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Agency Schedule Detail

Authorization Number :  50750020
Agency Series No. :  402-54-13
Status :  Active
Agency Web Link : 
Agency :  ODM
Confidential Description :   May contain personal medical information for Medicaid recipients.
Division :  ODMOPER
Vital Description : 
Section :  ODMOPERCLOP
Record Title :  Adjustment Files
Revision :  1
Record Description :  This record documents adjustments made to invoices from Medicaid providers for services rendered. Files contain adjustment request forms (ODJFS 6766 and 6767) and related correspondence detailing payment discrepancies or erroneous payments to providers. This documentation may be used by other ODJFS sections, the Attorney General’s office, or federal auditors to determine the correctness of payments, compliance to policy requirements, federal financial participation, and as supporting information in fraud investigations.
Retention Period Retention Justification Media Code Method of Disposal
Retain 90 days after hard copy is imaged and then destroy provided all pending audit findings/lawsuits have been released and resolved. All paper forms received are now scanned and digitized. Claims are imaged or submitted into MITS and once quality control is completed the paper copy is no longer of administrative value. Paper Shred
Retain 90 days after hard copy is imaged and then destroy provided all pending audit findings/lawsuits have been released and resolved. Case reviews, hearings, audits, and adjudication of billing discrepancies can extend up to 7 years from the date of the claim. Microform Shred
Retain 90 days after hard copy is imaged and then destroy provided all pending audit findings/lawsuits have been released and resolved. Case reviews, hearings, audits, and adjudication of billing discrepancies can extend up to 7 years from the date of the claim. Electronic Erase

Approvals

Status Name Title Date
Approved Dennis Hawk Records Coordinator 2/4/2019 3:31:00 PM
Approved Lisa Stafford Records Officer 2/5/2019 3:08:00 PM
Approved Terri Dittmar Record Administrator 2/6/2019 7:39:00 AM
Approved Fred Previts State Archivist 2/6/2019 11:29:00 AM
Approved Martin Meeks State Auditor 2/14/2019 12:48:00 PM

Notes

Date Reason User

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© 2025 - RIMS, State of Ohio