The doctor will see you now … anywhere, thanks to telehealth tech. But patients have found these visits are sneaking a hand into their wallets. Reports show that a growing number of hospital services across the country charge patients just to message their doctors. That’s leading to surprise fees as high as $50 for an email!
I know. It feels like we’re getting nickeled and dimed for everything from concert tickets to all the ongoing hidden cable fees. But charging patients to ask an online question seems pretty extreme. Doctors have their reasons. Patients are not happy. Let’s break it all down.
Uh-oh, is my clinic charging me extra like this?
Bottom line: You should check. Some hospital systems use proprietary software to do it on their end, while others charge via standard patient portals like MyChart. Hospitals in Ohio (including the Cleveland Clinic), Illinois, Maryland (including Johns Hopkins), Texas, Pennsylvania, Oregon and California have all taken the pricey plunge.
Doctors report that, so far, most of these billable messages come from people in their 50s and 60s. They have the technical know-how to send an online message and are more likely to have important questions about their health.
But that also means that younger patients may jump onto patient portals and shoot an email as they would to their bestie — without realizing that hospital systems have been quietly adding charges. So how’d that happen?
An exercise in patients: Why messages cost money now
Blame it on the telemedicine rush. Telemedicine was already a growing option in the 2010s but went into overdrive during COVID-19. Doctors and hospitals raced to implement systems and a massive wave of patients started learning to use them.
Telehealth portals couldn’t handle video visits like simple phone calls unless they opened call centers! Instead, they used emails to screen patients and chose only a few for online video chats with a doctor.
The problem is that’s still a lot of emails. And doctors (plus their assistants) were losing money and precious time, taking hours to go through email explanations of symptoms.
But there was a waiting solution: In 2019, the U.S. Centers for Medicare and Medicaid Services added new billing codes that allowed healthcare businesses to charge money for written messages. Slowly but surely, message fees have gone live.
Unfortunately, it sounds like a system ripe for abuse to me, and the last thing anyone needs is another medical charge. So let’s look at how to stop it.
Quick tips to dodge patient messaging fees
Secondary health insurance may cover patient-to-doctor messages, although it’s not guaranteed (and not everybody has it). But some chats are more likely to add dollar signs to your bill than others. To avoid that, follow a few key steps:
- If you need a doctor’s direct advice, try to wait for a covered visit to bring it up. Anything that takes a doctor more than five minutes counts. That can include prescription changes, unexpected changes in ongoing symptoms or conditions and regular check-ups on long-term conditions. Online messages about these topics get the bill hammer.
- If you’re scheduling appointments, getting a new refill on your prescription, asking about a recent medical visit or following instructions from your doctor to send them an update, you can probably message without worry. These messages don’t usually get billed.
- When possible, send direct emails through your email client, like Gmail or Outlook. These are less likely to be charged than a patient portal like MyChart, although it’s more challenging to contact a doctor’s office directly.
Finally, when in doubt, I encourage you to call your clinic and ask about their policies. Often, healthcare workers can help you determine the most affordable way to contact your doctor. Now you’re ready to stop any unexpected message bills in their tracks.
