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Dr. Farhaad Riyaz explains how emailing a doctor for medical advice might cost a patient

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Dr. Farhaad Riyaz explains how emailing a doctor for medical advice might cost a patient

January 16
16:32 2023

“Think before you press ‘send’ on that email to your healthcare provider, because it might just cost you a bit,” says Dr. Farhaad Riyaz, who is a dermatologist based in Virginia.

Several US health systems are now charging patients money for emailing their doctor–a service that was once free. For many patients, it is already hard enough to access doctors and the recent development has generated much debate online for American citizens who face soaring medical costs. These fees raise ethical questions: charging patients for emails affects both the patient-doctor relationship and our view of modern healthcare as a whole.

According to Dr. Riyaz, not all doctors support this new policy either. Some feel that it will discourage patients from reaching out with questions or concerns and that it will ultimately lead to worse health outcomes. Additionally, some worry that charging for email correspondence will disproportionately impact low-income patients who may already have difficulty affording quality healthcare. It’s no secret that US health systems have been struggling financially in recent years, with skyrocketing healthcare costs and a decline in quality services.

This trend of charging has nevertheless been spreading across the country and it’s best for patients to familiarize themselves with the concept.

Why are health systems charging for emails?

If you’re paying for healthcare, shouldn’t you be able to contact your doctor whenever you need to?

Unfortunately, it’s not that simple. Here’s why:

Emails take up a doctors’ time

Most doctors are already overworked. They must see patients, keep up with paperwork, and deal with insurance companies–all while trying to stay on top of the latest medical research. So, when they’re overwhelmed with replying to hundreds of virtual queries, it takes up time that they could be spending on other tasks for which they’re paid. Doctors also may not be able to address all emails in a timely manner.  

The fees will help cover healthcare costs

Another reason is that some healthcare systems view email as a tool to make money since patients are typically willing to pay for the convenience of being able to email their doctor. Some doctors may also charge for virtual advice because they feel that it is a personal service that they provide, and they should be compensated the same way they are for telemedicine services. This policy is being implemented to help cover the cost of providing care. The charges could be up to $50 per email, and they will be applied to all patients who use this service. The aim is to help offset the cost of providing healthcare, and it will also ensure that patients are able to get the care they need in time.

Virtual correspondence has become integral to medical care

Many healthcare providers believe that emailing should be considered a part of the overall care that patients receive, and thus, it should be billed accordingly. Some doctors argue that emailing saves them time in the long run because they can quickly answer questions or give guidance without having to schedule an appointment or wait for a callback. In addition, some say that patients who email their doctor are more likely to be engaged in their own health and more likely to follow through with treatment plans.

Where has the system been implemented?

The University of California, San Francisco (UCSF) announced in November 2021 that it would allow clinicians to bill insurers for certain types of virtual medical correspondence. Patients would be charged for emails that involve a medical evaluation, require more than a few minutes to respond, ask for a form to be filled out, or request a medication change. Patients won’t be charged for prescription refills, asking a follow-up question about an office visit within the last seven days, or if their doctor tells them to come in for an appointment. 

So far, UCSF has collected an average reimbursement of $65 per email consultation.  During the past year, 1.4% of email threads, or around 13,000, have resulted in a bill. Patients on Medicaid won’t have any out-of-pocket costs, and those on traditional Medicare might pay $3 to $6. Patients on private insurance will be billed a co-pay (around $20) on Medicare Advantage, the private insurance for Medicare.

Cleveland Clinic in Ohio has recently declared that they would charge for online messages, where the cost of one email can be as high as $50 for those on private insurance. In Chicago, Northwestern Medicine bills up to $35 for some messages.

NorthShore University HealthSystem, also in Chicago, has begun billing for certain messages on its patient portal, NorthShoreConnect. Out-of-pocket costs for people on Medicare will range from about $3 to $10, while patients with private insurance and Medicare Advantage may have co-pays like those for in-person and video visits. The cost will be $35 for uninsured patients.

Not all healthcare providers have joined the program yet. Some health systems have implemented their own secure messaging programs that allow patients to email their doctors free of charge. Others have not yet implemented any type of secure messaging system.

What should patients do?

If you are a patient in the United States, you should be prepared to be billed for emailing your doctor at any point in the future.  

There are a few things you can do to avoid being charged or reduce costs:

1. Check with your health system to see if they offer free or reduced-fee email services. Some health systems offer this service for free to a certain demographic of their patients, such as the elderly, those with disabilities, and veterans.

2. If your health system does not offer free or reduced-fee email services, and you cannot go in person for a consultation, consider using a different method of communication with your doctors, such as the telephone or regular mail.

3. If you must use email to communicate with your doctor, be sure to keep your messages brief and to the point. This will reduce the amount of time your doctor spends reading and responding to your messages and will help keep costs down.

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Website: https://drfarhaadriyaz.com/