10 Colo. Code Regs. § 2505-10-8.130.2

Current through Register Vol. 47, No. 11, June 10, 2024

Section 10 CCR 2505-10-8.130.2 - MAINTENANCE OF RECORDS

A. Each Provider shall:

1. Maintain legible, complete, and accurate records necessary to establish that conditions of payment for Medical Assistance Program covered goods and services have been met, and to fully disclose the basis for the type, frequency, extent, duration, and delivery of goods and/or services provided to Medical Assistance Program members, including but not limited to:

a. Billings,

b. Prior authorization requests,

c. All medical records, service reports, and orders prescribing treatment plans,

d. Records of goods prescribed, ordered for, or furnished to, members, and unaltered copies of original invoices for such items,

e. Records of all payments received from the Medical Assistance Program, and

f. Records required elsewhere in Section 8.000 et seq.

2. The records shall be created at the time the goods or services are provided.

B. Records of Providers shall include employment records, including but not limited to shift schedules, payroll records, and time-cards of employees.

C. Providers who issue prescriptions shall keep in the patient's record, the date of each prescription and the name, strength, and quantity of the item prescribed.

D. Records must be maintained for seven (7) years unless an additional retention period is required elsewhere in Section 8.000 et seq., or in an individual Provider participation agreement.

E. Each Provider shall retain any other records created in the regular operation of business that relate to the type and extent of goods and/or services provided (for example, superbills). All records must be legible, verifiable, and must comply with generally accepted accounting principles, auditing standards, and all applicable state and federal laws, rules, and regulations.

F. Each entry in a medical record must be signed and dated by the individual providing the medical service or good. Stamped signatures are not acceptable.

G. Providers utilizing electronic record-keeping may apply computerized signatures and dates to a medical record if their record-keeping systems guarantee the following security measures:

1. Restrict application of an electronic signature to the specific individual identified by the signature. System security must prevent one person from signing another person's name.

2. Prevent alterations to authenticated (signed and dated) records. If the Provider chooses to supplement a previous entry, the system must only allow a new entry that explains the supplement. The Provider must not be allowed to change the initial entry.

3. Printed or displayed electronic records must note that signatures and dates have been applied electronically.

H. At the discretion of the Requesting Agency, record verification may include, but will not be limited to, interviews with Providers, employees of Providers, billing services that bill on behalf of Providers, and any member of a corporate structure that includes the Provider as a member.

10 CCR 2505-10-8.130.2

44 CR 23, December 10, 2021, effective 1/10/2022