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Paper work/Files

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PMRNC:
First, EOB's Are considered to be a part of the DRS as well as PHI, under federal regulations. That's clear.
Second I guess it's import to say the federal regulations verbiage does cover "agencies" in regards to collectively calling them providers specifically ACT 481:

"Act 481 affects health facilities, agencies and healthcare professionals and imposes new laws relating to medical records. Imposed are requirements regarding patient notification, and the maintenance and disposal of medical records.

Regarding record retention and maintenance, healthcare providers, entities and agencies (collectively referred to as "Provider") are now required to:

(a) maintain a patient record for each individual to whom medical services were provided;

(b) maintain the records for a minimum of 7 years from the date of service unless federal or state law or medical practice standards require a longer retention period "

Second, you have to remember if you are a billing company you are either a covered entity or a business associate.

As for who owns.. and a doctor asking for his records back.. he shouldn't need them back if he followed the law himself and had his copies.. ie; his/her's source documents.   Your source documents are anything received by the office in order to do your job and they become your property by law as record of the work you did. If there is an audit of the practice, YOUR records will be evidence/records used to perform the audit thereby the liability of a billing company, essentially by saying you don't have to retain your source documents you are saying that an auditor will be directed to go to the provider for the records when it was your company that did the billing? That won't go over too well.

Finally, there is the legal definition of the LEGAL.Record 

Definition of the Legal Health Record

"The legal health record is generated at or for a healthcare organization as its business record and is the record that will be disclosed upon request. It does not affect the discoverability of other information held by the organization. The custodian of the legal health record is the health information manager in collaboration with information technology personnel. HIM professionals oversee the operational functions related to collecting, protecting, and archiving the legal health record, while information technology staff manage the technical infrastructure of the electronic health record.

The legal health record is the documentation of healthcare services provided to an individual during any aspect of healthcare delivery in any type of healthcare organization. It is consumer- or patient-centric. The legal health record contains individually identifiable data, (payment or treatment), stored on any medium, and collected and directly used in documenting healthcare or health status.

Legal health records must meet accepted standards as defined by applicable Centers for Medicare and Medicaid Services Conditions of Participation, federal regulations, state laws, and standards of accrediting agencies such as the Joint Commission on Accreditation of Healthcare Organizations, as well as the policies of the healthcare provider.

Legal health records are records of care in any health-related setting used by healthcare professionals while providing patient care service or for administrative, business, or payment purposes. Some types of documentation that comprise the legal health record may physically exist in separate and multiple paper-based or electronic or computer-based databases.  "


Of course, if questioning, it's best to talk to your attorney, again keep in mind your "formal" and legal "status" as a billing company.

Alice Scott:
Thanks Linda for that great explanation.  I'm sure it will be helpful and eye opening to many.
Alice

dfranklin:
WOW!  Definately opened my eyes!  I have been keeping my files but it looks like I better get a better grasp of the laws and guidelines on these things..I had no idea!

Thanks again!

PMRNC:
Record retention and ownership rights is actually 7 pages long in my compliance plan. The medical record is no longer just the medical record, with the development of HIPAA it then became the "legal record" / PHI and of course your DSR for your billing company. You could have a client terminate and 3 years later be subject to an audit which means YOUR records can and would be audited as well.

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