Agency Schedule Detail

Authorization Number : 580-0763

Agency Series No. : FIS-037C

Status : Active

Agency Web Link :

Agency : DMH

Confidential Description :

Division :

Vital Description :

Section :

Record Title : Medicare/Medicaid Cost Reports

Revision : 2

Record Description : Patient records concerning medicare/medicaid dollars. Includes printouts of expense reports, space utilization, asset depreciation, medicare billing statements, cost reports, medicare Part B costs and worksheets, indirect cost plan worksheets, etc.

Retention Period	Retention Justification	Media Code	Method of Disposal
Retain in office 6 years after final medicare audit reports are adjudicated, then destroy	P.L. 3334 ODHS Medicai	Electronic	Erase
Retain in office 1 year then transfer to the SRC. Retain records 6 years after medicare audit reports are adjudicated, then destroy	P.L. 3334 ODHS Medicai	Microform	Shred
Retain in office 1 year then transfer to the SRC. Retain records 6 years after medicare audit reports are adjudicated, then destroy	P.L. 3334 ODHS Medicai	Paper	Shred

Approvals

Status	Name	Title	Date
Approved	Andrea Fells	Records Officer	12/23/2008 12:07:00 PM
Approved	Michael Hardenbrook	Record Administrator	1/14/2009 10:46:00 AM
Approved	Martin Meeks	State Auditor	1/14/2009 1:00:00 PM
Approved	Fred Previts	State Archivist	1/21/2009 10:18:00 AM

Notes

Date	Reason	User