What are the records provider has to manintain?

Record Keeping Requirement

Medicaid requires that the provider retain all medical, fiscal, professional, and business records on all services provided to a Medicaid recipient.

Records can be kept on paper, magnetic material, film, or other media including electronic storage, except as otherwise required by law or Medicaid requirements. In order to qualify as a basis for reimbursement, the
records must be signed and dated at the time of service, or otherwise attested to as appropriate to the media. Rubber signatures must be initialed.

The records must be accessible, legible and comprehensible.

Types of Records That Must be Retained

Medicaid requires that the following types of records, as appropriate for the type of service provided, must be retained (the list is not all inclusive):
• Medicaid claim forms and any documents that are attached;
• Professional records, such as appointment books, patient treatment plans,
and physician referrals;
Medical, dental, optometric, hearing, and other patient records;
• Copies of sterilization and hysterectomy consents;
• Prior and post authorization, and service authorization information;
• Prescription records;
• Orders for laboratory tests and test results;
• X-ray, MRI, and CAT scan records;
• Business records, such as accounting ledgers, financial statements,
invoices, inventory records, check registers, cancelled checks, sales
records, etc.;
• Tax records, including purchase documentation;
• Drug utilization reports by drug NDC:
• Partnership records;
• Patient counseling documentation;
• Provider enrollment documentation;
• Purchase documentation; and
• Utilization review and continued stay approvals for psychiatric or substance abuse inpatient stays.

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