What is a medical billing services agreement?
A medical billing services agreement is the contract between a healthcare practice and the company it outsources billing to. The billing company prepares and submits claims, posts payments, chases denials and reports on the practice's receivables; the practice stays responsible for the care it provides, its clinical documentation and its decisions about refunds and write-offs. Because the billing company handles patient health information, privacy and records are as important as the fee.
This template covers the billing services, who assigns procedure and diagnosis codes, whether patient statements and credentialing are included, a claim submission deadline, the practice's responsibilities, compliance (only documented services billed, no code changes without approval, no payments for referrals), patient information and privacy — with a separate business associate or data processing agreement where the law requires one — monthly reporting and payments going straight to the practice, fees, ownership and return of records, errors and insurance, and a handover period when the agreement ends.
- Best for
- Physician, dental, therapy and specialist practices outsourcing billing
- Signed by
- The practice and the billing company, each with a job title
- Fees
- % of net collections, per claim, or a fixed monthly fee
- Length
- 3 pages, initialled on every page
When to Use a medical billing services agreement
- A private practice outsourcing billing for the first time
- Switching from one billing company to another
- A billing company onboarding a new practice client
- A growing group practice formalising an informal arrangement
What You Fill In
18 blanks, then the name and email of each person who signs: practice, billing company.
1 The parties
- Start date*
- Billing company's legal name*
- Billing company's address
- Practice's legal name*
- Practice's address
- Specialty and providers
2 Services
- Who assigns procedure and diagnosis codes* the Practice's providers, with the Billing Company reviewing for errors · the Billing Company's certified coders, from the Practice's documentation
- Patient statements and calls* included · not included
- Payer enrolment and credentialing* not included · included · available for the extra fee shown under other fees in section 6
- Claims submitted within (business days of receiving complete documentation)*
3 Fees
- Currency*
- How the Billing Company is paid* a percentage of net collections · a fee per claim submitted · a fixed monthly fee
- The percentage or amount*
- Other fees
- Invoices paid within (days)*
4 Other terms
- Billing company's errors and omissions insurance
- Notice to end (days)*
- Governing law*
5 Who signs
- Practice signature and date, job title, initials on every page · An owner or authorised manager of the healthcare practice.
- Billing company signature and date, job title, initials on every page · An authorised person at the billing company.
What the medical billing services agreement Covers
- Services
- The Practice's responsibilities
- Compliance
- Patient information and privacy
- Reporting and access
- Fees
- Records
- Errors, liability and insurance
- Term and ending
- General
Using the medical billing services agreement, step by step
1 Enter both parties
Add the billing company and the practice, and optionally the practice's specialty and providers so the scope is clear.
2 Define the services
Choose who assigns codes — the practice's providers with the billing company reviewing, or the billing company's certified coders from the practice's documentation. Say whether patient statements and credentialing are included, and how quickly claims go out.
3 Set the fees
Choose a percentage of net collections, a per-claim fee or a monthly fee and enter the figure. List any setup, credentialing or statement fees separately.
4 Insurance and notice
Set the billing company's minimum errors and omissions insurance and the notice period to end the agreement. The template also requires cyber cover appropriate to the patient data.
5 Sign the privacy agreement too
Where health privacy law requires it — such as a HIPAA business associate agreement in the US — sign that agreement before any patient information is shared. You can send it through VergeHR eSignature as well.
Tips Before You Send It
- Some payers and places restrict billing fees based on a percentage of collections. Check before choosing that option.
- Keep payments flowing directly into the practice's own bank account — the template doesn't let the billing company hold practice funds.
- Give the billing company individual logins to your systems, never shared ones, so access can be tracked and removed.
- Agree the handover in advance. The template requires records to be returned or transferred in a usable electronic format when the agreement ends.
Sign It Online In Minutes
- Fill in the blanks. Names, dates and amounts go straight into the agreement — the preview shows exactly where.
- Name who signs. Tick “This is me” for your own part. VergeHR builds the PDF with every signature, date and initials box on the right line, and you can check or move anything before sending.
- Send it. Each signer gets a secure link and signs from any device — no account needed. The signed PDF, with an audit trail and a Certificate of Completion, is filed in Files and emailed to everyone.
Medical billing services agreement: frequently asked questions
Does this replace a HIPAA business associate agreement?
No. The template includes confidentiality and security commitments, but where health privacy law requires a specific agreement — such as a business associate agreement under HIPAA in the US, or a data processing agreement elsewhere — the parties must sign one as well. The template says so and gives that agreement priority on patient data.
Who is responsible for coding errors?
It depends on who assigns codes, which you choose. The billing company fixes its own errors at its own cost and is responsible for payments lost through its missed deadlines or billing errors, but not for denials caused by the practice's documentation or coding decisions.
Can this agreement be signed electronically?
In most countries, including the US (ESIGN Act and UETA), the UK, the EU (eIDAS) and Canada, an electronic signature is generally valid for an ordinary commercial contract like this one. VergeHR keeps an audit trail and a Certificate of Completion with the signed PDF as evidence of who signed and when.
Is this template free?
Yes. The template is free to use with the eSignature app in VergeHR, and the people you send it to don't need a VergeHR login to sign.