Direct answer: Ask what you pay for (impressions, referrals, screens, or enrollments), who calls the patient and how fast, what their screen-fail rate is, and what happens to their fee if they miss the target. Then put the answers in the contract. Most vendor disappointment isn’t fraud, it’s a contract that paid for referrals when the sponsor needed enrollments, working exactly as written.

The ten questions

1. What exactly do I pay for? Impressions, referrals, completed screens, or enrolled patients? Everything downstream follows from this.
2. Who calls the patient back, and how fast? Demand a number, in minutes or hours, with the word median or average attached. Ours is 87 seconds on average from form submission to first call. Interest decays by the hour, and “the site follows up” means nobody does.
3. What do you count as a referral? Anyone who clicked, or someone double-screened against my actual criteria? This single definition explains most gaps between vendor reports and site experience.
4. What’s your screen-fail rate on trials like mine? And what were the top three fail reasons on their last comparable program? Watch whether they can answer with data at all.
5. Who owns the patient between phone screen and site visit? A named person, or a hope? That handoff window is where patients disappear. In our programs a dedicated advocate stays with each patient through the site visit, and 89% of the patients we walk in sign the ICF.
6. What site-level reporting do I get, and how often? Weekly, per site, showing referral-to-screen and screen-to-enrollment conversion. Averages hide dying sites.
7. What happens to your fee if you miss the target? The honest answers are “nothing” or “we don’t get paid.” Anything longer than a sentence is the first answer wearing a costume.
8. Can I talk to a sponsor whose trial was behind when you arrived? References from easy trials tell you nothing.
9. How do you reduce site burden, specifically? Pre-screened referrals, records retrieval, scheduling help, or are they just forwarding form fills for the coordinator to chase?
10. What happens to patients you contact who don’t qualify? The answer tells you how they’ll treat your patient community, and your therapeutic area is a small world.

The contract terms that keep everyone honest

• Payment milestones tied to enrollments, not referral counts
• Definitions section: what counts as a referral, a screen, an enrollment
• Site-level weekly reporting as a deliverable, not a courtesy
• First-contact time as a service level with a number in it
• An exit clause tied to conversion metrics, not just elapsed time

The one-question version

If you only have time for one: “What happens to your fee if enrollment misses?” Nearly 85% of interventional trials miss enrollment milestones, and RFPs overpromise timelines by 47% on average. A vendor who shares the downside has done the math on your trial. A vendor who doesn’t has done the math on your budget.

Frequently asked questions