It’s the middle of the night and all signs point to a UTI, or maybe you can’t sleep because you’re fretting about that mysterious new rash.
Sending a message through your secure, online patient portal, like MyChart, means you can ask your doctor questions and share symptoms, even at 2 a.m. This means getting care and relief faster — without having to go to your doctor’s office, urgent care or a virtual appointment.
Most healthcare organizations have offered the option to correspond with your doctor through a patient portal for some time. However, changes to federal rules allow doctors to seek reimbursement for providing medical advice through secure portals, so many healthcare organizations are now charging for medical advice via online messaging.
So, which messages cost money, and when does it make sense to send your doc a message versus scheduling an appointment?
Why does it cost to message my doctor?
First, let’s address the elephant in the room. You might be thinking, “Wait a minute, I used to message my doctor for free and now I have to pay? Say what?”
While healthcare teams previously answered patient messages for free, as the number of messages increased, this model became unsustainable.
For example, in 2019 UW Medicine doctors received just under 550,000 messages. In 2022, this number skyrocketed to more than 1.4 million messages.
Dr. Crystal Wong, a family medicine doctor and associate chief digital health officer at UW Medicine, says currently doctors are having to respond to the overflow of messages on their lunch break or while tucking their kids into bed.
“One of my colleagues received 550 patient messages in a month. When is she supposed to do that?” Wong says.
Adding a charge to receive messages on complex health topics, and using these messages in place of some appointments, means your doctors can devote more concentrated time to these messages.
“It takes a lot of medical expertise to answer a question comprehensively and take into consideration all the factors of you as a person. The service we want to offer is high value for the patient,’” Wong says.
Billing for messages offers a win-win: Your doctor has a more sustainable schedule, and you receive devoted, high-quality and more convenient care
What messages can you send your doctor for free?
The good news: most messages you send your doctor are 100% free.
Federal rules for Medicare and Medicaid billing allow doctors to seek reimbursement for the patient portal messages they respond to that take five or more minutes to complete. Other messages are free, and all major insurers including Medicare, Medicaid and commercial insurance cover these services.
“The big thing I want people to know is that the vast majority of messages will not be billed. It’s only a small subset of complex messages that take a lot of time and personalized medical advice to address,” says Dr. Adam Jayne-Jensen, internal medicine physician and associate medical director of the UW Medicine Primary Care Central Region.
You won’t be billed for messages about:
- Scheduling an appointment
- Refilling a prescription
- Asking a question that results in an appointment
- Asking a question about something you saw your doctor for in the past seven days
- Providing a health status update on a current condition
So, go forth and ask that clarifying question about your recent visit or send in a prescription refill request without worrying about charges.
What type of messages will your doctor bill you for?
Your doctor may bill you for messages that take more than five minutes, require medical expertise and that are a replacement for an appointment.
The good news part two: Billing for back-and-forth messaging allows doctors to give you quality care via MyChart message that can replace in-person or virtual appointments. (So long having to take time off work and sit in traffic to go see your doctor.)
“This is a super easy way to reach your healthcare team. There is a huge convenience factor for patients,” Wong says.
The messages that you may be charged for include:
- Requests for new prescriptions
- Questions about new symptoms or conditions
- Questions about changes to long-term conditions
- Requests to complete medical forms, like life insurance or medical clearance forms
- Requests for new referrals
When does it makes sense (and not make sense) to message your doctor?
Alright, so you know there are times when you can message your doc for free and cases where messaging costs money but can help you avoid the time and hassle of an appointment.
So, when does it make sense to message your doctor?
DO: Message for paperwork and new medication requests and adjustments
Filling out forms, requesting a new medication or an adjustment to a current medication are all examples of when it can simply be easier to correspond via MyChart message than go into your doctor’s office, Jayne-Jensen says.
For example, if you have anxiety and are looking to increase your medication dose, you might message your doctor to let them know, discuss symptoms and come to a decision on what is best for you. Similarly, if you have COVID-19 and want treatment, you could message back-and-forth about symptoms, onset and get a prescription — without having to go into urgent care or have a video appointment.
Insider tip: Jayne-Jensen encourages folks to include as much detail as possible in your message so that your doctor has the background information they need.
DON’T: Message for emergency care
While your doctor will get back to you in a timely manner, messaging through your patient portal is not an instantaneous service.
If you are in an emergency, call 911 or go to the hospital.
DO: Message your doctor instead of consulting Dr. Google
It’s tempting to self-diagnose a mental health condition after watching TikTok or turn to the internet for answers about your mystery cough. Instead, you can reach out to the doctors who know you.
“You are actually getting an answer from someone in your clinic who knows your health history,” Jayne-Jensen says. “This is a better way to provide quality medical care.”
Insider tip: You don’t need to stress about being double charged if you send a message and then have to come in for an appointment. Your care team monitors the messages, and if you need to come in you won’t be billed for the message.
DON’T: Force messaging if it’s not your thing
The ability to message your doctor to receive care is a service you can choose to use if you want — and it’s also something you can skip.
“It’s another option for patients to access care, but you can still call the clinic and come in for appointments if you prefer,” Jayne-Jensen says. “I don’t want patients to worry that this will impact their ability to access their care provider. If anything, this is going to improve access.”
The bottom line: healthcare for the future
Providing care via MyChart messages is just the latest shift in a wave of changes in how care is provided. As technology improves and society changes, there will continue to be new ways to get care that meets you where you are at.
“This is yet another step in the very gradual change in healthcare in the U.S. from a traditional model to a model that is much more in sync with most people’s daily habits and how they want to be cared for,” Wong says.