Agency Schedule Detail

Authorization Number : 855-0956

Agency Series No. : PAFF-03

Status : Active

Agency Web Link :

Agency : BWC

Confidential Description : Contains confidential billing and provider information. May contain provider social security and tax identification numbers, medical records, and specific treatment codes for an injured worker.

Division : BWCMSAD

Vital Description :

Section : BWCMSADPAFF

Record Title : Audit Report on Cambridge Adjustments; Fee Entry

Revision : 1

Record Description : The Audit Report on Cambridge Adjustments; Fee Entry is the supervisor’s weekly audit of subordinate work for Cambridge Adjustments, suspense worked in Medical Invoice Information System (MIIS), and for fee bill entry in Medical Invoice Information System (MIIS) or Cambridge. The Cambridge Adjustments are adjustment requests submitted by the Managed Care Organizations (MCO) to adjust previously paid invoices in the Cambridge billing system.

Retention Period	Retention Justification	Media Code	Method of Disposal
Retain in office for 3 years or until internal audit review is completed then destroy.		Paper	Shred
Retain in office for 3 years or until internal audit review is completed then destroy.		Electronic	Delete

Approvals

Status	Name	Title	Date
Approved	Kevin Gartrell	Records Coordinator	9/21/2009 8:55:00 AM
Approved	Melissa Roach	Records Officer	10/6/2009 10:45:00 AM
Approved	Michael Hardenbrook	Record Administrator	10/6/2009 2:08:00 PM
Approved	Martin Meeks	State Auditor	10/9/2009 8:20:00 AM
Approved	Fred Previts	State Archivist	11/10/2009 9:34:00 AM

Notes

Date	Reason	User