A BAA is the contract that creates the HIPAA obligation between a covered entity (a clinic, hospital, or insurer) and a business associate (the vendor that handles PHI on their behalf). It specifies what PHI the vendor can touch, what they must do to protect it, how breaches get notified, and what happens at termination.
Without a signed BAA, no HIPAA coverage exists, even if the vendor has every technical control. The covered entity is in violation the moment they share PHI with the unsigned vendor, regardless of how well the vendor handles the data afterward.
For a clinic buyer, the BAA is the first artifact to ask for, before the demo, before the pricing conversation. A vendor that hesitates, asks for higher tier pricing, or refuses entirely is telling you they are not actually positioned to handle clinical workloads. A serious vendor sends the BAA in the first meeting.
Vorel sends a signed BAA with every clinical master agreement. The BAA is not gated by plan tier, account size, or sales pipeline stage.