Before You Sign a Radiology AI Contract: A 10-Point Checklist

More radiologists are being asked to sign for software themselves: locums setting up their own tools, small groups without a procurement office, teleradiology contractors, and department leads consulted on an AI add-on to the dictation platform. The contracts are written by vendors who sell to hospitals, and they carry the hospital-scale terms by default. This is a plain checklist of what to read before you sign, and what the answer should look like for a tool you use case by case.

1. The term and the renewal

Find the initial term, then find the renewal clause, because the second one matters more. Many agreements renew automatically for the same length as the initial term unless you give written notice inside a window, often 60 or 90 days before the end date. Miss the window and you have signed for another three years without noticing.

• Ask: What is the initial term? Does it auto-renew, for how long, and what notice is required to stop it?
• Reasonable for a use-when-needed tool: month to month, cancellable from inside the product, with no notice period.

2. The exit

Price the exit before the entry. Early termination fees, the remaining balance of the term becoming due, and "convenience" termination that is allowed on paper but costs the full contract value are all common. Also check what happens to your data: can you export your reports, in what format, and for how long after termination?

• Ask: If I stop after three months, what do I owe? Can I export my data, and will it be deleted on request?
• Reasonable: nothing owed beyond the current month, export available, and deletion on request under the privacy policy.

3. Seats and minimums

Enterprise licensing is per seat with a minimum, and the minimum is frequently the whole department. That means the tool is paid for on behalf of colleagues who will never open it. For an individual it usually means you cannot buy one seat at all.

• Ask: Can a single radiologist subscribe? Is there a minimum number of seats or a minimum annual spend?
• Reasonable: one seat, one card, no minimum.

4. Pausing

Case mix varies. A month of routine outpatient work does not need a reporting assistant; a rotation on the trauma list does. Enterprise contracts have no concept of pausing, because infrastructure cannot pause. A capability tool can.

• Ask: Can I pause billing in a slow month and resume later without re-onboarding?
• Reasonable: yes, from inside the app, with your settings and history intact.

5. Usage caps and overage

Read what happens at the limit. Some plans stop working, some charge overage per report, and some quietly move you to a higher tier. A cap is fine; a surprise is not.

• Ask: Is there a monthly, daily, or hourly cap? What happens when I hit it? Is there any charge I did not opt into?
• Reasonable: a published cap, a visible usage meter, and no automatic charges.

6. The trial

A demo on the vendor's sample cases is marketing. A trial on your own de-identified cases is evidence. Check whether a card is required, how long the trial runs, and whether it converts to a paid plan automatically at the end. If it does, put the end date in your calendar the day you start.

• Ask: Can I try it on my own cases before paying? Does the trial convert automatically?
• Reasonable: a free tier that needs no card at all, so the trial never ends unless you want more. The evaluation guide describes a thirty-minute test on three of your own hardest cases.

7. Integration obligations

An integrated tool may require you to stay on a particular version of the dictation platform, buy a connector, or schedule IT work before it does anything. Each of those is a dependency on someone else's timeline, and each one becomes another reason you cannot leave.

• Ask: What has to be installed, configured, or upgraded before I can use this? Who does that work, and who pays for it?
• Reasonable: nothing to install. Text in, text out, beside whatever PACS and dictation system you already have. The best-of-breed stack article explains why that is a feature rather than a limitation.

8. Data, PHI, and the BAA

This section is the one that cannot be skipped, whatever the term. Read the data processing terms as carefully as the price. Where is data processed and stored? Which AI providers sit downstream, and are they under a BAA? Is PHI removed before text reaches a model? Is your data used for training, and is the exclusion the default or an opt-out you must find? Are there audit logs you can see?

• Ask: Will you sign a BAA, and on which plan? Is PHI detected and redacted before processing? Is my data excluded from training?
• Reasonable: automatic PHI detection and redaction before any model call, a BAA available, training exclusion by default, MFA, and access logging. The HIPAA article goes through each of these. And remember that a BAA with a vendor does not override your hospital's own policy on which services may receive patient information.

9. Price changes

Look for the clause that lets the vendor raise the price at renewal, and by how much. An annual uplift tied to an index is common in enterprise contracts. For a month-to-month tool the question is simpler: you see the price each month, and if it changes you can leave.

10. What happens if the vendor stalls

Small vendors fail and large vendors deprioritize products. Under a long contract, either one leaves you paying for a tool that is not improving. Under a monthly arrangement, the vendor has to earn each month, and if they stop, so do you. The exit clause is your protection against both outcomes, which is another reason to read it first.

How RadPro AI answers the checklist

RadPro AI was built to be the opposite of these contracts. The tool is tailor-made for radiologists, built around the radiology report rather than adapted from a general writing assistant, and the terms are written so that every item above has the short answer.

FAQ

I do not sign contracts; my department does. Why does this matter to me?

Because you are increasingly asked for an opinion on the AI add-ons, and because the tools that do not require a departmental contract are the only ones you can adopt on your own. Knowing which questions to ask makes both conversations shorter.

Is month to month really cheaper over a year?

Not always per month, and that is fine. A monthly plan costs more per month than an annual one; in exchange you pay for the months you use and none of the months you do not. For a radiologist whose complex cases come in runs, that usually works out ahead, and the annual option is there when it does not.

What should I do if a contract has no exit clause at all?

Ask for one in writing before signing. If the vendor will not add one for a tool that only needs text in and text out, that tells you what you need to know about how they expect the relationship to go.