Creating Charges and Invoices

Overview

Hint allow practices to configure coverage plans that can determine if/how much should be charged for specific items based on the patient's active memberships and any plan sponsors. When receiving charge data Hint will price, and route the charge in real time to the correct invoice. Hint will then return that information to you as the response to the api call.

Coverage rules can be based on a specific charge item (e.g. Flu Shot) or a charge category (Labs). Charge categories assigned to charges can also be valuable for the practice's financial reporting and employer utilization reporting needs.

If you want to issue and collect invoices, you should monitor the response for invoice information. If a charge was routed to a patient invoice you can issue and collect that invoice. If a charge was routed to an employer sponsor's invoice it will be collected as part of the routine billing for that sponsor.

API Design

Charge Items vs Categories

This setup will differ among practices; some will have a full list of charge items defined in Hint, other will have none. You will need to work with the practices to decide if you want to associate charges with charge items directly, or only by a category.

If you choose to use charge items directly, you can match those items by a unique code, or by using the id assigned by Hint to the charge item.

In your sandbox you can view charge items and categories in the Admin > Charges & Taxes section. You can Search for or List Charge Items via the api as well.

If you choose to use categories, you can reference them by using type options listed in the api reference for creating a charge.

  • memberships
  • labs
  • medication
  • vitamins_and_supplements
  • vaccines
  • imaging
  • supplies_and_dme
  • retail_items
  • office_visits
  • procedures
  • fees

Creating a Charge

Use the create charge endpoint to send charge information to us.

We will attempt to match an existing charge item by code if it is provided. We will apply coverage plan rules based on the charge item and category type specified in the post data. Here is an example of charge being posted without a Hint charge_item id. In this example we will try to find and match any existing charge items by the code 99381.

{  
    "charge_item": {  
        "name": "Initial Primary Care Visit",  
        "code": "99381",  
        "code_type": "CPT"  
    },  
    "price_in_cents": 3000,  
    "quantity": 1,  
    "category": {  
        "type": "office_visits"  
    },  
    "patient": {  
        "id": "pat-234lk3j24"  
    }  
}

Issuing Invoices and Collecting Payment

This step may differ between practices. You may want to let practices handle the issuing and collecting step, many have their office staff do this at patient check-out for example.

  1. Once all charges are added: Issue the patient’s customer invoice (the invoice id was returned in the charge create call)
  2. Once issued you can create a payment