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Agency Schedule Detail

Authorization Number :  590-0206
Agency Series No. :  REIMB-7C
Status :  Active
Agency Web Link : 
Agency :  DMH
Confidential Description : 
Division : 
Vital Description : 
Section : 
Record Title :  Explanation of Benefits EOB from Medicare/Medicaid and Third Party Insurance
Revision :  0
Record Description :  A statement of covered charges, remittance notices, and claim information from Medicare, Medicare and Third Party Insurance carrier’s from Mental Health services.
Retention Period Retention Justification Media Code Method of Disposal
Retain 2 years in office then transfer to SRC for an additional 4 years, then destroy. Proivded audited by the Auditor of State and the Audit report is released. Paper Shred

Approvals

Status Name Title Date
Approved Sue Slaughter Records Officer 11/8/2006 9:55:00 AM
Approved Michael Hardenbrook Record Administrator 11/8/2006 11:36:00 AM
Approved Martin Meeks State Auditor 11/8/2006 12:42:00 PM
Approved Steve Gutgesell State Archivist 12/4/2006 9:19:00 AM

Notes

Date Reason User

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