Messaging your healthcare provider can be a convenient way to get medical advice. You can create a message through your secure patient portal and your provider will typically reply within one to three business days. Depending on your needs and schedule, this can be a great alternative to an in-person or video visit.
Most messages are free, but starting January 1, 2023, if a response requires medical expertise and more than a few minutes of your health care provider’s time, it may be billed to your insurance. See the “What Counts” sections below for examples of what might be billed and what won’t.
Even if a message is billed to insurance, some patients won’t have to pay anything. For those who do, out-of-pocket expenses for this type of care vary by insurance plan and are often low. Here’s what to expect:
What counts as medical advice messaging?
If your physician or nurse practitioner need to make a clinical assessment or medical decision, order a test or medication, or review your medical history in order to respond to your message – or if it takes more than a few minutes to respond – the provider may bill the message exchange to your insurance. Thankfully, insurance companies recognize that virtual care is a valid and important way for patients to obtain medical advice.
Examples of messages that may be billed to insurance:
- A new issue or symptom requiring medical assessment or referral
- Adjusting medications
- Chronic disease check-in
- Flare-up or change in chronic condition
- Request to complete a form
What does not count as medical advice messaging?
If your message does not require clinical evaluation, nor medical advice from the physician or nurse practitioner – or if it can be answered quickly and easily – it won’t cost you anything.
Examples of messages that won’t be billed to insurance:
- Request for a prescription refill
- Request to schedule an appointment
- Message that leads your provider to recommend a visit
- Follow-up care related to a recent surgery (within the past 90 days) – with exceptions for some surgeries
- Update for your doctor when no response is needed
- Message that takes only a few minutes to answer
Why are some portal messages billed to insurance?
Messaging health care providers has become a popular way to seek medical advice, especially with the pandemic spurring demand for virtual health care options. Thankfully, insurance companies recognize that virtual care is a valid and important way for patients to get medical advice. They now cover all of the following:
- In-person visits
- Video visits
- Telephone visits
- Medical advice messaging (through your secure patient portal)
While the majority of messages sent through your secure patient portal are handled quickly and never billed to insurance, those that require time and expertise are a form of virtual care – and it makes sense to treat them as such, alongside other types of care.
We’re pleased to offer you all of these choices for getting medical care from Golden Gate OBGYN, and we’ll continue to do everything we can to provide our patients with timely, top-tier care.
To log into your unique patient portal, please click here.
