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

SERIES: 7917
TITLE: Claim adjustment exception
DATES: 1977-
ARRANGEMENT: None

DESCRIPTION: This is a list of claims adjustments that exceed the norm established for this type of transaction. 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 transaction control number, the medical records number, the transaction control number to be adjusted, the identification numbers of the provider and recipient to be adjusted, the date of service to be adjusted, the reason for the adjustment code, the identification number of the clerk preparing the adjustment, and, if an error is made, 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

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