More hospitals and insurers have started charging patients for virtual care services as they have grown in usage and providers are spending more time meeting patients in telehealth appointments and responding to their e-mails.

It’s extremely convenient for patients to be able to engage with their doctors by video visit, phone call or e-mail, but it’s resulted in physicians spending an inordinate amount of time on the steady communication.

Many hospital systems have started billing patients for e-mails they send to their physicians and, depending on the level of out-of-pocket expenses in their plan, they may pay just a few dollars for a copay or up $100 if they have a high deductible.

With these forms of communication growing in popularity, you will want to look at your health plans’ benefits summaries to see how much it will have to pay for these services.

The hospitals argue that physicians spend a significant amount of time responding to inquiries and it takes just as much time for them to conduct telemedicine and phone appointments as it does in-person visits.

A short five-minute session with a patient on a phone or video appointment will typically result in associated work, including reviewing the patient’s chart, updating notes and putting in orders for medications, tests or referrals.

The majority of doctor-patient messages are sent using encrypted portals to protect patient information under the Health Insurance Portability and Accountability Act. Doctors can communicate with patients using e-mail as long as they warn patients about using an unsecured channel.

Video visits are conducted in the same manner, using some type of portal that allows for two-way video communications.

Billing under insurance

Many of the country’s health insurers cover for hospitals for doctors’ e-mails and telehealth appointments. In turn, some insurers may charge patients a copay or they may have to pay for the service fully if they have a deductible they must first meet.

Charging for answering e-mails is especially controversial and some carriers worry about pushback, particularly if a patient has a follow-up question after an appointment.

It should be noted that not all patient-doctor e-mail communications carry fees, such as ones for prescription refills, scheduling appointments or follow-up care.

How it’s being billed

The amount that patients are being billed varies among hospital systems and insurers.

According to recent surveys, out-of-pocket telemedicine visits are an average of $30-75 nationally, with most visits at around $40-50. According to Becker’s Hospital Review:

• Medicare pays around $50 per televisit on average.
• Mayo Clinic charges up to $50 for some doctor messages.
• Humana’s health plan On Hand charges $0 to $5 per visit.
• Walmart offers its employees $4 telehealth appointments.
• SSM Health, a hospital system in St. Louis, charges $25.
• Summa Health, a hospital system in Akron, Ohio, charges $30.

The takeaway

Hospitals and providers are all charging different amounts for televisits, phone visits and their doctors sending e-mails. As well, insurers have different cost-sharing structures for their enrollees.

If you use telehealth services or message your doctor, it’s important that you understand what you will be paying out of pocket under your health plan for these services.