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/Moist-Barber 14d ago

I bill patients for that stuff. I have 1800-2000 patients and if even half of them think that sending messages is free and did it once a week?

Boom, that’s loads of extra work that I’m not paid for.

You don’t get to ask a lawyer a question without getting billed in 6-minute increments.

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u/Csherman92 14d ago

What other job is there where you can literally bill for making a phone call or answering yes? Or you can just send an auto message “please schedule a telehealth visit to address your concerns.” Making phone calls and answering people’s questions is part of my job. I don’t get to bill per question someone asks me.

Where do you get off thinking you’re so self-important that your time is more valuable than anyone else’s and you should be able to bill for answering questions? Most of the time, your nursing staff answers the questions. So you’re billing for your time when really it’s your nurse’s time?

Abuse the messaging system. I use it to communicate with my doctor because it takes forever for my doctor to answer my phone call and no one in reception relays my messages to the doctor. That’s fine if they bill you for actual medical advice but it’s not okay for you to get upset that patients ask questions and you think every question they ask you deserves to be billed. Have a little compassion for your patients. It’s not all about money. You make it seem like it’s all about money and to them, it’s their health. You deal with this stuff all the time! They don’t. So sudden symptoms are frightening to someone who has never had them before. And sometimes people talk themselves out of going to the ER because they have never had those symptoms or don’t think it’s “that bad.”

It’s fine if you don’t answer MyChart messages after hours. That’s fine. No one is asking you to work while you’re off.

Imagine if customer service people billed for all the questions they get asked.

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u/Comfortable_Two6272 14d ago

Im an consultant. All my time including easy phone calls and emails is billable. Im actually violating company policy to not bill and can be fired.

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u/msprettybrowneyes 14d ago

First of all, don’t assume “the receptionists don’t relay my messages”. Yes we do. We take note of your concerns, put it into a message to the nurses. After that, it is out of our hands. If you haven’t gotten a call back, that’s on the nurses and doctor’s, NOT on us. A lot of the times the nurses have to wait on the doctor to review the message, review your chart, etc. But again, that’s on clinical, not the receptionists. Hope this helps!

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u/nyc2pit 13d ago

We get that feeling because if YOU as a patient leave we don't even notice lol.

We're plenty busy without having to deal with the loads of entitlement you obviously have.

Save me the "it's all about the money" BS. This is a job and I expect to get paid. Your good will doesn't pay my student loans.

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u/UnfoundedDime 14d ago

You’re conflating customer service helping someone vs a physician having to read a message, review relevant medical records, assess the problem, develop a plan, provide medical advice, and place orders if needed. Also the liability associated with all that. Now repeat for the 3 additional replies related to the first one and multiple by 50 patients a week.

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u/Moist-Barber 14d ago

I don’t get paid hourly. I don’t get a salary.

I get paid by the work I perform, and if a bill isn’t sent then I don’t get paid.

Do you work for free? People come to me because of my experience and education so while it only takes me moments to make decisions, those add up. And I didn’t sacrifice 10+ years of my life to work for free.

Nurses triage my messages. And I send lots of people an automatic “please book an appointment” message.

But if someone is trying to get medical advice out of me through the portal then they better believe that they will pay for it.

To summarize: you have zero clue how busy and demanding my schedule is and what I have to do daily, and to top it off I have people demanding my attention randomly throughout the day?

They better be ready to pay for my time. Because someone has to, and I have a mountain of student debt to repay and mouths to feed just like everyone else.

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u/slowgait 14d ago

Don’t agree with the downvotes to your response. People are downvoting because they disagree with the system you didn’t create & they don’t want to take the time to understand. This is US capitalist healthcare and they like to be mad about it but not even bother to understand how to navigate it.

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u/[deleted] 14d ago

[deleted]

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u/nyc2pit 13d ago

I'm sorry you're not properly being compensated for your time and expertise.

Doesn't mean that others don't deserve to be.

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u/[deleted] 13d ago

[deleted]

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u/nyc2pit 13d ago

You should stick to what you're good at and not opine on what someone else's work day and workload looks like.

My bet is you would collapse under the workload of a normal PCP.

Tldr the rest of your rambling.

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u/Pitch_forks 13d ago

We (physicians) aren't salaried. If you weren't salaried, would you maintain such availability? I hope you have enough respect for yourself and place enough value on your time to demand compensation for it.

I like my line of work - it's mentally stimulating, and it's gratifying to help folks. It feels like my work matters and is a worthy use of my time. But you'd better believe I'm out if I hit the lottery. I do not have some higher calling to dedicate my life to helping others. At the end of the day, we are just people who chose this method to pay our mortgages and be able to do the things we want to do. Same as you.

And frankly, if the layperson wants to get mad at physicians finally standing up for themselves and try to turn on us due to their lack of perspective, I invite them to FAFO. Honestly, I'm getting tired of the 5-minute expert anyway.

Fortunately, in my neck of the woods, most of them are coming around. I am a PCP (family med physician) on call for my group today, actually. Several stupid phone calls that absolutely could have waited til Monday (or just not have even been made...), but one lady did apologize for intruding on my day off and thanked me for my help on a Saturday. That meant more to me than she could know!

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u/Heavy_Can8746 13d ago

Sounds like you should take a page out of their book If anything.

However, if you're field decides not to take a page out of their book.. that is, then your decision to deal with the consequences of such.

So get off your high horse, and start charging them people... Or at least speak with your particular field and advocate Why y'all should be allowed to. 

