How long you should keep medical bills and records depends on the type of record, applicable federal and state requirements, insurance rules, and whether the records relate to an active legal, tax, or billing matter. For patients, keeping medical bills and related documentation for several years can make it easier to resolve insurance disputes, verify payments, and document healthcare expenses. For medical practices, record-retention requirements can be considerably more specific and may vary by state, payer contract, record type, and professional licensing rules.
As a practical approach, patients should avoid immediately discarding medical bills, Explanation of Benefits (EOBs), receipts, and payment records after a claim is paid. Practices should maintain clinical and billing documentation according to the applicable retention requirements and their compliance policies.
For healthcare organizations that need help maintaining accurate billing documentation, claims, and revenue cycle records, The Medicator’s medical billing services provide support across billing, coding, claims processing, denial management, and accounts receivable.
How Long Should Patients Keep Medical Bills?
For routine medical bills, insurance statements, and payment receipts, keeping records for at least several years is a reasonable recordkeeping practice, particularly when the expenses may be relevant to taxes, insurance disputes, reimbursement questions, or legal matters.
Important documents to retain may include:
- Medical bills and itemized statements
- Explanation of Benefits (EOB) statements
- Insurance claim confirmations
- Payment receipts and canceled-payment records
- Outstanding balance notices
- Medical payment plans
- Receipts for healthcare-related purchases
- Correspondence with healthcare providers or insurance companies
If a bill is disputed, under appeal, involved in a payment plan, or connected to a legal matter, keep the documentation until the issue has been completely resolved.
How Long Should Medical Practices Keep Patient Records?
Medical practices need to follow applicable state and federal laws, professional licensing requirements, payer contracts, and organizational policies when determining how long to retain patient records.
The retention period can differ depending on:
- State medical-record retention laws
- Patient age
- Type of medical record
- Specialty
- Payer requirements
- Medicare or Medicaid participation
- Malpractice and litigation considerations
- Whether the record is part of an ongoing treatment relationship
- Federal or state regulatory requirements
Because requirements vary, practices should not rely on a single nationwide retention period for every type of medical record.
Are Medical Bills and Medical Records the Same Thing?
No. A medical bill primarily documents the financial side of healthcare services, while a medical record contains clinical information about the patient’s care.
A medical record can include:
- Patient history
- Examination findings
- Diagnoses
- Treatment plans
- Procedure documentation
- Medication information
- Laboratory and imaging results
- Physician and nursing notes
- Referral documentation
Billing records may include:
- CPT and HCPCS codes
- ICD-10-CM diagnosis codes
- Claim forms
- Payer responses
- EOBs
- Payment postings
- Adjustments
- Denial records
- Patient statements
- Correspondence concerning claims
These records can overlap, but they serve different purposes and may have different retention requirements.
Why Should Medical Practices Keep Billing Records?
Keeping complete billing documentation helps practices demonstrate that submitted claims were supported by appropriate documentation and medical necessity.
Properly maintained billing records can help with:
Claim Disputes
When an insurer questions a claim, historical documentation can help the billing team determine what was submitted and why.
Denial Appeals
A practice may need the original claim information, clinical documentation, payer correspondence, and payment history when appealing a denied claim.
Payment Reconciliation
Billing records allow staff to compare submitted charges against payer payments, contractual adjustments, patient responsibility, and outstanding balances.
Compliance Audits
Accurate records can help a practice respond to payer, governmental, or internal audits.
Accounts Receivable Follow-Up
Older unpaid balances require historical claim and payment information so billing teams can determine what happened and what action should be taken next.
What Medical Billing Records Should a Practice Retain?
A comprehensive billing recordkeeping system should generally account for more than just the original patient invoice.
Depending on the practice and applicable requirements, records may include:
- Patient registration and insurance information
- Eligibility verification documentation
- Authorizations and referrals
- Charge tickets or encounter records
- CPT, HCPCS, and ICD-10 coding information
- Submitted claims
- Clearinghouse reports
- Claim acknowledgments
- Payer remittance advice
- EOBs and ERAs
- Payment posting records
- Denial and rejection documentation
- Corrected claims
- Appeal correspondence
- Patient statements
- Refund documentation
- Accounts receivable activity
- Write-off and adjustment records
Maintaining this information in an organized system makes it easier to reconstruct the history of a claim when questions arise months or years later.
What Should You Do With Records You No Longer Need?
Medical records contain sensitive health and financial information, so they should not simply be thrown into ordinary trash or discarded without appropriate safeguards.
Practices should use secure disposal procedures consistent with applicable privacy and record-retention requirements. Electronic records should also be handled through appropriate secure deletion or destruction procedures when their retention period has expired.
Before destroying records, practices should verify that they are not subject to:
- An active audit
- An unresolved claim
- An appeal
- Litigation
- A payment dispute
- A legal hold
- A regulatory investigation
- An ongoing treatment relationship
How Long Should You Keep Medical Records for Minors?
Records involving minors can require special consideration because applicable retention requirements may account for the patient’s age and the period after the patient reaches adulthood.
Therefore, a practice should check the specific requirements of the state where it operates rather than applying the same retention period used for adult records.
This is particularly important for pediatric practices because prematurely destroying records can create problems when former patients request documentation after reaching adulthood.
What Happens If a Practice Cannot Find an Old Medical Bill or Record?
Missing historical billing documentation can make it difficult to determine whether a claim was correctly submitted, paid, denied, appealed, or written off.
For example, if a payer disputes an old claim and the practice cannot locate the original submission or supporting documentation, the billing team may have difficulty proving what occurred.
A structured A/R aging report can help practices identify outstanding accounts and determine which older balances require follow-up before they become difficult to recover.
How Can Medical Practices Improve Medical Record and Billing Record Management?
Practices can reduce recordkeeping problems by establishing a formal retention policy and assigning responsibility for maintaining records.
A practical process includes:
- Identify record categories: Separate clinical records, billing records, payer correspondence, financial records, and administrative documentation.
- Determine applicable retention requirements: Review federal rules, state laws, payer contracts, and specialty-specific requirements.
- Create a documented retention schedule: Establish how long each category must be retained.
- Secure electronic records: Use appropriate access controls, backups, and security procedures.
- Track outstanding claims: Avoid destroying records connected to unresolved financial matters.
- Document destruction: Maintain an appropriate record of what was destroyed, when, and under what policy.
- Review the policy regularly: Update retention procedures when laws, payer requirements, or organizational policies change.
How The Medicator’s Helps Practices Manage Their Billing
Record retention is only one part of an effective revenue cycle. Practices also need accurate coding, clean claims, payment posting, denial follow-up, and A/R management to ensure their billing information remains complete and actionable.
The Medicator’s medical billing services help healthcare practices manage billing and coding, claims processing, denial management, accounts receivable, and other revenue cycle functions.
If you’re unsure where revenue is being lost or whether your billing workflow needs improvement, you can request a free practice analysis to identify potential revenue cycle gaps. Practices can also reach the team through The Medicator’s contact page to discuss their billing requirements.
Protect Your Practice With Proper Record Retention
There is no single retention period that applies to every medical bill and medical record nationwide. Patients should keep important billing and insurance documentation for several years and retain disputed or legally relevant records until the matter is fully resolved. Medical practices should follow the specific retention requirements applicable to their location, specialty, payer contracts, and record types.
For practices, maintaining complete billing documentation also supports cleaner claims, more effective denial appeals, accurate A/R follow-up, and stronger compliance. If your practice needs help managing these processes, explore The Medicator’s medical billing services or request a free practice analysis.
