This is a question I get all the time, but unfortunately the answer is not always as clean and simple as you’d like. Here’s why:
1) Each state can dictate how long you must store records: if you start with your state law, this will cover the majority of your patients. Sounds good. Except that state laws vary and some laws are slightly vague (or even non-existent).
For most states, records storage is typically 5 years or more, here’s a quick reference on Chiropractic Records Laws in your State.
2) Medicare dictates you how must store records too: in addition to your state requirements (which would cover most commercial insurance plans, cash patients and worker’s compensation), Medicare also gets to weigh in on how long you must store records. And guess what – their answer does not always line up with your state requirements! Even worse, Medicare’s replacement plans (i.e. Medicare Advantage, etc) can have their own rules as well.
In general, it’s 6 yrs for “regular” Medicare patients and for 10 years for most Medicare managed care replacement plans.
Here’s the Medicare reference for records storage.
3) Chiropractic Records Storage for Minors: To complicate matters just a bit more, many states also have additional requirements for records storage for minors. Most of these additional limits only apply to minors with ongoing or potential litigation involved (i.e. a MVA case) but some states require extremely term storage form minors of all case types.
For example, in some states you have to keep records of minors until their 18th birthday, regardless of the age you treated them; others it’s even longer than that! See your state laws in the reference above or contact your state board to ensure that you are properly storing records for minors.
Disposal of Chiropractic Records
While common sense and HIPAA requirements dictate that you can’t just throw old records in the garbage, the logistics of disposing of your chiropractic records can be a little daunting.
In fact, I’ve seen many chiropractors put multiple shredders in the grave attempting to get rid of old chiropractic records or free up some storage space. Worse, they pay their employees to babysit the shredder for hours on end while more important work gets put on hold. In a word – don’t. Call a mobile shredding company. Watch with joy as they show up with a gargantuan type of “secure” garbage truck to sweep all your shredding away for a reasonable fee – time, money and shredder all saved in the process.
Can I Charge For Providing Copies of Medical Records?
The next most common chiropractic medical records question I get is with respect to whether a chiropractor can charge for making copies of medical records. Unfortunately, even this answer isn’t always straightforward so let’s break things down into categories:
A) Personal Injury – when providing copies of records to attorneys for the purposes of a motor vehicle accident litigation, settlement or negotiations, the simple answer is YES, you can charge for medical records. The limits to how much you can charge are dictated by your state.
B) Private Health Insurance – in most cases, medical records that are required for claims processing will NOT be paid by a health insurance company. That does not mean that you cannot attempt to charge them. But in many situations, if you are a contracted provider, your contract states that you will provide records upon request for claims processing purposes and (you guessed it), this will be done at your expense. Even if you are not a contracted provider, few health insurance companies will pay for medical records (but it’s certainly an option to try).
C) Worker’s Compensation – unfortunately, health records access in the Work Comp world is all over the map. Some Work Comp carriers and state funds pay, some don’t.
D) Patient Access to Health Records – every state requires that you provide records upon the request of the patient and most states accept that you may charge a “reasonable fee” for the copying. Again, how much is reasonable is typically defined by your state.
E) Medicare: essentially, Medicare views itself in the same manner as most private health insurance companies and does not pay for records requested as part of the claims processing process.
The Big Fat Disclaimer
And herein lies the big fat disclaimer for basically this entire article:
While every attempt has been made to convey accurate information in this article, all of the above entities mentioned can change their rules in regards to records storage. Fortunately, it’s not often that they do, but you should perform your own due diligence and make sure you are solid on your state laws before you hit the shredder!