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u/ArisuKarubeChota 13d ago

Truthfully…. that’s not a healthy work + life balance situation at all, and not a feasible lifestyle for most working professionals. Definitely not something to aim for especially when more and more physicians and APPs are being employed by heartless bureaucracy hospitals systems. The ruthless work culture in this country already sucks in comparison to other developed countries.

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u/UnfoundedDime 14d ago

What is your job?

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u/Csherman92 14d ago edited 14d ago

No one is demanding your attention with a MyChart message. They always tell you if it’s an emergency don’t use MyChart call 911 or go to the ER.

But what one thinks is a simple question and what you’re describing is not the same thing. If medical work needs to be done, certainly bill for it if it requires complex medical training. But if it is “is this normal?” Then I don’t think this should be billable. If it requires you to look at my chart, sure. Bill for it.

Please have some compassion for your patients because it’s quite obvious you don’t have any. I don’t work for free, but I am paid on what I produce. So if I don’t produce, I don’t get paid.

So I get paid similar to you. You don’t get a salary? Really? The hospital doesn’t pay you?

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u/UnfoundedDime 14d ago

That is literally the point of MyChart messages, to “demand” attention.

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u/Csherman92 14d ago

They typically do not answer right away. You’re not demanding a question. You’re basically leaving a message for your doctor to respond to you at their earliest convenience.

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u/UnfoundedDime 14d ago

Again that is still taking up time. Even at just 3 minutes a message multiply that by 30 messages a day x 5 days a week. That’s 7.5 hours a week answering only messages. A whole work day.

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u/Living-Target-9355 14d ago

If you have 30 messages a day you should work on your communication skills with answering your patients’ questions in office instead of moving to the next billable, sorry patient, as quickly as possible. If you have a few patients abusing the system address that with them individually.

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u/UnfoundedDime 14d ago

https://pmc.ncbi.nlm.nih.gov/articles/PMC4418542/

Here’s a study from 2015 that shows an average of 18.9 messages per 100 patients per month.

https://academic.oup.com/jamia/article/29/3/453/6458072

Patient messages have increased by 157% since 2020.

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u/Living-Target-9355 14d ago

The first one is data from 2001-2010, how much has changed in the functionality of the portal since then? I would guess nearly all of those questions were billing related because prior to the last 5-10 years you couldn’t access anything else when logging onto the portals.

The second link is to a survey with data from just before the pandemic to stats from July 2020, obviously skewed.

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u/nyc2pit 13d ago

You seem to have difficulty wanting to pay professionals for their time and expertise.

Why is that?

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u/slowgait 14d ago

Providers are reviewed by hospital group management on KPIs including MyChart response time/ volume. So yeah, it does affect compensation & pay.

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u/Moist-Barber 14d ago

I get paid for each and every bill that is sent. Literally every single bill, I get a “cut”. And if a bill isn’t sent then whatever happened (the charting, the paperwork, the liability) is all done completely for free.

Phone calls? No bill = I just used my personal time to answer questions.

Paperwork someone wants filled out? Again, if there’s no bill to the patient then I worked for free.

I have compassion for my patients. I’m very well liked and have good bedside manner. But I have strict boundaries on my time because otherwise everyone would demand my time and thus my money, and baby do I have loans that need to be repaid and they don’t repay themselves.

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u/nyc2pit 13d ago

👏 Louder.For.The.Ignorant.People.On.This.Thread. 👏

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u/ArisuKarubeChota 13d ago

Lawyers bill by the minute.

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u/Living-Target-9355 14d ago

Half of them aren’t sending messages once a week and if they are you need to deal with those patients. In the 3-4 years I’ve been a patient on mychart I’ve sent messages about a dozen times, usually related to treatment I was just provided or in need of (urgent care referral friday to ortho for bicep tendonitis when it was really a bicep tear so I sent photos of my arm and was sent for stat MRI on monday without seeing the doctor, which saved the doctor time seeing me just to send me to MRI). I’d bet 80% or more of your patients don’t send a message more than once or twice a year at most.

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u/UnfoundedDime 14d ago edited 14d ago

You’re not understanding the volume. Let’s take your example, a dozen messages over four years. It’s three messages a year or 0.25 messages a month, multiply that by 2500 patients and you have 625 messages a month. 25 messages per working day to answer using your example of a patient who hardly ever messages.

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u/Living-Target-9355 14d ago

Don’t have 2500 patients. Also, the vast majority of those patients questions are likely things your nursing or administrative staff should never have to ask you questions about before responding.

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u/HeparinBridge 13d ago

77% of US physicians are employees of hospital systems or large corporate entities, where their panel size is literally dictated to them by a non-physician administrator or executive. You are blaming doctors for decisions that politicians you voted for took out of their hands.

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u/Moist-Barber 14d ago

You don’t understand that this is the reality of my job. I’m inundated with messages. This is not a “one-off” thing like it is for patients.

You are wanting bespoke advice over messages; someone has to pay for that to be done.

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u/Heavy_Can8746 13d ago

Sounds like you should just become a primary care physician to show everybody else how it should be done. It is clearly not as hard as they are making it out to be....right?....

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u/psam6 13d ago

lol at “don’t have 2,500 patients” 😂😂😂 Do you really think doctors get much of a say in that? And even if they did cut their panel down to 1,500 patients… then people would just start complaining that it takes a year to get in to see a primary care doctor. Damned if you do, damned if you don’t.

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u/NavyBeanz 14d ago

Just don’t answer!

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u/[deleted] 14d ago edited 14d ago

[deleted]

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u/NavyBeanz 14d ago

Read my other comment in this thread. I am on your side 

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u/Csherman92 14d ago

This was in response to moist barber not you.

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u/NavyBeanz 14d ago

Oops. I think it replies to me though because I got it in my inbox