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| Entity No: "4629"
Record Series of Utah Government
Correspondence received and created by the bureau relating to bureau projects. Does not include executive correspondence, which might document office procedures or policies.
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Series: 12240
Creator Information Other Records Produced by This Entity Total Retention: Retain for 7 year(s) |
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 ...
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Series: 7917
Creator Information Other Records Produced by This Entity Total Retention: Retain for 9 year(s) |
This is a list of claims which need adjusted before they can be paid. This is part of COM number 68015E, MMIS Claims Exception Reports. It includes report and run dates, the identification number of the clerk inputting the data, the transaction control number, the ...
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Series: 7898
Creator Information Other Records Produced by This Entity Total Retention: Retain for 9 year(s) |
This is a list of claims from emergency transportation services that exceed the norm for this group of medicaid providers. This is part of COM 68015E, MMIS Claims Exception Reports. It includes run and report dates, the location code, the category of service, the ...
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Series: 7907
Creator Information Other Records Produced by This Entity Total Retention: Retain for 9 year(s) |
This is a list of credit applied to medicaid providers' accounts that exceed the norm established for this group. This is part of COM 68015E, MMIS Claims Exception Reports. It includes run date, category of service, transaction control number, clerk's identification ...
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Series: 7916
Creator Information Other Records Produced by This Entity Total Retention: Retain for 9 year(s) |
This is a computer output microfiche number 21103E listing the code number for medical diagnosis for use by health care providers in submitting claims and in filling out the claim form. It includes report date, the name and code number of the diagnosis, the minimum and ...
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Series: 7934
Creator Information Other Records Produced by This Entity Total Retention: Retain for 9 year(s) |
These are copies of correspondence received by the bureau from other bureaus in the division, other divisions in Health, other state agencies, providers, and others.
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Series: 16908
Creator Information Other Records Produced by This Entity Total Retention: Retain for 1 year(s) |
These are duplicate personnel records that are maintained by the bureau to enable management to appraise performance and handle other day-to-day supervisory matters. They include leave applications, personnel action request forms, performance plans, processing reports, ...
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Series: 16911
Creator Information Other Records Produced by This Entity Total Retention: Retain for 1 year(s) |
These logs and reports document the data entry of claims submitted electronically for reimbursement for services covered by medicaid. These documents are used as the source document for the data entry and serve as evidence that the claim has been processed. Includes the ...
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Series: 17425
Creator Information Other Records Produced by This Entity Total Retention: Retain for 5 year(s) |
These records document the medicaid buyout program. This special medicaid program is governed by UCA 26-18-401(1996), and allows qualified individuals to receive medicaid assistance whereby medicaid pays their medical insurance premiums to private insurance companies. ...
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Series: 17917
Creator Information Other Records Produced by This Entity Total Retention: Retain for 7 year(s) |
These records are a daily report of claims submitted electronically through the Utah Health Information Network (UHIN) from medical providers, for their patients on the medicaid system. Providers are contacted about transmission errors and asked to resubmit their ...
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Series: 18159
Creator Information Other Records Produced by This Entity Total Retention: Retain for 5 year(s) |
This is a file of all correspondence and memoranda generated by the bureau. It includes copies of outgoing correspondence to providers, other Health Department bureaus, state agencies, the federal government, and the general public.
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Series: 16909
Creator Information Other Records Produced by This Entity Total Retention: Permanent. Retain for 12 year(s) |
This is a list of Medicare claims that are crossed over to Medicaid claims for Medicaid partial payment. The report includes the medicare document number, medicaid transaction control number, recipient ID number, provider number, co-insurance amount, deductable amount, ...
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Series: 19003
Creator Information Other Records Produced by This Entity Total Retention: Retain for 9 year(s) |
This is a claim submitted by medical providers for services rendered under medicare and medicaid programs. The form includes patient's name, address, telephone number, date of birth, and sex, name and address of the insured party, the insured's identification number and ...
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Series: 7888
Creator Information Other Records Produced by This Entity Total Retention: Retain for 1 year(s) |
Reimbursement claims filed by medical providers for services covered by medicare or medicaid, and used by the bureau to approve payments to providers for eligible patients. Includes transportation claims, corrective forms, prior approvals, preadmissions, payment ...
Topics: Medicaid--Utah. Medicaid fraud--Utah. Medicare--Claims administration--Utah. |
Series: 6765
Creator Information Other Records Produced by This Entity Total Retention: Retain for 10 year(s) |
These are to reimburse long term care providers for services rendered under the medicaid and medicare programs. This document includes document number, a list of clients and the charges for service to those clients giving the client identification number, client name, ...
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Series: 7890
Creator Information Other Records Produced by This Entity Total Retention: Retain until administrative need ends |
This is a list of claims that were erroneously rejected by the MMIS. This is part of COM number 68015E, MMIS Claims Exception Reports. It includes run and effective dates, the transaction control number, the recipient and provider identification numbers,the category of ...
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Series: 7900
Creator Information Other Records Produced by This Entity Total Retention: Retain for 9 year(s) |
This is computer output microfiche number 68015A produced weekly showing the medicaid claims paid, denied, and in process. It includes the report date, the name of the health care provider, the provider's identification number, and the category of service. Other ...
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Series: 7929
Creator Information Other Records Produced by This Entity Total Retention: Retain for 9 year(s) |
This is a list of expired prior authorizations. This is part of COM number 68015E, MMIS Claims Exceptions Reports. It includes the run and report dates, the prior authorization number, the transaction control number, the recipient's name and identification number, the ...
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Series: 7896
Creator Information Other Records Produced by This Entity Total Retention: Retain for 9 year(s) |
This is a list of claims from pharmacists that exceed the norm established for this group. This is part of COM number 68015E, MMIS Claims Exception Reports. It includes run and report dates, the category of service, the location code, the clerk identification number, ...
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Series: 7912
Creator Information Other Records Produced by This Entity Total Retention: Retain for 9 year(s) |
This is a record of medicaid claims submitted for medicare recipients and the final disposition of those claims. This is part of COM 68015E, MMIS Claims Exception Reports. It includes run and report dates, the transaction control number, the recipient's identification ...
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Series: 7921
Creator Information Other Records Produced by This Entity Total Retention: Retain for 9 year(s) |
This is a part of COM 68015C, Batch Balance Reports. Includes batch date, batch number, the batch type (HCFA form 1500, Drugs, Indigent, etc.), the individual who input the data into the system, the batch control sheet total, and the disposition of the batch (accepted ...
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Series: 7938
Creator Information Other Records Produced by This Entity Total Retention: Retain for 9 year(s) |
This is a list of claims from dentists that exceed the norm for this group of providers. This is part of COM number 68015E, MMIS Claims Exception Reports. It includes run and report dates, the category of service, the location code, the clerk's identification number, ...
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Series: 7909
Creator Information Other Records Produced by This Entity Total Retention: Retain for 9 year(s) |
This is a summary of claims identified as unusual by the MMIS. This is part of COM 68015E, MMIS Claims Exception Reports. It includes run and report dates, the claim type, the exception code, a description of the exception, the number of occurrences, the number of ...
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Series: 7918
Creator Information Other Records Produced by This Entity Total Retention: Retain for 9 year(s) |
These are invoices submitted by dentists for reimbursement of services provided under the medicare and medicaid program. They include name, address, date of birth and sex of the patient; whether the client has health insurance other than medicaid, and, if so, the policy ...
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Series: 7889
Creator Information Other Records Produced by This Entity Total Retention: Retain until administrative need ends |