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

SERIES: 8129
TITLE: Mass adjustment documents
DATES: 1985-
ARRANGEMENT: None

DESCRIPTION: This record consists on two types of documents -- mass adjustment and mass credit -- used when changes to be input involve more than one provider. These documents include the identification number of the clerk inputting the data, the request number, the batch date and number to be adjusted, the selection criteria including the date element number, lower limit, and upper limit, the reason for the adjustment, the date of approval and the signature of the approving official, and the initials of the employee preparing the form.

RETENTION

Retain for 6 month(s)

DISPOSITION

Destroy.

RETENTION AND DISPOSITION AUTHORIZATION

These records are in Archives' permanent custody.

APPROVED: 08/1986

FORMAT MANAGEMENT

Paper: Retain in Office for 6 months and then destroy.

APPRAISAL

Administrative

These forms are microfilmed before they are input into the terminal. As they are preserved on film, the paper copy should only be kept long enough to verify that the information was correctly input into the system.

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