Have an Email Question for Your Doctor? It Might Cost You

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If you have a question for your doctor and decide to send an email, you might have to open your wallet.

A growing number of health care groups are charging patients and health insurers when doctors respond to emailed questions, according to The Wall Street Journal.

Doctors and others in the health care profession defend the practice on the grounds that they should be compensated for their time and expertise.

In 2021, the median cost of an “email claim” was $39, according to the WSJ, which cites a Peterson-KFF Health System Tracker analysis of private health insurance claim data from 2020 and 2021. The tracker is an online hub that monitors U.S. health system performance.

KFF notes that emails between patients and doctors became more common during the COVID-19 pandemic. As remote medical care became more widely practiced, new billing codes for digital health services were introduced.

The introduction of these billing codes led to changes in insurers’ payment policies that now allow providers to bill for emails.

KFF says the billing codes have resulted in physicians and other health care providers charging insurance companies and patients when the provider spends at least five minutes responding to an email from a patient.

According to the Peterson-KFF Health System Tracker report:

“Providers can bill up to once a week for the total time spent per enrollee for a new medical consultation. Providers cannot bill for emails if they are related to scheduling appointments or prescription refills, sent within 7 days of a visit (in-person or virtual), or are for follow-up after procedures.”

The good news is that patients with traditional Medicare generally are unlikely to face any out-of-pocket costs associated with these email claims, according to the WSJ.

Additionally, the Peterson-KFF Health System Tracker report notes that in the overwhelming majority of cases — 82% — commercial health insurance plans cover the full cost of these email claims.

However, that doesn’t mean every patient with commercial health insurance escapes unscathed. Some patients still get stuck with some out-of-pocket costs, with the median out-of-pocket cost among those patients being $25, according to the Peterson-KFF Health System Tracker report.

The number of patient-provider email claims in 2021 was roughly double the number of claims when the codes were first introduced in 2020, indicating a growing trend of such claims.

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