November/December 2003 1

The OMS’s Guide to Record Retention

Medical Records In general, medical records should beretained according to the timeframesin the box below. However, stateguidelines vary, and you shouldcheck with a local medical recordstraining program, your professionalliability carrier or your healthcareattorney.

be determined by state law, e.g.,Georgia has such a law whichbecame effective July 2001.)

The obligation to pay for the recordrests with the patient or the thirdparty who has requested theinformation. Since this is generallyan uninsured service, the doctor may

When a Doctor Ceases PracticeIf a doctor ceases to practice, he orshe may be obligated to eithertransfer patient medical records toanother doctor at a local addressand phone number, or notify patientsthat their medical records will bedestroyed in (state specific #) ___years unless they collect the recordsor request a transfer of the recordsto another doctor within two years.

You may wish to contact yourliability insurer for additionalguidance.

Medical Records in a GroupPractice that Is ChangingDoctors in a group practice usuallyhave an arrangement that clarifiesownership of the records and atransferring policy with respect topatient records. Despite the existenceof such an arrangement, it isimportant to note that doctors inany setting, e.g., solo practice, grouppractice, hospital, etc., are ultimatelyresponsible for their own patientrecords. Doctors must be aware thatagreements made with theirassociates do not supersede theirresponsibility to patients.

Typically, most doctors in a grouppractice have an agreement withtheir associates that addresses suchitems as:

PRACTICE MANAGEMENT

NOTESA Supplement to the AAOMS Today Newsletter November/December 2003

Record Type Retention PeriodPatient Charts ........................................................................PermanentlyPatient Charts – Alternative (adults) .....................Ten (10) years after the

most recent encounterPatient Charts – Alternative (minors) ........................Age of majority plus

statute of limitationsMedical Correspondence (to patients,to referrers about patients, etc.) ............................Permanently with chartX-rays ...................................................................Permanently with chart

Other MedicalRecord Issues

When a Patient Requestsa Record TransferWhen transferring medical records,you should maintain the originalrecord and transfer only a copy. Youmay charge the patient a reasonablefee to reflect the cost of the materialsused, the time required to preparethe material and the direct cost ofsending the material to therequesting doctor. (Note: This may

make reasonable attempts to collectthe fee in advance. Nonpayment ofthe fee, however, is not a reason towithhold the information.

When a Doctor RelocatesDoctors relocating their practice maytake the medical records with themor leave the records with adesignated custodian, along with anagreement that they will bepermitted ready access to them asrequired in the future and uponrequest.

2 November/December 2003

• The method for division ofmedical records upon terminationof the practice arrangement. Thisagreement usually specifies amethod for determining custodyof the medical records.

• Some reassurance that eachdoctor will have reasonable accessto the content of the medicalrecords for preparing medico-legalreports, defending actions, orresponding to a complaintinvestigation.

Often, if no such agreement exists,doctors dissolving their joint practicetry to agree on a system to determinewhich doctor is most responsible foreach record. For example, the doctorwho has created the greatestpercentage of the entries in aparticular patient record may beexpected to continue to maintain it.While the previous approach is

customary in most group practices, itis not mindful of the patient’s needs.See details in “Ask the Patient”below.

Ask the PatientMembers of a group practice mustbe cognizant that it is the patient’sprivilege to choose which doctorthey wish to maintain theirparticular patient records andprovide continuing medical care,regardless of the existence of anagreement within the practice. Acopy (or original) of the patient’srecords should be transferred anddoctors should agree how the cost ofcopying and transferring records willbe divided within the group. In thecase of planned group practicedissolution, the cost cannot becharged to the patient.

Unexpected Dissolutionof a Group PracticeUnexpected dissolutions of grouppractices create special difficulties.Ideally, doctors involved shouldamicably agree on a strategy forinforming patients and dealing withthe medical records. In the case of asudden, unforeseen departure of apartner or associate, records shouldbe kept at their present location untilpatients direct where they wish toreceive their ongoing health care.Reasonable access to medical recordsmust be given to all former partnersand associates.

Statutory RequirementsThere are some statutory require-ments on the keeping of medicalrecords. For example, certainMedicaid/Medicare reimbursementregulations require that the medicalrecords of recipients be available forreview for seven years.

AAOMS PRACTICE MANAGEMENT NOTES

Maintaining Tax, Financial and Employment Records Following are recommended time frames for maintaining non-medical practice records. Many of the records listedbelow will be maintained electronically. Downloading files to a disk or CD for storage is strongly recommended.

