AGENCY: Department of Health and Human Services. Healthcare Administration. Division of Integrated Healthcare. Office of Eligibility Policy

SERIES: 8001
TITLE: Medicaid Management Information System report item exception log-provider
DATES: 1981-
ARRANGEMENT: None

DESCRIPTION: This is computer output microfiche number 68210R, generated by the Surveillance and Utilization Review Subsystem. This report provides an index to the exception profile report. It includes the report date, the category of service, the provider's name and identification number, the period covered by the report, and the page where the profile begins.

RETENTION

Retain for 3 year(s)

DISPOSITION

Destroy.

RETENTION AND DISPOSITION AUTHORIZATION

These records are in Archives' permanent custody.

APPROVED: 08/1986

FORMAT MANAGEMENT

Computer output microfiche master: Retain in Office for 3 years and then destroy.

APPRAISAL

Administrative Fiscal

This record is part of a series used to produce a comprehensive statistical profile on recipients who deviate from pre-defined criteria for the purposes of analysis and review. This information is subject to federal audit and must be maintained for a three year period. However, two duplicate copies are not needed and should be disposed of.

PRIMARY DESIGNATION

Private