What should a teleradiology contract include?
The short answer
Twelve terms: coverage hours, report type (final or preliminary), turnaround by priority with a defined clock, critical-result calls, backup reader, credentialing responsibilities, integration, a HIPAA Business Associate Agreement, pricing and minimums, monthly reporting, term and notice, and the exit and transition plan.
| Term | What good language says |
|---|---|
| 1. Coverage hours | Exact start and end times, by day, including holidays and how changes are made |
| 2. Report type | Signed final reports, or preliminary reports and who finalizes them |
| 3. Turnaround | Targets by priority (stroke, STAT, routine), the clock used, and the remedy when missed |
| 4. Critical results | Call time, who is called, read-back, and how each call is documented |
| 5. Backup reader | A named backup credentialed at your hospital, and when they take over |
| 6. Credentialing | Who builds files, the target time to approval, and renewals |
| 7. Integration | HL7 orders, image routing, report delivery, priors, and who pays for interfaces |
| 8. BAA | A HIPAA Business Associate Agreement with the required provisions |
| 9. Pricing | Per study or per wRVU, any minimum, setup fee, and whether surcharges apply |
| 10. Reporting | A monthly scorecard: turnaround by priority and hour, every critical call |
| 11. Term and notice | Initial term, renewal, and notice period |
| 12. Exit | Transition support, parallel reads, report and data handling at termination |
How do you evaluate a provider’s turnaround promise?
Turnaround is the term most often written loosely. “30-minute STAT” means little until you know when the clock starts and what is excluded. Pin down five things:
- The clock. Images complete on the reader’s worklist to signed final is the fairest measure of the reader. Order-to-report measures your whole process. Stroke uses ED arrival to interpretation (CMS OP-23: 45 minutes).
- By priority. Separate targets for stroke, STAT or ED, and routine studies.
- By hour. Report overnight, evening and weekend turnaround separately from daytime; blended numbers hide nights.
- Medians and the share inside target. Not averages alone, which outliers distort in both directions.
- Exclusions and remedy. Which delays don’t count (incomplete images, missing history), and what happens to a read outside the target.
Then ask for a sample month of reporting before you sign. Our turnaround benchmarks guide explains each clock.
What must the Business Associate Agreement cover?
A teleradiology group handles protected health information, so HIPAA requires a business associate contract. Under 45 CFR 164.504(e), it must:
- Set out the permitted and required uses and disclosures of PHI
- Require appropriate safeguards against improper use or disclosure
- Require reporting of any use or disclosure not allowed by the contract, including breaches of unsecured PHI
- Require subcontractors that handle PHI to agree to the same restrictions
- Make PHI available for access, amendment and accounting of disclosures
- Return or destroy PHI at termination where feasible, or extend protections to what can’t be returned
- Allow the hospital to terminate for a material violation
What does CMS require in a telemedicine credentialing agreement?
If your hospital relies on the teleradiology group’s credentialing (credentialing by proxy), the agreement itself must meet CMS rules: a written agreement; for a telemedicine entity, credentialing standards that meet the hospital conditions of participation; a current list of each radiologist’s privileges; and a license issued or recognized by your state. Your hospital reviews each remote radiologist’s performance and sends back, at minimum, all adverse events and complaints (42 CFR 482.22(a)(3)–(4); for critical access hospitals, 485.616(c)).
Write the mechanics into the contract: who sends the privilege list, how often it is updated, and how adverse events flow both ways. More in our teleradiology credentialing guide.
What should happen at the end of the contract?
Most switching pain comes from an exit clause nobody read. Agree in advance: the notice period, whether the outgoing group keeps reading until the new group is credentialed, how in-flight studies at cutover are handled, and how reports and images already delivered stay in your system. Our guide to switching providers without a gap walks through a cutover step by step.
How the TeleRads agreement reads
| Term | TeleRads |
|---|---|
| Report type | Signed finals only, never preliminaries |
| Critical results | A phone call to your ED within 15 minutes, with read-back |
| Backup | A named backup, already credentialed at your hospital, every night |
| Credentialing | Done for you through an NCQA-certified CVO, built to Joint Commission standards; your medical staff office approves |
| Integration | HL7 orders, secure image routing to our PACS, signed reports back into your system; nothing to install |
| BAA | A HIPAA Business Associate Agreement with every hospital |
| Pricing | One monthly price, per study or per wRVU; no STAT, after-hours or weekend surcharges; monthly minimum and one-time setup fee quoted in your plan |
| Reporting | A monthly scorecard: turnaround and every critical call |
| Term | One year, then 90 days’ notice |
Your exact price and go-live date come in your free coverage plan.
Questions
What should be in a teleradiology contract?
Coverage hours, final or preliminary reports, turnaround targets by priority with a defined clock, critical-result calls, a backup reader, credentialing responsibilities, integration, a HIPAA Business Associate Agreement, pricing and minimums, monthly reporting, term and notice, and an exit and transition plan.
How should teleradiology turnaround be defined in a contract?
By priority (stroke, STAT, routine), with a stated clock, ideally images complete on the reader’s worklist to signed final, reported as medians and the share inside target, split by hour, with exclusions and a remedy for misses.
Does a teleradiology company need a BAA?
Yes. A teleradiology group handles protected health information as a business associate, so HIPAA requires a business associate contract with the provisions in 45 CFR 164.504(e).
What is credentialing by proxy in a teleradiology contract?
An arrangement, allowed by CMS under a written agreement, in which your hospital relies on the teleradiology group’s or a distant hospital’s credentialing and privileging decisions. Your hospital still reviews each remote reader’s performance and shares adverse events and complaints.
How long are teleradiology contracts?
Terms vary by provider. TeleRads agreements run one year, then 90 days’ notice.
What should happen when a teleradiology contract ends?
The agreement should cover the notice period, reading until the next group is credentialed, in-flight studies at cutover, and how delivered reports and images stay in your system.