Achieving harmony

Balance in Practice

Stephen Richardson, MD

This month's author discusses how he balances his career in dermatology with his passion for collecting and playing violins.

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How long should you keep your records?

One of the most common questions the practice management division at the Academy receives is how long a practice should keep its medical records. In additional to medical charts, practices need to be aware of retention requirements for other records — mainly business, legal, and financial documents.

How long should I store my medical charts?

Most practices face this predicament when storage becomes an issue. How long you are required to store your medical charts often depends on your individual state’s law as well as your malpractice carrier’s guidance. View an overview of each state’s law on record retention requirements. You should also contact your individual malpractice carrier to determine if they have additional requirements in order to maintain your malpractice coverage.

If you are facing a storage problem, you may want to consider scanning your charts and storing them on a server. This would allow you to shred your paper charts and maintain only electronic copies for those records that are not needed on a more frequent basis. (All paper charts should be shredded prior to disposal to ensure the privacy of protected health information). There are many vendors who would also perform this service for your practice; however you would need to follow appropriate HIPAA guidelines to ensure a breach of confidential information does not occur. This would include signing a business associate agreement with the vendor since they may have access to protected health information.

Do I need to store any financial statements that correspond with my medical charts, i.e. Explanation of Benefits forms, claims, etc.?

Yes, you must store these documents as they note your financial transactions for tax purposes. The Internal Revenue Service (IRS) requires that you maintain these records for at least seven years; however, the False Claims Act, a federal law that can hold a physician liable for defrauding the government, has a statute of limitations of 10 years. Thus, it is prudent to maintain these financial records for at least 10 years if you are participating in the Medicare program. Additionally, if your private payers have their own regulations concerning audits, you should maintain those financial records for their recommended amount of time. Many states have regulations concerning look-back timelines for payers, which would limit your retention time for these documents.

Are there any requirements to store employment records?

The U.S. Equal Employment Opportunity Commission (EEOC) requires that all employers keep personnel records for a minimum of three years. Any financial documents associated with employment, such as payroll forms, benefits paperwork, etc., should abide by IRS regulations. If there is an OSHA hazard or other issue with an employee, it would be wise to keep those personnel records for a longer period of time as any workplace injury or performance issue could have long-term implications.

What if I have an electronic health record (EHR)? Do I need to keep any paper records?

If you have an EHR in your office, you do not need to keep any paper charts on file as all your medical records are maintained electronically. There is no requirement to have a redundant storage system in place, but records should be retained electronically for the same amount of time as they would be required to be retained in paper form. Additionally, if you have a practice management system, you do not need to keep paper copies of your financial forms since most of your claims would be recorded in the system.

For additional guidance on record retention requirements, please consult the following table, reprinted from the AAD’s Starting and Marketing a Practice manual with permission from Daniel M. Bernick, Esq., MBA. Bernick is an attorney and consultant with the The Health Care Group, Inc. and Health Care Law Associates, P.C., in Plymouth Meeting, Pennsylvania.

 

Related Resources

How long should you keep different types of records?