Health Systems Begin Charging for Some Portal Message Responses

Nov. 16, 2022
At Cleveland Clinic and UCSF Health, responses that require a provider’s clinical time and expertise to answer may be billed to patients’ insurance

With an increasing number of patients using digital portals to message clinicians with questions about their care, some health systems are starting to bill insurers for the time it takes to respond. For instance, Cleveland Clinic has announced that starting Nov. 17 the Epic MyChart responses that require a provider’s clinical time and expertise to answer, may be billed to patients’ insurance.

A year ago, UCSF Health in San Francisco began charging for answering some portal messages if a response requires medical expertise and more than a few minutes of a provider's time.

Cleveland Clinic noted that since 2019, the number of messages providers have been answering has doubled. Going forward, messages taking five or more minutes for a provider to answer could get billed, including messages about:

• Changes to your medications
• New symptoms
• Changes to a long-term condition
• Check-ups on your long-term condition care, and
• Requests to complete medical forms.

The health system said the provider looking at the message might be reviewing the information the patient sent over and changing part of their treatment plan, or recommending they get a test to learn more. They might need to look at the medical history and do an in-depth review of the records to make sure they give the patient the best possible advice.

Patients may have to pay a co-pay based on your insurance company’s guidelines. Cleveland Clinic said some Medicare patients might have a small fee of $3 to $8. If patients with private insurance have a deductible, or this isn’t a covered benefit on their plan, they could owe $33 to $50.

A story on the web site noted that among the major Greater Cleveland hospital systems, University Hospitals said it is thinking of following in Cleveland Clinic’s footsteps, but MetroHealth System is not. “UH is discussing making similar changes to its My UHCare messaging system next year, based on the time a physician needs to complete a patient’s request, the hospital said. Elsewhere in Ohio, ProMedica said the idea is under consideration, though not currently in use,” the story said.