AGENCY: Department of Health and Human Services. Healthcare Administration. Division of Integrated Healthcare. Office of Medicaid Operations.
SERIES: 6765
TITLE: Medical claims
DATES: 1979-
ARRANGEMENT: Chronological, thereunder numerical by transaction control number
DESCRIPTION: 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 adjustments, invoices, health insurance claims, pharmacy claims, outpatient claims, and long-term care turnaround documents. Information contained within this record includes but is not limited to: patient name, address, telephone number, birth date and gender; whether the client has health insurance; name, address, and medicaid provider number of the health care provider; description of services performed and charges; health care provider signature, and the health care financing reviewer.
RETENTION
Retain for 10 year(s)
DISPOSITION
Destroy.
RETENTION AND DISPOSITION AUTHORIZATION
Retention and disposition for this series were specifically approved by the State Records Committee.
APPROVED: 08/1986
FORMAT MANAGEMENT
Paper: Retain in Office for 10 years and then destroy.
Microfilm master: Retain in Archives for 10 years and then destroy.
Microfilm duplicate: For records prior to and including 2004. Retain in Office for 10 years and then destroy.
Paper copy: Retain in Office until administrative need ends and then destroy.
Computer data files: For records beginning in 2004 and continuing to the present. Retain in Office for 10 years and then delete.
Microfilm duplicate: For records prior to and including 2004. Retain in Agency Record Center for 10 years and then destroy.
APPRAISAL
Administrative Fiscal
This disposition is based on the administrative and fiscal value of these claims. The state is required under 42 CFR 455 (1994) to investigate complaints of medicaid fraud or abuse, but it does not specify any statute of limitations. UCA_76-1-302(1)(a)(1994), specifies that prosecution for a felony must commence within 4 years after it is committed. The statute of limitations for reimbursement is 8 years as stated by UCA_76-1-302(1994). The statute of limitations for bringing action on false claims of 6 years and is covered by 31 USCS 3731. The federal government has 3 years in which to audit these records.
PRIMARY DESIGNATION
Private
SECONDARY DESIGNATION
Controlled