Series Title (Agency Series #): Description, Retention (Legal Citation)
Breast And Cervical Cancer Client Records (DOH28-001): Documents that clients have been assessed for eligibility, referred to an appropriate facility, and received necessary services. Records include data forms, copies of progress notes, copies of test results, and related records. Information includes client's name and demographic information, cervical screening information, breast screening information, pap test results, and mammogram results. The provider (either county or contractor) maintains a medical case record for each client. Data forms are also sent to the state Breast and Cervical Cancer Coalition and entered in the county's Health Information System.
Retention: Retain 6 years after last service. (MOAR 166-150-0065(20))
Community Partner Funding Records (DOH28-002): Documents the funding of community organization outreach and client screening services. Funding is provided for one year and must be applied for annually. Grant funds originate with the Center for Disease Control and the Susan G. Komen Foundation. Records include funding applications, partner monthly and quarterly reports, service plans, BCCP reviews of partner programs, and related correspondence.
Retention: Retain 5 years. (MOAR 166-150-0110(17))
Provider Agreements (DOH28-003): Provider agreement to honor medicare billing rates and not bill clients any other amount. Informal agreements show date, name of provider, boilerplate agreement, and provider representative signature.
Retention: Retain 2 years after expiration. (2009-0001/025)
Provider Billing Records (DOH28-004): Documents program review of provider (both county clinic and contracted clinic) billings for services provided. Includes copies of client vouchers, voucher summary reports, county clinic bill, and staff notations verifying client eligibility, claim amount, payment codes, and services provided. Contractor bills are paid via check by the Health Department's accounts payable division; county clinic bills are paid via fund transfer.
Retention: Retain 6 years. (45 CFR 164.530(j))