AGENCY: Department of Health. Bureau of Information Technology

SERIES: 8239
TITLE: Provider exception log
DATES: 1985-2006.
ARRANGEMENT: None

DESCRIPTION: This is computer output microfiche number 68210N, generated by the Surveillance and Utilization Review Subsystem. This report serves as an index to the exception profile report. It includes the report date, the category of service, the provider's name and identification number, the page in the exception profile where this person's profile begins, the forced exception indicator, the county and area where the provider is located, and the provider's type of practice.

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