Agency Schedule Detail

Authorization Number : 50750006

Agency Series No. : 404-62-39

Status : Active

Agency Web Link :

Agency : ODM

Confidential Description : Contains personal medical information of Medicaid recipients requesting inpatient services.

Division : ODMLEGL

Vital Description :

Section : ODMLEGLPRIN

Record Title : PEER Reviews

Revision : 2

Record Description : Records of the Hospital Utilization Review Contractor is decisions concerning hospital pre-admission screening of Medicaid requests for inpatient services. Surveillance Utilization Review (SUR) staff oversees the reviews to ensure the Hospital Utilization Review Contractor is performing their functions as contracted. File includes, but are not limited to, documentation indicating what the review is for, approval, dollar amounts, reason why requests were denied, number of monthly denials by hospital, and appeals.

Retention Period	Retention Justification	Media Code	Method of Disposal
Retain until superseded, obsolete or replaced, then destroy.	OAC 5160.1-40	Electronic	Erase
Retain 5 years, and then destroy.	OAC 5160.1-40	Paper	Shred

Approvals

Status	Name	Title	Date
Approved	Dennis Hawk	Records Coordinator	5/2/2023 3:04:30 PM
Approved	Terri Dittmar	Record Administrator	5/11/2023 7:30:48 AM
Approved	Fred Previts	State Archivist	5/11/2023 10:57:39 AM
Approved	Martin Meeks	State Auditor	5/15/2023 10:20:34 AM

Notes

Date	Reason	User