Full office visit co-pay charged for MyChart message

[u/arwenthenoble]

I had a question about a temporary medication I was taking and sent a message via MyChart. The message was only regarding the medication (no other health questions were asked).

I received my EOB and was charged a full $50 co-pay like when I go in person for a visit or have a full video visit. When I looked online, I see in general messaging costs listed as much lower than a visit. Does this mean my insurance doesn’t differentiate a full visit from a brief question in a message? If I had known, I would’ve scheduled an online telehealth visit instead.

I’ve had a lot of medical costs this year and another random $50 stings. I will avoid using MyChart going forward.

[u/Low_Mud_3691]

Patient's abuse the message system. I'm not surprised that the office has that policy in place. You probably signed something about it either at intake or another time.

[u/mayday4aj → u/Low_Mud_3691]

Yup this right here. Especially in fam med. Its why we cant have nice things, people just over abuse the system. Treatment discussion is fine but the entirely different discussion is the issue. The worst are patient asking for a full written conversation of a new, never before talked about medical concern, asking for a referral to a medical issue we never discussed, do a prior authorization for a med denial or "just fill out this form" situations for fmla, disability

[u/anonymowses → u/Low_Mud_3691]

Last time I used MyChart, my doctor said I did all the work for her.

I thought I had a UTI. I did self-pay labs (~$20) so I could get them fast with cultures.

Through MyChart 1) Gave my doc a heads up that I took the test and was waiting on cultures. 2) Listed the dates and types of antibiotics I've used previously. 3) Asked if I should do a telemedicine or in-person visit.

She let me know the culture results and which antibiotic she sent to the pharmacy. She said no need for an appointment and thanked me for my thoroughness. Next time I was in the office she thanked me for doing her job.

I would be miffed if I had a full co-pay, but don't expect them to work for free either. I just hope the doctor can make the call instead of an automated system billing everyone.

[u/McAnki_Agar → u/anonymowses]

Nice job but 99.99% of patients don’t do this. It’s a “why would I go see the doctor when I can just message them?” And it’s never a simple message. It’s always “hey in our last visit you said I should do X, that’s not working. What else should I do?”.

Might be heavily affected by the fact that I’m in pain medicine but it’s a significant burden to my workload. I would disable my chart messaging if I could just for self preservation. Patients can call and leave a message if they’d like.

[u/nyc2pit → u/McAnki_Agar]

My staff answers them.

If it needs me to look at it, it needs an appt.

[u/decafjasminetea → u/anonymowses]

…And one day she will do this but the person (who she didn’t examine or give ED precautions to or do vitals on) will have pyelonephritis and get septic and die and then she will be liable. The number of times a patient thought they knew what was going on but was wrong I can’t even count. I’m not trusting random people. I want to examine the patient.

[u/nyc2pit → u/anonymowses]

Lol at this doctor not knowing her worth.

I'd still charge you. You are still asking my advice and want me to write the prescription. If I give you a drug that says causes you to end up horribly disfigured, you'll still sue me. So yeah, you're getting charged.

[u/chiddler → u/nyc2pit]

Doctors are paid for advice but also for liability.

[u/nyc2pit → u/chiddler]

Damn straight!

You think I'm not getting sued if you die after I prescribe the wrong med for that message you think should only have taken me 2 sec?

[u/wighty → u/anonymowses]

but don't expect them to work for free either

In addition, I think patients need to understand that it is about risk as well... anytime physicians are diagnosing, making recommendations, prescribing treatments, ordering testing, etc we are taking on liability. I really don't think patients should be mad at being compensated for that. Same rings true for the once a year or whatever routine follow up... yeah your blood pressure is still well controlled for the fifth year in a row, but giving you another year of medication is still a potential liability/risk to the physician.

[u/RajDek → u/anonymowses]

How did you get the self pay labs done?

[u/toychristopher → u/Low_Mud_3691]

Do patients abuse it or is it just not clear what it's for? I mean I'm sure some people abuse it but others really might not understand what should be a visit and what can be a simple message.

[u/Living-Target-9355 → u/Low_Mud_3691]

Then they should process the copay prior to allowing the message to be sent. That’s ridiculous that they’re charging for questions being asked related to treatment already occurring.

[u/MrPBH → u/Living-Target-9355]

It is actually based.

[u/youre-stupid-69 → u/MrPBH]

*cringe*

[u/meliora2316 → u/Living-Target-9355]

Most (perhaps all) insurance companies prohibit charge prior to rendering medical services. Co-pays are different than rendering medical services hence the charge at check in and then a bill after services rendered

Based on the elements that went into the doctor’s response it would be impossible to charge beforehand

Many health systems have explore the concept of charging prior to sending and it’s always a no-go