Medical Billing Contract
1. Introduction
This Medical Billing Contract (the "Contract") is entered into this [DATE], (the “Effective Date”), by and between [Your Company Name] ("Billing Company"), a company, having its principal place of business at [Your Company Address], and [Healthcare Company] ("Healthcare Provider"), a company with its principal place of business at [ Healthcare Company Address].
2. Purpose
The primary objective of this particular contractual Contract is to clearly define and stipulate the terms and conditions, the preconditions, rules, and requirements under which the company that is designated and chosen to handle the medical billing matters, referred to as the Billing Company, is mandated and committed to deliver and offer its specialized medical billing services to the entity requiring these services, in this context referred to as the Provider.
3. Term
This Contract is set to begin its term on the 4th day of April in the year 2050. Following its commencement, it is expected to stay operative and enforceable for a total duration of two years. Please note that the duration may, however, be cut short before the aforementioned termination date if the contract is dissolved in alignment with any applicable termination clauses and provisions that have been stated and agreed upon within this contract.
4. Services
The Billing Company shall provide the following services to the Provider:
4.1 Billing Services:
The process involves preparing and submitting medical claims to either insurance carriers or directly to the patients.
4.2 Revenue Cycle Management:
The process of overseeing and regulating the revenue cycle is imperative. This involves following up on claims thoroughly and ensuring a comprehensive resolution of any inquiries related to billing.
4.3 Coding:
The process of assigning suitable medical codes to diagnoses and various medical procedures is done for the purpose of streamlining billing procedures.
4.4 Credentialing:
Responsibility involves assisting with the enrollment and credentialing processes of providers with various insurance carriers. This involves facilitating the provider's communication with the carriers, ensuring that all documentation is correctly filled out and submitted promptly, and performing periodic follow-ups to ensure that the credentialing process is moving forward as expected.
4.5 Reporting:
The provision of reports regularly concerning activities related to billing, the collections that have been undertaken, and the performance of the financial aspect is a key component of our role.
4.6 Compliance:
The process of making certain that there's adherence to all the pertinent healthcare regulations, which encompass the Health Insurance Portability and Accountability Act (HIPAA) along with guidelines related to billing, is crucial.
5. Responsibilities of the Provider
5.1 The Provider Obligations
Provide accurate and timely documentation of patient encounters for billing purposes.
Maintain compliance with all applicable healthcare regulations.
Notify the Billing Company of any changes in practice, services, or billing procedures.
6. Responsibilities of the Billing Company
6.1 The Billing Company Obligations
Process and submit medical claims promptly and accurately.
Pursue timely reimbursement of claims from insurance carriers and patients.
Provide support and assistance to the Provider in addressing billing inquiries and denials.
Maintain confidentiality of patient information by HIPAA regulations.
Keep the Provider informed of any significant changes in billing regulations or practices.
7. Fees and Payment
The Provider shall pay the Billing Company for services rendered based on the following fee structure:
7.1 Percentage of Collections:
The Billing Company shall receive 5% of the total collections on claims processed.
7.2 Flat Fee:
Alternatively, the Provider may choose to pay a flat monthly fee of $2,000.
Payment shall be made every month, within 30 days of receipt of an invoice from the Billing Company.
8. Termination
Either party may terminate this Contract upon 30 days written notice to the other party for any reason or for cause, including but not limited to a breach of contract or failure to perform obligations.
9. Confidentiality
Both parties shall maintain the confidentiality of patient information and any proprietary or sensitive information disclosed during this Contract.
10. Governing Law
This Contract shall be governed by and construed by the laws of the State of California.
11. Entire Agreement
This Contract constitutes the entire understanding between the parties concerning the subject matter herein and supersedes all prior contracts and understandings, whether written or oral.
12. Amendment
Any amendment to this Contract must be made in writing and signed by both parties.
13. Severability
If any provision of this Contract is held to be invalid or unenforceable, the remaining provisions shall remain in full force and effect.
IN WITNESS WHEREOF, the parties hereto have executed this Contract as of the date first above written.
[YOUR COMPANY NAME] (Billing Company)
[DATE SIGNED]
[HEALTHCARE COMPANY] (Healthcare Provider)
[DATE SIGNED]
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