Using Hint and Spruce Together in a DPC Practice (2027)

Do Hint and Spruce Integrate?

Yes, Hint and Spruce have a native, two-way integration. Hint lists Spruce in the Hint Marketplace as an integration in its Patient Communications category, and Spruce's help center says patients added to Hint are automatically added to Spruce as contacts, with contact updates flowing both ways. The integration keeps names, phone numbers, emails, birth dates and membership tags in step, and Spruce says it is available on its Communicator plan. What it does not document is moving billing events or tasks between the two, so practices still decide who handles those handoffs.

Hint and Spruce show up together in a lot of direct primary care stacks because each one does a different job well. This guide covers what each tool does, exactly what the integration syncs according to each company's own pages, how practices typically divide the work, and the three places where work most often has to cross from one tool to the other.

Every vendor detail below was checked on Hint's and Spruce's own websites and help centers on October 29, 2026. Both companies update their products often, so confirm the details on a demo before you change your setup.

What Does Hint Do in a DPC Practice?

Hint is the membership and billing system for many DPC clinics. Its pricing page describes member onboarding, membership management, self-scheduling and automated billing, with employer management and billing, eligibility autosync and advanced membership pricing on the Pro plan. Hint also sells a full platform with its own clinical EMR, and a "Billing Only" option for practices that want Hint's membership and billing next to a different EHR.

Hint's Launch plan starts at $290 per month with one clinician and unlimited members, per its pricing page. Card transaction fees on Launch are listed at 3% + $0.30.

In practice, Hint is the record of who is a member, which plan they are on, which employer pays for them, and whether their last payment went through. When someone on the team asks "is this patient current?", Hint is where the answer lives. For a wider look at billing options, see our guide to DPC membership billing software for 2027 and our Hint Core integration page.

What Does Spruce Do in a DPC Practice?

Spruce is a healthcare communication platform. Its listing in the Hint Marketplace describes a business phone system with texting, faxing and telemedicine, where every call, text, fax and voicemail about a patient sits in one place, and patients can text without logging in to an app or portal. For a DPC practice, that makes Spruce the front door, because members can text or call the practice number from their own phone.

Spruce's plans page lists two plans:

• Basic, with a HIPAA BAA.
• Communicator, which adds integrations and API access.

Basic is $24 per user per month and Communicator is $49 per user per month.

Both plans come with a 14-day free trial and month-to-month billing, per the same page. If you are weighing messaging options more broadly, our post on HIPAA-compliant texting for DPC compares the field, and our Spruce integration page covers how it fits with other tools.

What the Hint and Spruce Integration Actually Syncs

The Hint Marketplace page for Spruce describes it as a two-way integration that adds patients from Hint to Spruce as contacts and keeps their information updated in both systems. The listing shows "900+ connected." Here is what each company documents.

• Name. Hint field: Name. Spruce field: Contact name. Documented by: Hint and Spruce.
• Phone number. Hint field: Phone number. Spruce field: Contact phone. Documented by: Hint and Spruce.
• Email address. Hint field: Email address. Spruce field: Contact email. Documented by: Hint and Spruce.
• Date of birth. Hint field: Date of birth. Spruce field: Contact date of birth. Documented by: Hint and Spruce.
• Gender. Hint field: Gender. Spruce field: Contact gender. Documented by: Hint and Spruce.
• Plan and group details. Hint field: Provider, membership, location, group, employer, plan. Spruce field: Contact and conversation tags. Documented by: Hint and Spruce.
• New patient conversation. Hint field: New patient added in Hint. Spruce field: Optional new phone or note conversation. Documented by: Spruce.

Settings Spruce's help center describes

Spruce's Hint integration article adds a few details worth knowing before you connect:

• When the accounts are first connected, Spruce imports all Hint patients as contacts.
• Demographic syncing is on by default and can be turned off.
• When a new patient is added to Hint, Spruce can open a new standard phone conversation (the default), open a Note conversation, or do nothing.
• Hint tags sync to both the contact and the conversation by default. Provider tags need a request to Spruce's support team.
• If a patient texted the practice before signing up in Hint, Spruce may show "Multiple Matching Contacts," and the article links to a fix.
• Manual linking of a Spruce contact to a Hint patient is done on the web version of Spruce.
• After you connect, Spruce asks you to allow 1 to 2 days for its team to finish the setup.

The same article notes that if a practice also has Spruce's Elation integration, demographics will import from Hint. That matters for the many DPC clinics that run Elation for charting and Hint for billing, and it is a good question to raise on a demo so you know which system wins when two records disagree.

What we could not find

We could not find documentation on either site for syncing invoices, payment status, failed charges or membership cancellations into Spruce as events, or for turning Spruce conversations into tasks inside Hint. The documented integration is about keeping the contact record and its tags the same in both places. If your practice needs more than that, ask both vendors what is on their roadmap, and look at Spruce's Integrations section, which lists an API with REST endpoints and webhooks for custom builds.

How DPC Practices Split Work Between Hint and Spruce

• Pick Hint if you sell to employers, take eligibility files from a TPA, or want to keep your EHR and run only memberships and billing. Where it wins: employer billing and eligibility feeds; billing sold on its own, beside another EHR.
• Pick Spruce if you want texts, calls, faxes and video with patients in one shared inbox. Where it wins: calls, texts and faxes in one place; one per-user plan for the whole team.
• What Tabflows does not do: bill memberships or charge cards; replace your patient messaging.

