How Long Do Doctor’s Offices Keep EOBs?
Doctor’s offices generally keep EOBs (Explanation of Benefits) for 7-10 years, though state and federal regulations can influence this timeframe. Knowing how long doctor’s offices keep EOBs helps patients understand record-keeping practices and navigate potential billing discrepancies.
Understanding Explanation of Benefits (EOBs)
An Explanation of Benefits, or EOB, is a statement from your health insurance company detailing the healthcare services you received, the amount billed by the provider, the amount the insurer paid, and your out-of-pocket responsibility. It’s not a bill but rather an informational document vital for understanding healthcare costs.
- Purpose of EOBs: Clarity on medical billing, verification of insurance claims, and identification of potential errors.
- Content of EOBs: Date of service, provider name, services rendered, billed amount, amount covered, patient responsibility (copay, deductible, coinsurance).
Factors Influencing EOB Retention
Several factors affect how long doctor’s offices keep EOBs. These considerations include:
- State Laws: Varying state regulations regarding medical record retention often influence EOB storage policies.
- Federal Regulations (HIPAA): While HIPAA focuses primarily on patient privacy and access, it implicitly necessitates record retention for compliance and potential audits.
- Professional Guidelines: Medical professional organizations may offer recommendations or guidelines on record-keeping practices.
- Statute of Limitations: Legal timelines for medical malpractice claims can impact record retention needs.
- Office Policy: Ultimately, individual doctor’s offices establish their own policies, often adhering to the most stringent legal requirement.
The Legal and Regulatory Landscape
Navigating the legal requirements can be complex. Here’s a general overview:
| Regulation Type | Impact on EOB Retention |
|---|---|
| HIPAA | Focuses on patient access and privacy, requiring secure record-keeping for potentially many years. |
| State Medical Record Laws | Dictate minimum retention periods, often longer than HIPAA’s implied requirements. |
| Statute of Limitations | Influences the need to retain records for potential legal claims. |
| IRS Regulations | Indirectly impact EOBs by requiring documentation for tax purposes related to healthcare spending. |
Why Retention is Important
Maintaining accurate records, including EOBs, benefits both the doctor’s office and the patient.
- For the Doctor’s Office: Accurate billing, defense against potential lawsuits, compliance with audits.
- For the Patient: Verification of medical bills, tracking healthcare spending, dispute resolution with insurance companies.
Best Practices for Patients
Patients should also maintain their own copies of EOBs.
- Keep all EOBs organized: Create a filing system (physical or digital) to easily access records.
- Compare EOBs with medical bills: Verify that the amounts match and that you’re only paying what you owe.
- Question any discrepancies: Contact your insurance company or doctor’s office to resolve billing errors.
- Consider digital storage: Scan or photograph EOBs for easy access and backup.
What Happens When EOBs are Destroyed?
While doctor’s offices must adhere to retention periods, eventually, EOBs are typically destroyed.
- Secure Shredding: Paper documents are shredded to protect patient privacy.
- Secure Deletion: Electronic records are securely deleted to prevent unauthorized access.
- Consider Alternatives: If you need records after they’ve been destroyed, request them from your insurance company, as they typically keep records for longer periods.
How does HIPAA affect how long doctor’s offices keep EOBs?
While HIPAA doesn’t explicitly state how long doctor’s offices keep EOBs, its requirements for patient access to their medical records and the need to maintain the security and integrity of protected health information (PHI) implicitly necessitate retention for a significant period.
What is the typical retention period for EOBs in my state?
Retention periods vary by state. Contact your state’s medical board or health department to determine the specific requirements in your area. You can often find this information on their website.
Can I request copies of EOBs from my doctor’s office even after I’ve moved or changed insurance?
Yes, you generally have the right to request copies of your medical records, including documentation used to create those records such as EOBs, from your former doctor’s office, subject to their retention policy and applicable state laws.
What should I do if I notice a discrepancy between my EOB and my medical bill?
Contact both your insurance company and your doctor’s office to investigate the discrepancy. Keep detailed notes of your conversations and provide them with copies of the EOB and medical bill.
Is it safe to store my EOBs digitally?
Storing EOBs digitally can be safe if you take appropriate security measures. Use strong passwords, enable two-factor authentication, and store your files in a secure cloud storage service or encrypt them on your computer.
What happens to my EOBs if my doctor retires or closes their practice?
In such cases, another physician or a record storage company often takes over the practice’s records. Contact your former doctor’s office to find out who is responsible for managing the records and how to request access.
Does my insurance company keep records of my EOBs even longer than my doctor’s office?
Yes, insurance companies typically retain EOBs for a longer period than doctor’s offices. Contact your insurance provider directly for information on their record retention policy.
Can I access my EOBs online through my insurance company’s portal?
Most insurance companies offer online portals where you can access and download your EOBs. This is often the easiest way to obtain copies of your EOBs.
Are there any exceptions to the standard EOB retention period?
Yes, exceptions may exist for minors (where records are kept until a certain age plus a set number of years) or in cases involving legal claims or ongoing medical treatment.
What information is considered PHI (Protected Health Information) on an EOB?
PHI includes any information that can identify an individual and relates to their past, present, or future physical or mental health condition, including your name, date of birth, medical record number, and the specific services you received.
Why is it important for patients to understand their EOBs?
Understanding your EOBs empowers you to monitor your healthcare spending, identify potential billing errors or fraud, and make informed decisions about your healthcare.
If I suspect medical billing fraud, what should I do?
Report your concerns to your insurance company, your state’s insurance commissioner, and potentially the Office of Inspector General (OIG). Provide them with any supporting documentation, such as the EOB and medical bill.