Tax and Financial Files

Accounts Payable Ledger.................................................................................................................................Permanently

Accounts Receivable Ledger-Annual ...........................................Six (6) years after the due date of the practice tax return

Accounts Receivable Ledger-Monthly............................................................................................................Two (2) years

Bank Statements with cancelled checks.......................................Six (6) years after the due date of the practice tax return

Capital Asset Records.................................................................Six (6) years after the due date of the practice tax returnfor the year in which the asset is disposed

Cash Receipts Journals ...............................................................Six (6) years after the due date of the practice tax return

Check Register............................................................................Six (6) years after the due date of the practice tax return

Daysheets....................................................................................Six (6) years after the due date of the practice tax return

Deeds, Mortgages, and Bills of Sale.................................................................................................................Permanently

Deposit Books & Slips................................................................Six (6) years after the due date of the practice tax return

November/December 2003 3

Depreciation Schedules ....................................................................................................................................Permanently

Encounter Forms ........................................................................Six (6) years after the due date of the practice tax return

Financial Statements – Annual (year end)........................................................................................................Permanently

Financial Statements – Periodic .....................................................................................................................Two (2) years

General Ledger ................................................................................................................................................Permanently

Income Tax Returns (Correspondence & Audits) ............................................................................................Permanently

Income Tax Returns (Federal & State) ............................................................................................................Permanently

Insurance Policies (expired) .........................................................................................................................Three (3) years

Insurance Records, CurrentAccident Reports, Claims, Policies, etc. ...........................................................................................................Permanently

IRA and Keogh Plan Contributions,Rollovers, Transfers and Distributions ............................................................................................................Permanently

Paid Invoice-Expenses.................................................................Six (6) years after the due date of the practice tax return

Payroll Ledger ............................................................................Six (6) years after the due date of the practice tax return

Payroll Tax Returns.........................................................................................................................................Permanently

Petty Cash Vouchers....................................................................................................................................Three (3) years

Stock and Bond Certificates (canceled)........................................................................................................Seven (7) years

Vouchers for Payments to Vendors, Employees, etc.(includes allowances and reimbursement of employees,officers, etc., for travel and entertainment expenses) ...................................................................................Seven (7) years

Employer

Employee Personnel Records (after termination) .........................................................................................Seven (7) years

Employment Applications ...........................................................................................................................Three (3) years

Time Cards and Daily Attendance Reports .................................................................................................Seven (7) years

Other

Accident Reports/Claims (settled cases) .......................................................................................................Seven (7) years

Correspondence, General ..............................................................................................................................Two (2) years

Correspondence, Legal and Important Matters ...............................................................................................Permanently

Correspondence, Routine with Customers or Vendors ..................................................................................Two (2) years

Minute Books of Directors, Stockholders, Bylaws and Charter .......................................................................Permanently

Trademark Registrations, Patents and Copyrights...........................................................................................Permanently

This issue of Practice Management Notes was provided by Gates, Moore and Company, which specializes in practicemanagement, tax and accounting services. For more information, visit their Web site at www.gatesmoore.com.

This is number 79 in a series of articles on practice management and marketing for oral and maxillofacial surgeons developed under the auspices ofthe Committee on Practice Management (Larry J. Moore, chair, Robert W. Emery, Brent T. Garrison, Jerry L. Halpern, Rickey L. Hurst,Donald P. Lewis, Jr., Robert T. Watts, Jr., Robert L. Coles, consultant, and Thomas M. Weil, consultant) and AAOMS staff. Completesets of previously published Practice Management Notes are available online at www.aaoms.org.

PRACTICE MANAGEMENT MANUAL: A Guide toManaging the OMS OfficeAAOMS is pleased to offer our comprehensive Practice ManagementManual — a must have for all OMS practices! Includes information aboutbusiness start-up and organization, patient financing, personnel and officeadministration, technology information, marketing, regulatory complianceand business analysis, and contract negotiations. Manual includes acomprehensive set of office forms to help you operate your officeefficiently, and a CD-ROM so you can customize them for your practice.

Member: $165Nonmember: $495Institution: $330Order Code: PMM02

AmericanAssociation ofOral andMaxillofacialSurgeons

Let AAOMS Help You TakeCare of Business!

includes forms on CD

TO ORDER, CALL 800/366-6725 OR 770/442-8633 FAX 770/280-4140 OR ORDER ONLINE WWW.AAOMS.ORG