AGENCY: Department of Health. Bureau of Information Technology

SERIES: 8233
TITLE: Recipients exception profile report
DATES: 1985-2006.
ARRANGEMENT: None

DESCRIPTION: This is computer output microfiche 68210G, part of the Surveillance and Utilization Review Subsystem. This lists those recipients whose activities were found to be unusual for their peer group so that the department can investigate these activities. It includes the report date, the class of service, the name and identification number of the recipient, the county where the recipient is located, the exception criteria chosen by the department and those criteria for which the recipient falls under, the dates of the report periods and the total amount of the claims submitted during that period, any specific procedure or diagnosis being reported, and the number of occurrences per the procedure.

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 3 years and then destroy.

APPRAISAL

Administrative Fiscal

This record is part of a series used to produce a comprehensive statistical profile on participants who deviate from pre-defined criteria for the purposes of analysis and review. This information is subject to federal audit and must be maintained for three years.

PRIMARY DESIGNATION

Private