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

SERIES: 7902
TITLE: Pre-admission continued stay
DATES: 1977-
ARRANGEMENT: none

DESCRIPTION: This is a list of pre-admission/continued stay approval forms input into MMIS. This is part of COM number 68015E, MMIS Claims Exception Reports. It includes run and report dates, the location code, the identification number of the clerk inputting the data, the name of the individual inputting the data, the transaction control number, the recipient's name, age, sex, identification number, date of birth, and address, the provider's identification number, the recipient's insurance type code, the recipient's aid category code, the recipient's fund type code, whether the recipient has other insurance, if the recipient has received medicare, the dates of service and the medicare identification number, the patient's admission dates, the attending and admitting physicians' license numbers, the name and telephone number of the responsible party, the diagnostic codes and onset dates, the surgical procedures codes and dates, and the approved level of care codes and the beginning and ending dates of stay.

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

PRIMARY DESIGNATION

Private