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Agency Schedule Detail

Authorization Number :  855-1120
Agency Series No. :  MSAD-29
Status :  Active
Agency Web Link : 
Agency :  BWC
Confidential Description :  Records contain the injured workers’ claim numbers and billing information.
Division :  BWCMSAD
Vital Description : 
Section :  BWCMSAD
Record Title :  Hospital Reimbursement Review Bill Worksheets
Revision :  0
Record Description :  The Hospital Reimbursement Review Bill Worksheets contain the injured worker claim numbers and billing information; which are populated from a data warehouse report. This worksheet is simply used to help bill reviewers do research faster than looking up the information in the BWC system. The reviewer may make notes on the worksheet with additional research findings.
Retention Period Retention Justification Media Code Method of Disposal
Retain the Hospital Reimbursement Review Bill Worksheets for 2 years, provided audited by the Auditor of State, audit report is release, and then destroy. Paper Shred

Approvals

Status Name Title Date
Approved Kevin Gartrell Records Coordinator 8/31/2009 11:40:00 AM
Approved Melissa Roach Records Officer 8/31/2009 4:39:00 PM
Approved Michael Hardenbrook Record Administrator 9/9/2009 3:23:00 PM
Approved Martin Meeks State Auditor 9/10/2009 1:57:00 PM
Approved Fred Previts State Archivist 9/18/2009 10:01:00 AM

Notes

Date Reason User

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