Medical Coding and Billing Services Contract

Provider/Practice: [Name] · Billing Company: [Name] · Effective Date: [Date]

1. Services

Billing Company will provide medical coding and billing services for Practice, including: [claim coding, claim submission, denial management, patient statement generation, payment posting].

2. Fee

[Percentage of collections of [%] / flat fee per claim of [Amount] / flat monthly fee of [Amount]], invoiced [Frequency].

3. HIPAA Compliance and Business Associate Agreement

As Billing Company will handle protected health information (PHI) on Practice's behalf, the parties will execute a separate HIPAA Business Associate Agreement, which governs PHI handling and is incorporated by reference.

4. Coding Accuracy

Billing Company warrants it will code claims accurately based on documentation provided by Practice, and will not engage in "upcoding" or other fraudulent billing practices.

5. Practice's Responsibilities

Practice will provide accurate, timely clinical documentation to support coding, and will review claims before submission where required by internal compliance procedures.

6. Denial Management

Billing Company will track claim denials, resubmit corrected claims where appropriate, and provide Practice with [Frequency] reports on denial rates and reasons.

7. Data Security

Billing Company will maintain administrative, technical, and physical safeguards for PHI consistent with HIPAA Security Rule requirements.

8. Term and Termination

This Agreement runs [Term] and either party may terminate with [Notice Period] notice, with a transition plan for outstanding claims.

Provider/Practice: ______________________ Date: ____________ Billing Company: ______________________ Date: ____________

*This document is provided for informational and educational purposes only and does not constitute legal advice. A HIPAA Business Associate Agreement (Section 3) isn't optional paperwork — it's a specific federal legal requirement any time a third party like a billing company handles PHI on a covered entity's behalf, and both parties can face real penalties for operating without one.*