AGENCY: Department of Health. Division of Medicaid and Health Financing. Bureau of Financial Services

SERIES: 80578
TITLE: Claims processing assessment system audit files
DATES: 1985-2014.
ARRANGEMENT: Alphanumerical by month, thereunder numerical by case number

DESCRIPTION: This is a file of claims randomly selected by the computer for this CPAS audit which is a federal mandated state audit. This audit is required of HCF to perform 600 inquiries per fiscal year. This audit samples files from UB-82 claims, LTC claims, HCFA 1500 claims, Dental claims, EPSDT claims, and Pharmacy claims. This file includes the claims processing review schedule with unit number, recipient ID number, service date, local code, recipient name, vendor billing, original claim history inquire, provider master record, and client data sheet.

RETENTION

Retain for 3 year(s)

DISPOSITION

Destroy.

RETENTION AND DISPOSITION AUTHORIZATION

Retention and disposition for this series were specifically approved by the State Records Committee.

APPROVED: 12/1989

FORMAT MANAGEMENT

Paper: Retain in Office for 1 year and then transfer to State Records Center. Retain in State Records Center for 2 years and then destroy.

Microfilm master: Retain in State Records Center for 3 years or until audit and then destroy.

Microfilm duplicate: Retain in Office for 2 years or until audit and then destroy.

Microfiche master: Retain in Office until administrative needs ends and then destroy.

APPRAISAL

Administrative Fiscal

This audit file is governed by 42 CFR 431.800 which sets up a quality control section to verify claims paid by state agencies with medicaid money . This retention is recommended by 45 CFR 205.145. This record series was approved in Febuary 1988 and now the agency is requesting to microfilm this record and has requested these Retention changes to be made to this record series.

PRIMARY DESIGNATION

Private

SECONDARY DESIGNATION

Protected. 63G-2-305(11) (2008)

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