Beginning Thursday, it may cost you or your insurance company if you want to message with your Cleveland Clinic doctor via the health system’s electronic portal.
The Cleveland-based health system said it will begin billing insurance companies for some messages that take physician’s clinical time and expertise. Some patients may have to pay a copay based on the insurance company’s guidelines.
The Cleveland Clinic operates 21 hospitals in Ohio, including Akron General, Medina Hospital and Mercy Hospital in Canton, as well as facilities in several states and internationally. The health system also includes outpatient physician offices and wellness facilities throughout Northeast Ohio.
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Why is Cleveland Clinic charging for MyChart messages?
The clinic said virtual options have played a bigger role in recent years.
As a result, the amount of messages providers have been answering has doubled since 2019, according to the health system.
The health system said providers respond to messages within three business days.
“Most of these messages are free,” the health system said in a statement. “However, starting November 17, 2022, MyChart responses that require your provider’s clinical time and expertise to answer may be billed to your insurance. There may be a co-pay based on your insurance company’s guidelines. This will allow us to continue to provide the high level of care you have come to expect from Cleveland Clinic.”
The Cleveland Clinic said it won’t charge for messages that can be answered in less than five minutes or without a clinical assessment or medical decision-making.
A clinic spokeswoman said the health system had begun communicating the change to patients via email, messages on the MyChart app and on a Cleveland Clinic web page with FAQs.
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What MyChart messages will be billed to my health insurance?
The clinic said messages that will be billed usually require the provider’s medical expertise and take longer for your provider to answer — typically taking five or more minutes.
That could include messages about:
- Changes to your medications.
- New symptoms.
- Changes to a long-term condition.
- Check-ups on your long-term condition care.
- Requests to complete medical forms.
“The provider looking at your message might be reviewing the information you sent over and changing part of your treatment plan, or recommending you get a test to learn more. They might need to look at your medical history and do an in-depth review of your records to make sure they give you the best possible advice,” the health system said.
Patients may be billed for MyChart messages with Cleveland Clinic physicians, nurse practitioners, physician assistants, clinical nurse specialists and optometrists based in Ohio, Nevada, Cleveland Clinic Weston and Cleveland Clinic Indian River, the health system said.
What MyChart messages will be free?
“The quick rule of thumb is to think of time and expertise,” said the clinic.
The clinic said providers will not bill for messages about:
- Scheduling an appointment.
- Getting a prescription refill.
- Asking a question that leads to an appointment.
- Asking a question about an issue you saw your provider for in the last seven days.
- Checking in as a part of your follow-up care after a procedure or follow-up care related to a recent surgery that occurred within the past 90 days.
- Giving a quick update to your provider.
- A request preceded by a visit for the same problem in prior seven days.
- A request that results in an appointment for the same problem in the subsequent seven days.
Will I know if a MyChart message will be billed?
“When a patient initiates a MyChart Medical Management question, they are informed of the possibility of charges being associated with their request based on the provider needed for the response,” a clinic spokesperson said. “The patient will have the option to proceed with their message or be redirected to request an appointment with the provider instead.”
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What should I expect if my MyChart message is billed to insurance?
If your message is billed to your insurance, you may not be charged or may see a low out-of-pocket cost, the clinic said. Different insurance plans cover different things.
Here are a few examples of what you can expect, according to the clinic:
- Have Medicare? There’s no out-of-pocket cost for most people. Some might have a small fee of $3 to $8. If you’re a Medicare patient with secondary insurance, you’ll owe $0.
- Have private insurance? Most insurance providers cover these messages at little to no cost to the patient. If you have a deductible or this isn’t a covered benefit on your plan, you could owe $33 to $50.
- Have Medicaid? There may be some charges billed to your insurer, but there will be no copays charged to the patient.
Will other area health systems start charging to message doctors in MyChart?
Cleveland-based University Hospitals, which operates UH Portage Medical Center in Ravenna and physician offices in the Akron region, said it is evaluating a similar policy, which could be implemented next year.
In a statement, UH said: “We are currently discussing similar changes at UH depending on the physician’s time required to complete a patient’s request. In the event their requests require more than a simple response, the message may be elevated to a billable encounter. Some examples may include detailed chart review, research regarding a specific issue, communication with other caregivers or additional questions or communication with the patient. “
Akron Children’s Hospital also is evaluating whether to bill for messages through MyChart, which are currently free.
Mike Bernstein, spokesman for Summa Health System, which operates Akron City Hospital, Barberton Hospital and outpatient facilities and physician offices, said there are no changes to its system, which also uses MyChart. “We strongly encourage communication between our patients and providers and have no plans to charge for messaging.”
Western Reserve Hospital in Cuyahoga Falls also has no plans to charge for messages to physicians via its messaging system called Follow My Health, spokesman Mark Bosko said.
Unity Network physicians, a network of more than 100 independent physicians with 31 offices in the area also has no plans to charge for messages on its eClinical Works portal, said Bosko, who is also the group’s spokesman.
Aultman Hospital in Canton does not charge to message its physicians on its electronic portal, Cerner, and has no plans to charge at this time, a hospital spokesman said.
Beacon Journal staff reporter Betty Lin-Fisher can be reached at 330-996-3724 or blinfisher@thebeaconjournal.com. Follow her @blinfisherABJ on Twitter or www.facebook.com/BettyLinFisherABJ. To see her most recent articles and columns, go to www.tinyurl.com/bettylinfisher
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