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MEDICAL SERVICES POLICY MANUAL,SECTION A A-100General Program Information

A 132 MedicalRecords

A-132 Medical Records MSManual 07/01/20 Medical records and the Medical Review Team (MRT) reports are a part of an applicant’s or recipient’s case record and, as such, will be considered according to (MS A-130). A-133 Medical Providers/Services Organizations MSManual 01/01/14 If a provider furnishes an individual’s full name (including middle initial), date of birth, Social Security Number, and date of service, the County Office may release limited information. Information which may be released is limited to Medicaid ID #, beginning date of eligibility, whether or not a recipient was eligible on a specific date, services for which an individual is eligible, and TPL information (including policy numbersand typeof coverage, if known). It will be an administrative decision whether or not time and staff are available to provide the information. A-134 Collateral Information MSManual 07/01/20 Collateral information (evidence provided by persons other than the applicant/ recipient or by written documents) will be obtained only when necessary to establish eligibility. The applicant or recipient will be informed that the source of collateral information will be contacted. The eligibility worker will protect the rights of the applicant/recipient during collateral interviews, and will give only the information necessary to enable the collateral to understand the need for the information requested. A-140 Retention of Medicaid Case Records MSManual 07/01/20 The Medicaid electronic case recordmust be kept for a minimum of five (5) years after case closure. EXCEPTION: If an audit by or on behalf of the Federal Government has begun but is not completed at the end of the five year period, or if audit findings have not been resolved at the end of the five year period, the records will be retained until resolution of the audit findings. (Central Office will notify the County Office when an audit by the Federal Government is to be conducted, of the cases to be audited, and when the audit has been completed.) Documents provided to the County Office that do not have to be returned to the applicant will be destroyed by burning or shredding once scanned into the electronic case record.