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

SERIES: 8175
TITLE: Interim verification of medical eligibility
DATES: 1984-
ARRANGEMENT: None

DESCRIPTION: This is a record received from the Department of Social Services issued to medical assistance recipients while a medical card is being produced. The bureau uses this copy to verify client eligibility if a question of payment arises during this interim period. This record includes the period of eligibility; the client's name, address, identification number, and primary physician or Family Health Plan; the signature and date of signature of the approving official; and the case name and case number.

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 is only needed until the client information is entered into the data system. A one year period will suffice for all administrative needs.

PRIMARY DESIGNATION

Private

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