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

SERIES: 7965
TITLE: Patient assessment section log
DATES: i 1982-
ARRANGEMENT: Chronological

DESCRIPTION: This record monitors the inflow of medicaid documents which helps ensure that responses are prompt.

Included in this record are the date that the Patient Care Transmittal Form (10A) is received; date an incomplete form is returned to person submitting the form; document log number; transaction control number; name of patient, dates telephone approval is given; date approval becomes effective; date information was sent to data entry; date written approval is sent to facility; dates of interim, 30, 90, and 180 day reviews; and date case is closed.

RETENTION

Retain for 1 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 1 year and then destroy.

APPRAISAL

Administrative

This record has administrative and fiscal values, but because it is an internal control document, it has no long-term value and should be disposed of promptly.

PRIMARY DESIGNATION

Private