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Managed Care Operations/Provider Program Integrity files

RDA Number
2040
Effective Date
Record Series Abstract
These records include but are not limited to investigative notes, medical records, claims data, provider histories and correspondence with other agencies. These records are used to investigate providers for fraud waste and abuse in TennCare managed programs
Record Series Active
Yes
Cut Off at End of
Other
If Other, Explain
The record becomes inactive and the retention period starts when the case is closed.
Total Retention Years
10
Total Retention Months
0
Retention End Action
Destroy
Disposition Notes
Records are maintained in either paper or electronic format in agency as long as space is available. Transfer to State Records Center as necessary. Destroy by state approved method ten (10) years after case closed. STS maintains Electronic Records on secure platforms for the life of the retention period.
Allotment Code
31865
Record Location
(Paper) Records 310 Great Circle Road 418.4E File Storage Room, and Richards & Richards (Electronic)Installed on production servers in the South Data Center and TennCare Data Center
File Arrangement
Numberical by T Prime Case Number
Date Range
to
Annual Accumulation
(Paper)20 Cu FT (Electronic) 60 GB.
Current Volume
(Paper)188 Cubic Feet (Electronic) 600 GB
Record Value
Administrative
Legal
Audit Requirements
Both
Information Shared Outside the State
Yes
Shared Agencies
Centers for Medicare & Medicaid Services
Essential Record
Yes - Original
Essential Record Stored
(paper )418.4E File Storage Room and Richards & Richards (Electronic)Installed on production servers in the South Data Center
Essential Record Media Type
Electronic
Confidential
Yes
Confidential Legal Citation
45 CFR 155.1210, 45 CFR 164.502
Does this Record Series Contain Sensitive Information?
No
Agency Retention
10 years
Records Center Retention Period
5
System Name
T Prime and Y Drive
Hardware Description
(TPrime) Software is custom written by DXC. installed on the physical SharePoint server in the South Data Center. (Shared Drive) (Y:Drive)Shared drive on the STS file drive in the South Data Center for OPI directory. The Y:drive is located in the TennCare Data Center
Software Description
(TPrime) installed on production servers in the South Data Center. (Shared Drive) (Y:Drive) PI keeps various documents to support cases. Directory OPI is where most documents are kept
System Location
(TPrime)Not on a shared drive; on physical hardware in the South Data Center. Shared Drive Y:Drive Physically located in the North Data Center for the OPI directory. The Y:Drive is located in the TennCare data center
Backup Procedures
(TPrime) STS maintains backup plans for this hardware. Contact is David Beachboard at STS. (Shared Drive)STS server is backed up by David Beachboard. (Y:Drive) is backed up by DXC staff
Disaster Recovery
(TPrime)The Backup plan is maintained by Kim Converse with DXC. Formerly stored on opsplaner but now being stored on Sharepoint (Shared Drive)STS server is to be restored by STS staff. (Y:Drive) DXC would restore server in the TennCare datacenter at an alternative site
Data Migration Description
Data is migrated as part of normal server migration process
Legacy Revision UUID
542