Subject: Request for a written medical billing proposal - [practice name]

Hello,

We are comparing billing companies and would like a written proposal.

ABOUT OUR PRACTICE
- Specialty and setting: [for example, outpatient therapy, primary care, ABA]
- State: [state]
- Clinicians: [number]   Locations: [number]
- Current EHR or billing software: [system]
- Work we want you to do: [full billing / specific tasks]
- Work our staff will keep: [tasks]
- Start date we have in mind: [date]

OUR NUMBERS (monthly averages for the same recent period)
- Collected from insurers: $[amount]
- Collected from patients: $[amount]
- New claims sent: [number]
- Older unpaid insurance balances: $[total], [how old]

PLEASE PUT THESE IN WRITING
1. Your rate, and exactly what it is charged on. Do patient payments, copays collected at our front desk, and payments on older claims count? Is the base actual cash received or an allowed amount that can include unpaid patient responsibility?
2. Any monthly minimum: the amount, when it starts, and exactly which fees count toward it or are added outside it.
3. Every other recurring fee, with its unit and payment schedule: software, per-provider, per-claim, clearinghouse, statements, eligibility checks. Identify any annual prepayment and the rate for each clinician category.
4. Every one-time fee: setup, training, data migration, credentialing per payer and provider. State when fees begin, including before onboarding or credentialing is complete.
5. What is included and what is not: denials, appeals, patient statements, patient phone calls, prior authorizations, credentialing.
6. How you count claims if you charge per claim: first claims, corrected claims, secondary claims, resubmissions.
7. Your terms for our older unpaid balances.
8. What happens to your fee if an insurer takes a payment back.
9. Contract length, renewal, notice to cancel, rate increases, exit fees, and how we get our data when we leave.
10. Where insurance payments are deposited: our bank account or yours, and who controls the account.
11. A sample monthly invoice at the numbers above, and a first-year total.
12. Anything you cannot price yet.

These are totals only. Before we share any patient information, please send your business associate agreement and tell us how to send data securely.

Thank you,
[name]
[title]
[phone or email]