This is a form filled out by medicaid applicants to choose the type of health care they wish to have. They may choose to join a Health Maintenance Organization, an Independent Practice Association, or Case Management. The form is then used as an input document for the ...

Series: 8132
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Total Retention: Retain for 4 year(s)

This is the application, medicaid agreement, and other documentation submitted by health care providers to enroll in the medicaid program. This record series is divided into the following categories: pharmacies, medical transportation, optometrist, laboratories, ...

Series: 8137
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Total Retention: Retain for 9 year(s)

These are letters received from federal auditors on cases in which both the federal government and the Division of Health Care Financing have audited medicaid cases and have made different determinations. The letters inform the state of the federal findings and gives ...

Series: 8139
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Total Retention: Retain for 4 year(s)

This is a COM listing of the MMIS procedure codes to be used by health care providers in submitting claims for reimbursement for services. This report is produced monthly. It includes report date, the type of service, the code number, the name of medical procedure, the ...

Series: 8156
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Total Retention: Retain until administrative need ends

This is a COM report number 68075B on recipients currently suspended from the medicaid program.

Series: 8159
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Total Retention: Retain for 1 year(s)

This is a daily COM run number 68075A consisting of updates of errors found in various MMIS reports.

Series: 8161
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Total Retention: Retain for 1 year(s)

This is a part of COM 68075A, MMIS RCT09, RCT10, RCT32, RCT11, RCT12 reports. It includes the report date, the recipient's name and identification number, the reason for the error, and the correction made.

Series: 8163
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Total Retention: Retain for 1 year(s)

This is a part of COM 68075C, RCT51, RCT53, RCT55, RCT57, RCT50 reports. It includes run date, family last name, case number, individual's identification number, the category code, the name, age, sex, and date of birth of the recipient, and the date the case opened.

Series: 8167
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Total Retention: Retain for 1 year(s)

These are copies of all correspondence and memoranda generated by the bureau.

Series: 8174
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Total Retention: Permanent. Retain for 2 year(s)

This is an analysis of the amount of money spent on the medicaid program by county. This is part of COM 68115A, MARS reports. It includes run date, effective date, month of the report, the county, the medical assistance category, and the number of inpatient claims, ...

Series: 8108
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Total Retention: Retain until administrative need ends

This is a statistical overview of the medicaid program. This is part of COM 68115A, MARS reports. It includes run date, effective date, and a status report on recipients (gives number eligible, number participating, the percent participating, and the average cost per ...

Series: 8116
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Total Retention: Retain until administrative need ends

This is a computer printout showing expenditures on the medicaid program by types of service. Used as an audit tool. This list includes the run and report dates, the range of warrant numbers, the dates of the warrants, the low organizational, account, and activity ...

Series: 8145
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Total Retention: Retain for 6 month(s)

This is a computer output list of those individuals who had been suspended from the MedUtah program and have been reinstated to the program. This list includes the run date, the family last name, the case number, the individual's identification number, the category ...

Series: 8142
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Total Retention: Retain for 1 year(s)

This is a COM report produced bi-monthly listing those clients receiving medical assistance. It includes date of the report, county and district code, type of assistance, category of assistance, case number, client identification number, client name, effective date of ...

Series: 8150
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Total Retention: Retain until administrative need ends

This is a computer output also used as an input document. This is used to inform the bureau of any payments to the health care providers and they in turn input the information into their system. This record includes the run and report date, the name and identification ...

Series: 8125
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Total Retention: Retain for 1 year(s)

These files document clients on medicaid or medicare who require special home health care. Information includes patient eligibility, medical need, type of home care required, such as nurse or aide, and medical equipment required.

Series: 10487
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Total Retention: Retain for 6 year(s)

This is a data input form used to credit the accounts of health care providers. It includes the transaction code number to be adjusted, the provider and recipient identification numbers to be adjusted, the dates of service to be adjusted, the reason for the adjustment, ...

Series: 8128
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Total Retention: Retain for 6 month(s)

These are psychiatric case files used by the bureau to document eligible client's psychiatric hospital stay. The information includes hospital review, treatment plans, hospital payments, and medical and billing records. Also includes prior approval, medication ...

Series: 10492
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Total Retention: Retain for 6 year(s)

These are denied applications from individuals requesting payment assistance from medicaid/medicare for vision related medical assistance. Vision care approvals are found in series 10498. The information includes correspondence, application, medical information, reason ...

Series: 10495
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Total Retention: Retain for 6 year(s)

These are approved applications from individuals requesting payment assistance from medicaid for surgery medical assistance. The information includes correspondence, application, medical information, reason for denial, and denial letter.

Series: 10501
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Total Retention: Retain for 6 year(s)

Prior approvals including medical, hospital, and laboratory records which give approval for rehabilitation of individuals on Medicaid visiting doctors or clinics for medical treatment by a medical provider, (not continued stay). Approval is granted by the ...
Topics:
Medicaid--Utah.
Hospitals--Rehabilitation services--Utah.

Series: 14076
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Total Retention: Retain for 6 year(s)

These files document the department's position on issues discussed at formal administative hearings regarding health care provider reimbursement complaints. Includes the Hearing request, Denial letters, Copies of Federal and State regulations, staff notes, ...

Series: 19243
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Total Retention: Retain for 6 year(s)

These are medicaid requests for medical supplies used by qualified individuals in the program. Includes type of medical equipment/supply, whether item was rented or purchased, price of unit, and physician approval letter.

Series: 15311
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Total Retention: Retain for 6 year(s)

This record series documents requests from Medicaid clients for transportation to health care providers for medical needs. Information includes name of Medicaid client, date of transport to health care provider, type of treatment received, vehicle used, location of ...

Series: 22565
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Total Retention: Retain for 8 year(s)

These records document requests by Medicaid clients for medical services pertaining to transplants. Information includes medical records and other documentation supporting the request.

Series: 23242
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Total Retention: Retain for 10 year(s)