What to decide first
- Which services and exclusions the contract names
- How fees, minimums, add-ons, and scope changes work
- How cancellation, renewal, and transition support are handled
- What happens to reports, access, and unresolved claims at exit
Match The Contract To The Service Scope
The contract should describe the work the vendor will actually perform. Compare the written scope against the sales conversation before signing.
Look for billing, coding, denials, payment posting, patient billing, credentialing, reporting, old AR, implementation, data migration, software access, and training. If a service was discussed but does not appear in writing, ask for clarification before treating it as included.
Questions to ask vendors
- Which services are included in the base agreement?
- Which services are excluded or billed separately?
- Does the contract name implementation, data migration, software access, and training?
- Are vendor-owned and practice-owned responsibilities both documented?
Review Fees And Change Triggers
Pricing terms should explain the current model and what changes the cost later. Setup fees, monthly minimums, percentage fees, per-claim fees, and add-ons should be easy to identify.
Ask how volume, providers, locations, payer mix, service scope, denial projects, old AR cleanup, credentialing, coding review, and patient statements can affect the fee.
Questions to ask vendors
- Are there setup fees, monthly minimums, or recurring add-ons?
- How do fees change when provider count, locations, volume, or payer mix changes?
- Which projects are separate from ongoing billing?
- Is notice required before changing scope?
Clarify Cancellation And Renewal
Cancellation terms matter before the relationship starts. The practice should know notice periods, renewal timing, termination fees, and transition obligations.
Automatic renewal, early termination fees, transition limits, and open-claim responsibility should be clear enough for an owner or administrator to explain back before signing.
Questions to ask vendors
- How much notice is required to cancel, reduce scope, or decline renewal?
- Does the agreement renew automatically?
- Are there early termination fees or transition limits?
- Who remains responsible for open claims after notice is given?
Plan The Data Handoff
The practice needs access to its billing history, reports, and open-work status if the relationship ends. Ask how that handoff works before signing.
Useful handoff materials may include reports, files, claim notes, AR worklists, denial logs, payment posting records, payer follow-up history, appeal status, and patient balance information.
Questions to ask vendors
- Which records are returned at termination?
- What export format and timing should the practice expect?
- Does the vendor support a handoff call or transition report?
- Who owns unresolved payer follow-up, appeals, and patient balances during transition?
Define Wind-Down, Open Work, And Offboarding
Termination does not automatically finish open claims, denials, patient balances, or payer follow-up. Ask how the vendor handles active work during the notice period and after the effective termination date.
System access should also be created, managed, and removed deliberately. The practice should know who approves, reviews, and removes access for EHR, practice-management, clearinghouse, portal, inbox, and reporting tools.
Questions to ask vendors
- Does the vendor continue working open claims, AR, denials, appeals, and payment posting during a wind-down period?
- Which work stops immediately and which work continues through a transition window?
- How are final invoices, outstanding balances, and transition support handled?
- How quickly is access removed after termination?