The usual split is simple. Hint owns money and membership, and Spruce owns conversations. A practice that keeps to that line rarely has to wonder where something should be recorded.

• Hint handles enrolling members, choosing plans, collecting card or bank details, recurring billing, employer groups and eligibility, invoices and payment history.
• Spruce handles the practice phone number, texts and photos from patients, faxes in and out, voicemail, after-hours routing, and video visits.
• The EHR holds the clinical record. Some practices use Hint's own EMR, and others pair Hint billing with Elation, Akute, Cerbo or another chart. Our DPC EHR comparison walks through those options.

Because the integration syncs plan, employer and membership tags into Spruce, the person answering a text can see at a glance which plan a patient is on without opening Hint. That small detail saves a lot of tab switching across a day of messages. What we could not find in either vendor's docs is a way for it to alert the team when something changes in Hint mid-conversation, which is where the handoffs come in.

Where the Handoffs Happen

Most of the friction in a Hint and Spruce practice is not inside either tool. It is in the moments when something starts in one tool and needs someone to act in the other. Three of those come up in nearly every DPC.

New member onboarding

A new member signs up in Hint. With the integration on, Spruce creates the contact and, by default, a new phone conversation. That is a good start, but the welcome itself still needs a person or a template. Someone has to send the first text, share intake forms, help book the first visit and request outside records. If a new signup lands on a Friday evening, it is easy for that first conversation to sit unopened until Monday. Our guide to patient onboarding software covers what a complete first week looks like.

Failed payment follow-up

Hint's support article on its failed charge retry schedule describes a careful automated process. When an auto-pay card fails, Hint retries it after 24 hours, then after another 48 hours, and once more about 10 days after the first failure. Hint emails the patient at day 1 and day 10 by default, and practices can customize those emails or add more. If the last card retry fails, Hint notifies practice users. Hint says it does not retry failed ACH payments and sends notifications only.

That notice arrives in Hint, but the friendliest fix is often a quick text from the practice number in Spruce, because a text from their own doctor's office is often easier for a patient to answer than a billing email. Nothing in the documented integration moves that notice into Spruce, so a person has to see it and start the conversation. Our post on membership billing decline follow-up lays out a workflow that keeps members from slipping away over an expired card.

Messages that become tasks

Patients text Spruce about everything, and some of those messages are really requests that touch Hint. "Can I add my daughter to my plan?" "I changed jobs, can my new employer pay?" "Please pause my membership while I'm traveling." Each one starts as a conversation in Spruce and has to end as a change in Hint, and often a reply back in Spruce confirming it was done. Our post on Spruce messaging workflows for DPC covers how practices keep that inbox moving. The gap is that the Hint side of the request lives somewhere else, so it depends on the person who read the message remembering to finish it.

A Simple Hint and Spruce Workflow Table

This is the table we suggest DPC teams fill in for their own practice. The left two columns are what usually happens. The right column is where the work needs to end up for the loop to be closed.

If you track a few numbers from this table, such as how long a failed card stays unresolved or how many new members get a welcome text within a day, you will know quickly whether the handoffs are holding. Our list of DPC metrics to track in 2027 has more ideas.

Setting Up Hint and Spruce Well

A few choices at setup make the pair work better from day one.

1. Confirm your Spruce plan. The Hint integration needs Communicator, per Spruce's help center, so check that every user who needs it is on that plan.
2. Pick the new patient conversation setting on purpose. A standard phone conversation is the default. If your team prefers to start with an internal note before reaching out, Spruce offers a Note conversation instead.
3. Decide on tags early. Plan, employer and location tags are useful in Spruce for filtering, so ask Spruce support to set up provider tags if you want them.
4. Clean up duplicates once. Patients who texted before enrolling can create duplicate contacts. Fix them on the web version of Spruce using its linking steps, then make it part of onboarding.
5. Write down who owns each handoff. For each row in the table above, name the role that closes the loop. That one page prevents most "I thought you had it" moments.

If you are still choosing the rest of your stack, our guides to the best DPC software for 2027 and the DPC software stack by stage put Hint and Spruce in the context of everything else a practice runs. For practices just getting started, the 2027 guide to starting a DPC practice covers the rest of the launch checklist.

Connecting the Work Between Hint and Spruce

The native integration does its job well, which is keeping one patient record consistent across billing and messaging. The parts it leaves to the team are the follow-ups, like the failed card that needs a text, the new member who needs a welcome, and the request that has to be finished in another tool. Those gaps are about how the tools are built, not about how hard a team is working.

That is the gap Tabflows was built for. Tabflows is a dedicated tech team that connects the tools a clinic already uses, including Hint, Spruce and the EHR, so the work between them gets done, with follow-ups, tasks and patient context in one place. It does not replace Hint or Spruce. It makes sure the handoffs in the table above actually reach the end of the row. You can see how it fits on our integrations page.

Sources

Checked on November 4, 2026: hint.com/pricing, sprucehealth.com/plans and hint.com/core/find-your-price. Spot a wrong fact? Email a correction.