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MEDICAID CLAIMS Records

RDA Number
656
Effective Date
Record Series Abstract
This RDA covers records used in processing claims for payment by Health Care Finance & Administration such as crossover claims, Intermediate Care Facility for Mental Retardation, payments and payments to Department of Children Services. As well as, records generated from managed care entities containing information on claims they have paid or denied for various medical services provided to our enrollees. These records contain data from current operations as well as archived data that is used in analysis of long term medical cost trends and patterns.
Record Series Active
Yes
Cut Off at End of
Other
If Other, Explain
After closure of the claim
Total Retention Years
20
Total Retention Months
0
Retention End Action
Destroy
Disposition Notes
Files are cut off after closure of the claim, maintained for twenty years. Records may be maintained in either paper or electronic format, as long as the electronic content has been verified for completeness, accuracy, and usability. Records in Paper format may be transferred to the State Records Center. Records in electronic format shall be maintained in Strategic Technology Solutions (STS) approved software and server environment. Any sensitive of confidential information contained therein shall be destroyed according to standards for destruction of confidential information
Allotment Code
31865
Record Location
State Data Center
File Arrangement
Alpha/Numeric
Date Range
4/1977 - current
Annual Accumulation
30 cu ft. .5 GB
Current Volume
300 cu ft. 2 GB
Record Value
Administrative
Fiscal
Legal
Audit Requirements
Both
Information Shared Outside the State
Yes
Shared Agencies
Medicare and Medicaid
Essential Record
Yes - Original
Essential Record Stored
State Data Center
Essential Record Media Type
Electronic
Confidential
No
Confidential Legal Citation
45 CFR 164.502
Does this Record Series Contain Sensitive Information?
No
Agency Retention
20 YEARS 0 MONTHS
System Name
InterChange
Hardware Description
Shared server environment at STS's Data Center South.
Software Description
SQL Database
System Location
STS Data Center South, Smyrna TN.
Backup Procedures
Standard STS Data Center backup procedures are in place. Backups are taken nightly and stored on-site. Weekly backups are taken to Iron Mountain storage facility
Disaster Recovery
The application resides at the Data Center which is backed up nightly. Backups are stored off-site weekly. Recovery in a disaster could take between one (1) to three (3) weeks
Data Migration Description
The data resides in am SQL database located at the Data Center. If there were a need for migration. It could be done by STS database administrators.
Legacy Revision UUID
65