AGENCY: Department of Health. Bureau of Information Technology

SERIES: 8283
TITLE: Claim adjustment exception
DATES: 1985-2002.
ARRANGEMENT: None

DESCRIPTION: This is a list of claims adjustments that exceed the norm established for this type of transaction. This is part of COM 68015E, MMIS Claims Exception Reports. It includes run and report dates, the category of service, the location code, the clerk's identification number, the transaction control number, the medical record number, the transaction control number to be adjusted, the identification number of the provider and recipient to be adjusted, the date of service to be adjusted, the reason for the adjustment code, the identification number of the clerk preparing the adjustment, and, if an error is made, the error code, a description of the error, and the status.

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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