Want to email your doctor?you may be charged for it

Hospital systems across the country now charge for some messages that patients send to their doctors. The doctor says she spends more time perusing her queries online. Some messages are so complex that they require the level of medical expertise that is typically provided during the clinic visit. .

But patient advocates worry that these new fees could discourage people from contacting their doctors, adding even more complexity to the U.S. healthcare system. Opaque billing process.

Cynthia Fisher, founder of Massachusetts-based Patient Rights Advocate, said, “It’s a barrier that denies access and makes people hesitant or afraid to communicate, and it’s the patient who has poor quality of care and far better outcomes.” can be harmful,” he said. A non-profit organization that promotes transparency in hospital pricing.

explosion of Telemedicine in the last 3 years — The COVID-19 outbreak and easing federal regulations on online care have prompted many physicians to increase communication with their patients. Consultations that used to be conducted in the office have changed to visits using computers and smartphones. The health care system is also inviting patients to submit questions to doctors at any time using the new online portal, Jack Lesneck Jr., president of the American Medical Association, told his Associated Press.

“When people realized this was cool and could improve their care, I saw hospitals and practice groups saying to their patients, welcome to your portal…. You can,” says Resneck. “We’ve noticed that the doctor gets dozens of these a day for her and doesn’t have the time built in to do the work.”

Fees vary by patient and hospital system, with messages costing as little as $3 for Medicare patients and $160 for uninsured people. In some cases, the final bill amount depends on the time the doctor spends on the response.

Healthcare systems that have implemented these new policies, often in recent months, have automatically warned patients that they may be billed when they message doctors through online portals such as MyChart. It says it will. Send test results to the patient.

According to the Centers for Medicaid and Medicare, under the new billing rules, doctors are allowed to bill Medicare for as little as five minutes of time spent online messaging over a seven-day period.

Physicians should be compensated for the time they spend providing expert medical advice, according to University of Chicago health economist Catherine Baker. But it’s also important that hospital systems are transparent about what patients can expect to pay as these new rates roll out, she added.

“If copayments are not made clear to patients in advance, copayments accomplish nothing,” said Biker.

Physicians at the University of California, San Francisco process about 900,000 email threads (3 million total messages) per year, according to system spokesperson Jess Berthold.

The hospital has announced that it will start charging in November 2021. some of those messages, after noticing spikes during the pandemic. Over the course of a year, his 1.4% of email threads, or about 13,000, resulted in charges.

Only certain messages trigger billing. For example, patients will not be billed for refilling prescriptions, scheduling appointments, follow-up questions regarding visits within the last 7 days, or if a doctor advises to schedule a visit accordingly.

What type of message prompts you to bill? Send your doctor a picture of a new rash, ask him to fill out a form, or ask you to change your medication.

Navigating how much you end up borrowing can be trickier.

With UCSF, Medicaid patients sending messages to their doctors have no copay, while traditional Medicare patients may have to pay $3-$6. Patients with private insurance are typically charged a copay of about $20. This also applies to patients on Medicare Her Advantage, Medicare’s private insurance plan.

Ohio’s Cleveland Clinic rolled out the latest major hospital system to announce rates for online messages. Similar guidelines late last month, If you have private insurance, the message can cost as much as $50. Northwestern Medicine in Chicago charges him $35 for some messages, but less than 1% of the communications he gets billed for, spokesman Christopher King said.

All of these systems use the online portal MyChart. Epic, the privately owned software company that runs MyChart, doesn’t track which healthcare systems charge patients for messages, his spokesman Barb Herandez said in an email. The company did not respond to questions about whether it received a portion of its fees from these charges.

Giving advice to patients online saves them time and money in the long run, the hospital system claims. If doctors can answer patient questions via email, patients can save time waiting for appointments and taking time off work to go to the doctor’s office.

Moreover, some patients simply prefer the convenience of getting answers from their doctors quickly on the app, added UCSF’s Berthold.

“When patients have the ability to talk to their doctor immediately when they have questions or concerns, they can seek care sooner and get treatment sooner,” said Berthold.

But Fisher argues that it can backfire if patients think twice before messaging their doctor. I may rely on you.

“It becomes a slippery slope, and that slippery slope is not in the patient’s favor,” she said.