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Agency Schedule Detail

Authorization Number :  50750008
Agency Series No. :  404-62-16
Status :  Active
Agency Web Link : 
Agency :  ODM
Confidential Description :   Contains recipient personal medical information to request services from Medicaid providers.
Division :  ODMLEGL
Vital Description : 
Section :  ODMLEGLPRIN
Record Title :  Provider Audit Reviews (Desk/Self - Full Scale)
Revision :  2
Record Description :  This record contains documentation of civil reviews by SUR analysts investigating Medicaid providers (e.g., doctors, dentists, medical suppliers, pharmacies and ambulance services) for potential over/under utilization of services. Reviews are conducted on providers from random samples of their records which must support the type of service and charges being billed. File contains, but is not limited to, records of procedures taken by analysts during an investigation; settlement agreements and adjudication orders; related correspondence, forms, logs, random samples used to identify and build cases on potential abusers; recipient complaints against providers; remittance statements; 1099 listing; and SUR subsystem reports.
Retention Period Retention Justification Media Code Method of Disposal
Retain in office until case audits are settled and closed and 5 years in the records center. Then destroy provided audits are completed and released and all discrepancies are resolved. OAC. 5160-1-40 Paper Shred
Retain until superseded, obsolete or replaced, then destroy. OAC. 5160-1-40 Electronic Erase

Approvals

Status Name Title Date
Approved Dennis Hawk Records Coordinator 5/2/2023 3:04:59 PM
Approved Terri Dittmar Record Administrator 5/11/2023 7:31:18 AM
Approved Fred Previts State Archivist 5/11/2023 11:06:30 AM
Approved Martin Meeks State Auditor 5/15/2023 10:15:33 AM

Notes

Date Reason User

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