As early as 2022, healthcare systems in the United States started charging for certain MyChart messages. Legal nurse consultant Cambria Nwosu warns that this phenomenon may be on the rise.
Nwosu posted a TikTok this month in which she breaks down the growth of these policies across the country.
“MyChart is a software platform many healthcare organizations utilize to communicate with their patients,” she says.
Nwosu says Multicare in Tacoma, Washington recently joined the growing list of healthcare systems which charge for certain MyChart messages.
The company is “aiming to manage the increasing volume of patient communications,” she says.
As of July 1 of this year, Multicare charges for MyChart messages that require more than five minutes of clinical time and medical expertise to address, according to the company’s website.
For these messages, Medicaid patients pay nothing and Medicare patients pay $3 to $7. The out-of-pocket cost is $35.
Some of the people who commented on Nwosu’s TikTok expressed concerns with these costs.
“$35 for uninsured seems excessive,” one viewer wrote.
“$35 is more than my copay for a visit,” another said. “Ridiculous!”
The Multicare website says “most private insurance carriers cover this at little to no cost to patients.”
In her TikTok, Nwosu lists several U.S. healthcare organizations who have similar policies to Multicare. The list includes the Cleveland Clinic, which first implemented this practice in 2022.
As of March this year, at least 22 hospitals have started charging for some patient MyChart messages, according to STAT.
“If you are receiving healthcare in the United States, you are utilizing MyChart or some other form of direct messaging to contact your physicians,” Nwosu says in her video. “Pay attention, especially that this billing inquiry is now starting to come.”
Viewers split on MyChart charges
Some viewers commented in support of these policy changes.
“Answering patient messages takes up a significant amount of time,” another said. “Reimbursem*nt is appropriate.”
“If y’all had any idea of the sheer volume of MyChart messages we get every single day,” another wrote. “If the questions are simple, no worries. When the messages are sent to avoid an office visit? Charge away.”
“Healthcare is the only service that people EXPECT to get service for free,” one viewer commented. “The demand for free services is insane.”
On the other hand, many commenters shared their issues with charging for MyChart messages.
“I pay for insurance which means I can barely afford to go to the doctor,” one viewer said. “Now they want to charge me for a damn email? Ridiculous.”
“People with money won’t care about the cost,” another said. “People who don’t have much money again will be disadvantaged.”
“This is going to disproportionately harm the poor and underinsured,” another commented. “Hard to see how it squares with an equity driven approach to patient care.”
Others said they miss phone calls being the standard communication among doctor’s offices.
“You used to be able to speak to someone when you called and now you can’t,” one viewer said. “You get a call center to take a message. This is so outrageous. Mine has already implemented this.”
“I mean if they answered the phone I wouldn’t have to message,” one viewer wrote.
“We were forced into using MyChart so they could track responses,” another said. “Now they want to bill us?”
“So we’ve replaced calling a doctor for free to being billed for a text message?” another asked.
Unintended consequences
Some healthcare professionals shared the potential effects of these policies.
“That is going to be extremely difficult to track,” one viewer said. “Because sometimes the provider doesn’t even answer the RN does.”
“This is going to clog up the phones so much,” another wrote.
“As an ER nurse, this makes me wonder if more ppl will just over-utilize the ER for non emergent things,” another commented.
Other viewers shared alternative options.
“As a provider would prefer a limit on messages directed to providers monthly,” one viewer said. “Some patients truly abuse it but most patients use it appropriately, with the exception of those who expect a response in an hour.”
@cjnlegalnurse This will most likely be a national standard for billing…what aee your thoughts? #fypシ゚viral #nursing #medicine #billing #consulting #epic ♬ original sound – Cambria Nwosu, DNP, RN, LNC
“Maybe we should actually have universal healthcare already,” another wrote.
Nwosu did not immediately respond to the Daily Dot’s request for comment.
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