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

SERIES: 8003
TITLE: Medicaid Management Information System report item exception log-treatment and analysis
DATES: 1981-
ARRANGEMENT: None

DESCRIPTION: This is computer output microfiche number 68210T, generated by the Surveillance and Utilization Review Subsystem. This report provides an index to the exception profile report. It includes the report date, the class of treatment and diagnosis, the provider's name and identification number, the period covered by the report, and the page where the profile begins.

RETENTION

Retain for 3 year(s)

DISPOSITION

Destroy.

RETENTION AND DISPOSITION AUTHORIZATION

These records are in Archives' permanent custody.

APPROVED: 08/1986

FORMAT MANAGEMENT

Computer output microfiche master: Retain in Office for 3 years and then destroy.

APPRAISAL

Administrative Fiscal

This record is part of a series used to produce a comprehensive statistical profile on participants who deviate from pre-defined criteria for the purpose of analysis and review. This information is subject to federal audit and must be maintained for a three year period. However, two duplicate copies of the fiche are unnecessary and should be disposed of.

PRIMARY DESIGNATION

Private

---