r/HealthInsurance • u/arwenthenoble • 14d ago

Claims/Providers Full office visit co-pay charged for MyChart message

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.

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u/arwenthenoble 14d ago

Thank you. I guess I just have a high copay for a message then.

16

u/wighty 13d ago

Yeah, to be honest the anger should be directed toward the insurance company.

I get extremely frustrated at physical therapy co-pays as well, as at least around me a lot of plans you owe a co-pay for every single session and not just the whole treatment course (ie 2 days a week x 6 weeks = 12 total co-pays, instead of one co-pay... most of the time these co-pays approach paying for the entire visit at around $50 or so).

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u/Resse811 13d ago

I don’t understand why you would expect to be billed differently for PT sessions.

Yes you pay a co pay for each session because each session is a separate appt. Why would 12 visits be charged as one?

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u/wighty 13d ago

They are getting the same copay or sometimes worse than when they see a physician... I can't tell you how many times I tell a patient I recommend PT and they say they won't do it because it will cost them $300-600. My goal would be to make it actually feasible for patients.

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u/Resse811 13d ago

Right because again each session is considered an appt. That’s why each session would be charged a co pay. It’s like seeing a doctor 12 times. You wouldn’t pay a single co pay for all those visits.

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u/wighty 13d ago

... my whole point is you aren't seeing a doctor. You aren't getting diagnosis/treatment/education in one visit from a physician. Some courses of PT might be able to get away with 1 visit, but majority do not. Paying the same level of co-pay is pretty ridiculous. If you make it like a $5 co-pay, fine, pay per visit. $50 co-pays on a PT visit is pretty much the entire cost, and the insurance is hardly paying anything.

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u/Silent_Cookie9196 13d ago

Agree- have also experienced this. I was shocked when this happened to me, because they didn’t collect anything until the end, and it was over like $600 for the PT visits.

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u/will0593 13d ago

Work is work. Why should they answer a message for free?

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u/msprettybrowneyes 14d ago

Did your initial messages necessitate multiple replies that spanned 7 days?

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u/JDWhite1982 13d ago

The spanning 7 days part just means that you bill the code once even if you have multiple communications over the course of the week so long as it doesn't add up to more than 10 minutes of total physician time spent. There are higher level codes that apply for longer totals of time but they're still only billable once every 7 days.