January 10, 2023 : Some health systems in Chicago, Cleveland, and San Francisco, are now assessing patients for sending specific messages to doctors via online portals like MyChart.
During prescription refills, scheduling visits, and requesting follow-up questions shortly after a visiting would likely not result in a charge, sending a photo of a new rash, requesting a form be filled out, or ordering a change in medication.
Meanwhile, major hospital systems in Minnesota, including Hennepin Healthcare, M Health Fairview, HealthPartners, Allina Health, and Essentia Health, notice they don’t charge for essential messaging services. However, patients should be mindful that certain E-visits may cost them.
“We at Hennepin do not ask for payments for messages that are direct communications between the patients and the doctors,” Hennepin Healthcare physician and chief health information officer Dr. Deepti Pandita expressed. “What we do charge for is certain visit classes that could be sort of administered through the patient portal named E-visits.”
At the same time, HealthPartners says, “For E-visits irrelevant to a recent visit or diagnosis, there may be related charges.” HealthPartners states patients are generally not charged for follow-up questions, desired test results or work, and school forms submissions.
Dr. Pandita tells some hospital systems are charging for particular messages owing to a surge in online messaging and telehealth over COVID. She tells a Hennepin Healthcare doctor may get hundreds to thousands of notifications daily without getting reimbursed for overtime work.
“A moderate provider who practices full time could actually be answering notifications for three to four hours after their work day is done,” she told.
Nevertheless, Dr. Pandita points out that doctors may be incentivized to reply to online messages and says this may only help some patients.
“This is not a right trend from the lens of health equity,” she said. “MyChart or any patient portal is generally an English only medium for people who have admission to Internet … We are really leaving out a huge magnitude of patients who don’t have the patient portal permit … Providers who are getting incentivized for specific message types will prefer those than the message classes that are not being incentivized.”
Cynthia Fisher is the creator of Patient Rights Advocate, a Massachusetts nonprofit pushing for hospital cost transparency nationwide.
“Around $50 for an e-mail, are you kidding? Patients fear, already, being overcharged by the clinics,” Fisher expressed. “These electronic health record charges are creating a barrier, containing communications with their doctor about their health and health.”
She states skipping a simple check-in could be even more costly if the medical problem is serious. Patients may want to take advantage of hospital cost check tools when available and pay attention to what’s on each hospital bill, as particular charges may be rebutted.