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Configuring Your Membership Rates and Billing Options
Configuring Your Membership Rates and Billing Options
Tasha Demkiw avatar
Written by Tasha Demkiw
Updated over a week ago

Billing in Arrears

Some providers bill at the end of the billing period, otherwise known as billing in arrears. This can help protect the provider in states without legislation that ensures that Direct Primary Care practices are not treated as insurance products by state regulators. To learn more about why you might want to do this, you can read our Best Practice article on the topic, and also read about state advocacy for DPC here.

To enable this option you simple click the On/Off toggle in this section and we will automatically bill memberships at the end of the monthly billing period instead of the beginning, which is the default option. To protect the provider from rendering services before receiving payment for an entire quarter or year, only a monthly billing period is supported for practices who are billing in arrears. All of the options related to Annual, Semi-Annual and Quarterly will disappear when arrears billing is activated on the membership plan.

Default billing period

Some providers bill monthly and tend to price that way, while others bill on an annual basis. Depending on your preference, you can select an appropriate Default Billing Period. Your default option, will be the first option for member signup. All other billing options will be priced based on this default.

Additional billing periods

Some practices incentivize patients to pay for their memberships on a quarterly, semi-annual, or annual basis by providing a discount on their membership. For example, if you bill monthly, but want to offer a 10% discount for patients who pay their membership annually, you can turn the 'Annual' Additional Billing Period option on, and then define a 10% discount. See the screenshot below. If you leave the Default Discount field blank, no discounts will be applied but you can still allow patients to pay quarterly, semi-annually, or annually.

Minimum Enrollment Period

If you define a minimum enrollment period, we will warn you when canceling a membership, if the membership is ending within the minimum enrollment period. We will also let patients know about the minimum enrollment period if you are using the member signup form for enrolling new patients.

Invoice Detail

You can adjust the invoice charge name for each membership. You can edit the Charge Name and Charge Description.

Membership Registration Fees

You can define registration fees for each individual who joins the practice. You can also define a maximum registration fee for a group or family. These fees can be automatically applied upon member signup or when you activate a membership from Hint. You can override the default registration fees on an individual basis as needed. For registration fee purposes, a family or group is any 2 or more people on the same membership.

Individual Membership Fees

If you have the same fee for all ages, you can simply define a single monthly or annual rate for all age ranges. To support age-based pricing, you can add in age ranges and define the rates for each range.

We will automatically adjust membership pricing if people enter a new age category. Your practice will receive a notification when one or more patients on a membership will be switching to a new age tier on their next invoice. This notification can be found here.

If Family Memberships or Group Pricing are enabled, individual membership fees can change depending on the discount rules defined below the age tiers.

If you have additional billing periods set up with discounts, sometimes the membership fees do not calculate evenly. For example: If the 'annual' billing period is enabled, and the monthly rate for a child is $89/m, and for an adult is $119/m, with a default discount of 10%, the annual rate for a child would come to $961.20 and for an adult would be $1,285.20.

In this situation, you might want to opt to set your annual rate for child to $960, and for adult $1,280. To do this you would simply need to click the 'Edit' button next to each of the annual rates. If you make a mistake and want to reset the manual overrides to the automatically generated rates, you simply need to click the 'Reset'. This logic applies for any pricing option where different billing periods are an option.

Age Restriction

You can set minimum or maximum age restrictions to prevent patients outside of the age ranges you treat from enrolling through online signup. This also provides a warning message to your practice admins if they attempt to enroll a patient who doesn't meet the age requirements.

If a patient enrolls and ages into a restricted age range, they will continue to bill at the age tier listed in the age based pricing section until their membership is terminated. However your practice will be sent a notification letting you know a patient has aged out. That notification can be viewied here.

Family Membership Fees

Our pricing algorithms allow you to define either Family Membership Discounts, or Group Membership Discounts.

Family membership fees can be defined so that rates for couples, two parent families, and single parent families, can automatically be calculated on both our member signup and in Hint. To turn on any family rates, just toggle the on/off buttons next to each family rate option.

If you have aged based pricing, couple and family rates can override these rates. However, our algorithms will always pick the rate that ends up being lowest for the customer. If you have age based pricing that is more than just child and adult, and would prefer your membership rates to factor in these ages when they calculate group discounts, you should consider using our Group Membership Fees option.

For families with children, you can define how many children will be included in the family rate and what age constitutes a child. You can turn this off if there is no limit. You can also define a rate for any children above the limit as well as define how many additional children you will include on the membership. In the example below, a family of 4 would be charged, $303. If a family had more than 2 children, each additional child would be $40.

You can also include a rate for any additional adults you would like to include on the membership. In the above example, a couple with a child over the age of 26 would be charged the $214 monthly couple rate as well as the $107 monthly additional adult rate.

When a child ages out of the child age limit you have set, they will either have the additional adult rate applied to them (if you have set that up) or they will be charged the individual rate for the new age tier they entered into. In the example we have been using above, if one child in the family of 4 turned 27, the child's rate would either go to $107 or to $119. Again this would depend on whether or not you had the additional adult fee set up.

Group Membership Fees

Our pricing algorithms allow you to define either Family Membership Discounts, or Group Membership Discounts.

Group discounts allow you to define a membership range, such as 2 members to 3 members, and either a $ discount, or a % discount. We also allow you to define how our algorithm applies discounts, either in tiers depending on what order members are added, or if the discount is applied to the entire group retroactively.

To switch to Group Membership Fees, click 'Switch to Group Membership Pricing' under where it says 'Family Membership Fees'.

So if your Individual Membership Fees are defined as:

  • 25 & under: $60/m

  • 26+: $80/m

And you have the following members in a group:

  • Sally, 40

  • John, 39

  • Jack, 16

  • Molly, 14

  • Sam, 11

If the 'Apply Discounts in Tiers' option is selected as below

The membership rates will calculate as:

  • Sally, $80 - $0 = $80/m

  • John, $80 - $10 = $70/m

  • Jack, $60 - $10 = $50/m

  • Molly, $60 - $20 = $40/m

  • Sam, $60 - $20 = $40/m

With the same scenario above except with a 10% and 20% discount respectively, the membership rates will be calculated as follows:

  • Sally, $80 - $0 = $80/m

  • John, $80 - $8 = $72/m

  • Jack, $60 - $6 = $54/m

  • Molly, $60 - $12 = $48/m

  • Sam, $60 - $12 = $48/m

If the 'Apply Same Discount to Entire Group' option is selected as below:

The membership rates will calculate as:

  • Sally, $80 - $20 = $60/m

  • John, $80 - $20 = $60/m

  • Jack, $60 - $20 = $40/m

  • Molly, $60 - $20 = $40/m

  • Sam, $60 - $20 = $40/m

With the same scenario above except with a 20% discount, the membership rates will be calculated as follows:

  • Sally, $80 - $16 = $64/m

  • John, $80 - $16 = $64/m

  • Jack, $60 - $12 = $48/m

  • Molly, $60 - $12 = $48/m

  • Sam, $60 - $12 = $48/m

Special Rates

If the rates above do not fully cover your fee schedule, you can define special rates below (e.g., "College Student"). You can then manually apply these on a per-person basis when creating the membership. They will also be displayed on patient invoices in place of the charge's name.

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