AGENCY: Department of Health. Bureau of Information Technology

SERIES: 8256
TITLE: Aged prior authorization
DATES: 1985-2002.
ARRANGEMENT: None

DESCRIPTION: This is a list of expired prior authorizations. This is part of COM 68015E, MMIS Claims Exception Reports. It includes the run and report dates, the prior authorization number, the transaction control number, the recipient's name and identification number, the provider's identification number, and the authorization procedure giving the beginning and ending dates, the supply/diagnosis/drug code, the number of units authorized and used, and the dollar amount authorized and used. The fiche includes an index.

RETENTION

DISPOSITION

RETENTION AND DISPOSITION AUTHORIZATION

These records are in Archives' permanent custody.

APPROVED: 08/1986

FORMAT MANAGEMENT

Computer output microfiche master: Retain in Office for 1 year and then transfer to State Records Center. Retain in State Records Center for 9 years and then destroy.

APPRAISAL

Administrative Legal

PRIMARY DESIGNATION

Private

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