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How long should we keep our credentialing records?

Medical Staff Legal Advisor, August 1, 2005

Q: What are the legal requirements relating to record retention for physician credentialing records? If there are no specific legal requirements, is there an industry standard used by most hospital medical staff offices?

A: There are no general legal requirements specific to maintaining credentialing records, although some states may have laws on the subject. However, depending on what documents are included in the files, certain rules may apply. For example, EMTALA on-call records have to be kept for five years.

Different hospitals have different overall requirements, and often different requirements for separate parts of the credentialing file. We recommend establishing one retention time period, perhaps related to the date of termination of staff membership. We also recommend establishing a standard destruction of documents policy.