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

SERIES: 7921
TITLE: Medicare crossover payment records disposition
DATES: 1977-
ARRANGEMENT: None

DESCRIPTION: This is a record of medicaid claims submitted for medicare recipients and the final disposition of those claims. This is part of COM 68015E, MMIS Claims Exception Reports. It includes run and report dates, the transaction control number, the recipient's identification number and name, the provider's identification number, the category of service, the dates of service, the status (accept, reject), the amount of the medicare and the amount of the medicaid payments.

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

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