTION

Retain for 9 year(s)

DISPOSITION

Destroy.

RETENTION AND DISPOSITION AUTHORIZATION

These records are in Archives' permanent custody.

APPROVED: 08/1986

FORMAT MANAGEMENT

Computer output microfiche master: For records beginning in 1977 through 2002. Retain in Office for 2 years and then transfer to State Records Center. Retain in State Records Center for 7 years and then destroy.

CD-ROM: For records beginning in 2002 and continuing to the present. Retain in Office for 9 years and then destroy.

Computer data files: Retain in Office for 9 years and then delete.

APPRAISAL

Administrative Fiscal

PRIMARY DESIGNATION

Private