AGENCY: Department of Health and Human Services. Office of Children with Special Healthcare Needs
SERIES: 81999
TITLE: Vendor authorization payment log
DATES: 1982-
ARRANGEMENT: Numerical by authorization number
DESCRIPTION: This is a record of all vendors who have authorization to receive payments for services to handicapped patients. This form is also used for statistical purposes, to identify outstanding authorizations, and to track vendor claims. It includes the authorization number, the vendor's name, the type of service, the prescription date, the patient's name, the patient's number, the service date, the total claim amount, the amount to be paid by others, the identification of the other payer, and the amount to be paid by the state.
RETENTION
Retain for 2 year(s)
DISPOSITION
Destroy.
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 destroy.
APPRAISAL
Administrative
This record has only administrative value. Retention in office is recommended due to the small quantity.
PRIMARY DESIGNATION
Private