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Agency Schedule Detail

Authorization Number :  50750023
Agency Series No. :  402-54-27
Status :  Active
Agency Web Link : 
Agency :  ODM
Confidential Description :   may contain recipient's personal medical information for services provided under the Medicaid program.
Division :  ODMOPER
Vital Description : 
Section :  ODMOPERMITS
Record Title :  MMIS Summary Ad Hoc Reports
Revision :  1
Record Description :  Ad hoc reports generated by MIS from the MMIS, Medicaid Management Information System, including MMIS sub-systems Control D and MARS, Monthly Administrative Reporting System to monitor payments to providers for services provided to Medicaid recipients to ensure services and claims are being paid/denied in accordance with Ohio Medicaid program requirements. Data includes medical health care eligibility, health care insurance, prior authorization, surveillance and utilization audit findings, case and claims/remittance information and buy-in summaries/totals of premiums paid by providers and recipients for health care services. Information is used to monitor operational performance and cross-match state and county welfare records to minimize duplicate payments.
Retention Period Retention Justification Media Code Method of Disposal
Retain systems generated microfiche 7 years, and then destroy. Retention period required by ODJFS (ODHS) Medicaid Handbook. Microform Shred
Retain 7 years and then download to reel tape by MIS until no longer of administrative value. Retention period required by ODJFS (ODHS) Medicaid Handbook. Electronic Erase
Printed reports in office 1 year, then destroy. Paper Shred

Approvals

Status Name Title Date
Approved Dennis Hawk Records Coordinator 2/4/2019 4:12:00 PM
Approved Lisa Stafford Records Officer 2/6/2019 3:31:00 PM
Approved Terri Dittmar Record Administrator 2/7/2019 7:37:00 AM
Approved Fred Previts State Archivist 2/11/2019 10:49:00 AM
Approved Martin Meeks State Auditor 2/14/2019 1:33:00 PM

Notes

Date Reason User

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