Agency Schedule Detail

Authorization Number : 845-0540

Agency Series No. : IC-ADM-10

Status : Active

Agency Web Link :

Agency : OIC

Confidential Description : May contain claim information

Division : OIC0001

Vital Description :

Section : OIC00010001

Record Title : CareWorks Quarterly Report

Revision : 0

Record Description : A quarterly claim activity report of the IC Workers Compensation claims managed by the CareWorks Managed Care Organization. The report consists of, but is not limited to, metrics such as Allowed Claim Summary, Allowed Claim Lag Time Average, Claims by Month, Claims by Day of Week, Bill Type Summary, Average Medical Cost Per Claim, ICD code allowances etc.

Retention Period	Retention Justification	Media Code	Method of Disposal
Retain 5 years from the end of the quarter of the report.		Paper	Shred
Retain 5 years from the end of the quarter of the report.		Electronic	Delete

Approvals

Status	Name	Title	Date
Approved	Kamal Kapoor	Records Officer	12/3/2019 10:13:00 AM
Approved	Terri Dittmar	Record Administrator	12/4/2019 8:29:00 AM
Approved	Fred Previts	State Archivist	12/4/2019 1:45:00 PM
Approved	Martin Meeks	State Auditor	12/5/2019 11:18:00 AM

Notes

Date	Reason	User