Our quantity-based coverage rule allows you to guard against the overutilization of certain services. One example where you commonly see this rule used is with home visits. Perhaps you want to offer home visits as a membership benefit but don't want your patients abusing the system and overutilizing this visit type.

Using this example, you can setup a coverage plan rule that specifies that each patient on a certain plan will receive a set number of home visits per year, resetting on either the calendar year or the patient's annual renewal date. Once their allotted number of visits has been exceeded, HintOS will automatically charge the patient or their employer-sponsors a cash fee-for-services rate for additional home visits.

Invoicing

When invoicing a patient for a home visit or any product or service governed by a limited quantity rule, HintOS will automatically recognize how many home visits the patient has utilized. If the patient is within their free home visit limit, HintOS will automatically zero out the price of the visit. In this case, we can tell the patient is still within their two visit limit for the year as this home visit is being provided at no cost. Once their visit limit is exceeded, HintOS will automatically charge the full home visit cash fee-for-service amount.

Tracking Utilization of Services

The number of home visits the patient has left can be viewed under the patient's membership details, on their "patient" tab. (i.e. below we can see the patient only has one free home visit remaining). And by scrolling over the "?" we can see when this service was utilized.

You can also view when the unit amounts are scheduled to reset so you're kept in the loop on when the patient will have a new allotment of units to utilize:

To learn more about Coverage Plans and how to create a quantity-based rule, click here.

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