Medical Advice Messaging
Important Changes to Messaging for Medical Advice
MyChart messaging is a tool for simple, non-urgent messages about existing health problems.
As healthcare providers, we understand that communication between patients and their care teams is essential for high-quality medical care. One of the many ways to connect with UR Medicine providers is through MyChart messaging, which was designed for simple, non-urgent messages about existing problems.
Our providers now receive more than two million MyChart messages each year. Many of these messages are complex and would be better handled through an office or telemedicine visit so that we can provide the care our patients expect and deserve. That’s why we’re clarifying our standards for MyChart messaging.
Patients can still use MyChart messaging for follow-up questions from a recent visit and simple questions about existing problems like scheduling appointments and medication refills. However, starting July 17, 2023, we’re asking patients to use office or telemedicine visits to get a medical diagnosis or treatment for new problems and complex issues. MyChart is also an option, but if your message is about a new health concern, or a change in your condition that requires your provider to spend five minutes or more of their time and their medical expertise, it may be billed to insurance as a "medical advice message". Copays and deductibles may apply.
Why is UR Medicine Making This Change?
The original intent of MyChart messaging was to provide patients and any proxies or stand-ins with a simple tool for communicating non-urgent messages about existing problems. Over the past decade, healthcare systems across the nation have seen a dramatic increase both in the number of messages sent to our providers and the level of complexity of the messages.
By billing for medical advice messages, we are following other systems across the country in refocusing MyChart messages to be used as originally intended – for non-urgent, simple messages about existing problems. We will bill for complex messages that require your provider’s medical expertise and take more than five minutes of their time.
In similar health systems nationwide, 1-3% of messages were billed as Medical Advice Messages. Most messages will continue to not be billed.
Messaging your doctor can be a convenient way to get medical care and advice. We also have other options like On-Demand Video Visits, which are a great alternative to in-person or telephone visits.
How Much Will I Be Charged for MyChart Messaging?
Based on what we’ve seen in similar health systems rolling out similar programs across the country, the number of MyChart message responses that are billed to insurance is low – in most cases, less than 3% of responses were billed.
If a message response requires the medical expertise of your provider and more than a few minutes of their time, they will determine whether the message exchange should be billed to insurance.
If the message is billed to your insurance, you will receive a message back from your doctor along with a response to your question letting you know it will be billed. Even if a message is billed to insurance, many patients won’t have to pay an out-of-pocket cost. For those who do, these costs can vary by insurance plan.
Here are common ranges of costs:
|Insurance Type||Patient Out-of-Pocket Cost|
|Medicare Advantage||Average: $6|
|Commercial Insurers||Copay average: $24|
If deductible, average: $45
What if I Don’t Have Insurance or the Money to Pay the Copay?
UR Medicine provides financial help to patients receiving care who qualify for assistance pursuant to our Financial Assistance Policy. This assistance is available to insured and uninsured patients based on income and personal circumstances.
Learn more about your financial assistance options and contact our team.
What Types of Messages Will Be Billed as Medical Advice Messages?
Providers can bill your insurance for complex messages that require medical expertise or more than five minutes of their time. Examples of message responses that may be billed to your insurance include:
- Reviewing medical records
- Providing a diagnosis
- Assessing a new issue or symptom
- Adjusting medications
- Chronic disease check-ins or changes in a chronic condition
- Changing a treatment plan
- Referring to services, testing or imaging
- Other complex medical advice
Financial assistance is available.
What Types of Messages Are Not Billable?
We expect that most messages we receive and respond to WILL NOT be billed to insurance. Health systems across the country that have launched similar programs have found that less than 3% of messages are billed.
Messages that we receive most often and will continue to not be billed, include:
- Scheduling appointments
- Requesting prescription refills
- Asking about an issue you saw your provider for in the last seven days, including in-person and virtual video visits
- Giving a quick update about your health to your provider
- Questions about most lab and imaging results that do not change your treatment plan
- Messages that only take a few minutes to answer
- Interactions with your Psychiatrist, Psychologist or other mental health providers
Again, these types of message responses will not be billed to insurance.
Frequently Asked Questions
July 17, 2023
MyChart messaging is great for simple questions about your care. However, over the past decade, we have seen a dramatic increase both in the number of messages sent to our providers and the level of complexity of the messages.
By billing patient insurance for complex messages that take provider time and medical expertise, we hope to reset the types of questions patients send via MyChart and ensure that our providers have the appropriate time to spend on their response. Quick questions like appointment scheduling, prescription refills and health updates will continue to not be billed.
Message responses that require the medical expertise and more than five minutes of your provider’s time will be billed as medical advice messages.
Medical expertise means that your provider is using their medical training and decision-making to respond and make a recommendation, change to your treatment plan or referral to a new specialist or service.
During the 5+ minutes that your provider is reviewing and responding to your message, they may:
- Open and review your medical record
- Check your current medications and make adjustments
- Review your specialty providers and appointments
- Provide recommendations, a diagnosis or changes to your care plan
Only new, complex messages that take your provider’s time and medical expertise to respond to, including detailed reviews of your medical record, adjustments to your treatment plan or referrals to additional services, may be billed.
If the message is about the same topic within 7 days, there will not be additional billing.
UR Medicine providers will not bill your insurance for their response if it is answered over 3 business days after you sent the message.
We are using a variety of notification methods to alert patients about this new process. All notifications will include a link to our website with information about billing practices. The notifications include:
- A patient’s MyChart landing page will have a prominent box that explains the new change.
- Patients will receive an automated message in the MyChart Message box, alerting them of our new approach.
- Patients should receive a message from their provider if a response to their message required more than five minutes of the provider’s time and expertise, resulting in a possible charge to their insurance.
Providers will review each MyChart message they receive and determine whether their response requires medical expertise and more than 5 minutes to respond. In their response to your message, they will inform you if that response resulted in a bill being sent to your insurance.
We believe most MyChart messages will NOT be billed to our patients, as similar health systems have launched with this same approach have found that less than 3% of message responses are billed to patients’ insurance.
For those message responses that are billed to patient insurance, most patients will be charged to their typical copay or deductible. The charge is typically lower than in-person and virtual video visits.
Our intention is not to reduce our patients’ communication with their providers but rather to ensure providers can spend appropriate time reviewing and responding to complex messages and are compensated for the care they provide.
We will be closely monitoring the types of messages that are billed and will be adjusting our policies if we detect any trends that show inequities or barriers to care.
For billing questions, contact the UR Medicine billing departments:
For Strong Memorial Hospital, Highland Hospital, & Professional Bills
General: (585) 758-7650 or 1-888-925-4301
Financial Counseling/Case Management: (585) 275-2273
8:00 a.m. to 5:00 p.m.
For Jones Memorial Hospital, Noyes Health, St. James Hospital, and Thompson Health
(585) 396-6515 or toll free 1-833-978-8325
8:00 a.m. to 4:30 p.m.
Eastman Institute for Oral Health
(585) 275-5051, option 5
8:30 a.m. to 5:00 p.m.
Messaging providers has become a popular way to seek medical advice, especially with the recent demand for virtual health care options. As a result, in addition to covering in-person visits, insurance companies now cover:
- Video visits, including On-Demand Video Visits
- Telephone visits
- Medical advice messaging (through MyChart)