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

SERIES: 7960
TITLE: Medical review sample books
DATES: 1984-
ARRANGEMENT: None

DESCRIPTION: This is the hospital utilization post-payment review is done on a sampling basis. This file contains all the information on hospital utilization from which the sample to be tested is taken. It includes the claims history request form and claims history detail report, distribution of cases report, the sample selection report, a statistical summary by hospital, cases identified for potential recovery reimbursement, review calendar, and contact log. Information includes the recipient's name, age, sex, date of birth, identification number, marital status, mental status, and diagnosis; the provider's name, identification number, and address; and a record of the number and type of claims for services submitted by the hospital.

RETENTION

Retain for 3 year(s)

DISPOSITION

Destroy.

RETENTION AND DISPOSITION AUTHORIZATION

These records are in Archives' permanent custody.

APPROVED: 08/1986

FORMAT MANAGEMENT

Paper: Retain in Office for 3 years and then destroy.

APPRAISAL

Administrative Fiscal

This record is subject to federal audit so that the auditors can verify the adequacy of the sampling procedure. No retention guidelines have been given; however, the federal audit period is three years.

PRIMARY DESIGNATION

Private