AGENCY: Department of Health. Bureau of Dental Health

SERIES: 81943
TITLE: Dental health medicaid orthodontic assessment file
DATES: 1985-1988.
ARRANGEMENT: alphabetical by name

DESCRIPTION: This is part of the utilization control required by 42 CFR 456. This file is used to verify that patients have been examined and that treatment has been approved under medicaid. It includes the patient's name, address, date of birth, sex, and identification number; the provider's name, address, and provider number; the type of treatment given; the treatment dates; the amount of the charges; the dates of review and the results of the review. The Division's Responsible Authority states that this record is now obselete and no longer used. C. Michael Fitzerald 11/7/89 by Dean Henriod.

RETENTION

DISPOSITION

RETENTION AND DISPOSITION AUTHORIZATION

These records are in Archives' permanent custody.

APPROVED: 06/1987

FORMAT MANAGEMENT

Paper: Retain in Office for 2 years and then transfer to State Records Center. Retain in State Records Center for 1 year and then destroy.

APPRAISAL

Administrative Fiscal

42 CFR 456 requires utilization review, but does not specify retentions. As the potential for federal audit exists, a three year retention is required.

PRIMARY DESIGNATION

Private

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