AGENCY: Department of Health. Division of Health Care Financing. Medical Assistance Program. Clearfield Office

SERIES: 6357
TITLE: Adult indigent medical eligibility case files
DATES: 1981-2014.
ARRANGEMENT: Alphabetical by patient name

DESCRIPTION: Medical and billing records for individuals needing subsidized medical care, who do not qualify for medicaid or medicare. The information is a complete record of medical services received by indigent individuals and documents information concerning patient financial status, payments, certification of eligibility, medical need and notice of denial.

Information includes client name, social security number, county code, description of patient's condition or symptom's, diagnosis, medical history, laboratory results, provider name and address, medication, notice of denial and patients' hearing requests, hearing outcome, third party investigation, and employment status. These case files are used only for Davis County, and are maintained at the Clearfield facility. The Clearfield office does not have a clinic, therefore all clients are referred to other local authorized medical facilities.

RETENTION

DISPOSITION

RETENTION AND DISPOSITION AUTHORIZATION

Retention and disposition for this series were specifically approved by the State Records Committee.

APPROVED: 06/1997

FORMAT MANAGEMENT

Paper: Retain in Office for 2 years after case is closed and then transfer to State Records Center. Retain in State Records Center for 5 years and then destroy.

APPRAISAL

Administrative

This disposition is based on the administrative needs expressed by the agency.

PRIMARY DESIGNATION

Private

SECONDARY DESIGNATION

Controlled. Psychiatric information