Habit of Care keeps provider-directed work, client completion, clinician review, payer policy, provider readiness, coverage, and claim state connected without treating them as the same evidence.
Readiness setup
Step 01Practice and providerKeep organization gates separate from each provider’s evidence.
Start with the gates that protect client information
Record the practice agreement, Part 2 determination, required access control, and remittance approach before importing client information. Then add each treating provider’s exact credential and dated evidence. A lookup result alone does not establish enrollment or claim readiness.
Connected care
02
Provider and client
Carry provider-directed work between appointments
The provider chooses the focus, activity, instructions, timing, and review cadence. Clients complete the work in Habit of Living. Completion flows back as supporting evidence, but it does not invent practitioner minutes or turn ordinary portal activity into a qualifying device.
Service evidence
Step 03Clinician review and lockRecord only service facts the treating provider can support.
Immutable
Review
Classify
Record time
Lock
03
Treating provider
Separate client activity from the provider’s service record
The clinician reviews relevant results and records diagnosis, consent, monitoring, care-plan, coordination, time, date, and claim-field evidence. The saved route preview reloads this server-stored snapshot; browser-supplied replacements cannot alter it.
Illustrative gross allowed amount
20 payable care monthsExample
$1,186.60gross allowed
20 × $59.33 illustrative 2026 nonfacility average
Observed 2026 carrier-file range: $53.56–$74.37Not a payment promise
The deterministic result lists each blocker and retains the rule, provider evidence, care record, and claim version used. Controlled-beta submission remains disabled until every release gate passes. The example uses 2026 CMS nonfacility carrier-file amounts for G0323; locality, participation, coverage, cost sharing, sequestration, secondary processing, denials, and adjustments can change the outcome.
Does a completed assignment make a care month billable?
No. Client completion can support clinician review, but it does not create practitioner time, establish coverage, or qualify a device. The treating provider must classify and lock the service evidence.
Does an active eligibility response prove a claim is ready?
No. Coverage, provider enrollment, policy rules, service evidence, claim fields, and release gates are reviewed separately.
Which insurance route is executable first?
The first controlled-beta rule is a narrow Original Medicare FFS G0323 route for a clinical psychologist in the published MAC, office, and date scope. Other credentials and routes remain visible but fail closed until a matching rule and provider evidence are reviewed.
When does platform pricing begin?
There is no setup fee and no platform charge until the practice records its first positive payable claim. After that, the monthly fee is the greater of $49 or the usage formula shown on the pricing page. Denied controlled-beta claims do not create an insured usage fee.
Does Habit of Care promise coverage or payment?
No. Route results and projections are decision support. Payer policy, enrollment, client coverage, claim processing, cost sharing, adjustments, and denials can change the actual outcome.
A simpler path from care to evidence
Connect care. Verify before submission.
Start setup without a software charge. Pricing begins only after the practice records its first positive payable claim.
