AGENCY: Department of Health. Division of Medicaid and Health Financing. Bureau of Authorization and Community Based Services

SERIES: 8122
TITLE: Provider list by license number
DATES: 1984-
ARRANGEMENT: Numerical by license number

DESCRIPTION: This is a computer output listing health care providers enrolled in the medicaid program. This record includes the run date, the license number, the provider's name, the old provider identification number, the new provider identification number, and the enrollment status of the health care provider.

RETENTION

Retain until superseded

DISPOSITION

Destroy.

RETENTION AND DISPOSITION AUTHORIZATION

These records are in Archives' permanent custody.

APPROVED: 08/1986

FORMAT MANAGEMENT

Paper: Retain in Office until updated and then destroy.

APPRAISAL

Administrative

This record is used to verify provider license numbers when a question arises on claims submitted by the provider. As such, it has no value past its useful life. This record is produced only on request, thus the retention period given.

PRIMARY DESIGNATION

Private

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