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Cleveland Clinic to start billing patients' insurance for some MyChart messages

Starting Thursday, 'messages that involve a longer amount of your provider's time and medical expertise' will cost money. However, 'most' will still be free.

CLEVELAND — Cleveland Clinic's MyChart feature has been a game-changer in the digital age, allowing the hospital system's patients to make appointments, check medical records and billing, and do so many other things from the comfort of their computer or smartphone screens.

One notable aspect has been MyChart messaging, which lets patients speak with their health care providers about basic things like symptoms, medications, or just general check-ups. The Clinic says the number of these messages has doubled since 2019, likely due to the expansion of remote health care brought on by the COVID-19 pandemic.

Since their inception, all MyChart messages have been free to those who have signed up with their insurance. However, starting Nov. 17, that will change, as Cleveland Clinic has announced "some" messages will now be billed to patients' insurance.

"Our providers answer hundreds of MyChart messages each week," Clinic officials said in a statement. "Sometimes, they can quickly answer and get you the information you need. Other times, it requires time to look through your medical records and provide medical advice. Messages that involve a longer amount of your provider's time and medical expertise will be billed to your insurance."

So, just what kind of questions will now cost more? The hospital cited inquiries about the following as ones that "could" be billed:

  • Changes to your medications
  • New symptoms
  • Changes to a long-term condition
  • Check-ups on your long-term condition care
  • Requests to complete medical forms

However, Cleveland Clinic says "most" MyChart messages will still be free at no additional cost to patients or insurance. These include messages about:

  • Scheduling an appointment
  • Getting a prescription refill
  • Asking a question that leads to an appointment
  • Asking a question about an issue you saw your provider for in the last seven days
  • Checking in as a part of your follow-up care after a procedure
  • Giving a quick update to your provider

But for the ones that will be billed, just how much will it cost? The Clinic states that "most people" with Medicare will pay nothing out-of-pocket and those with secondary insurance will also owe nothing extra, although "some might have a small fee of $3 to $8." For those with private insurance, "most" providers will cover the messages "at little to no cost to the patient," but those with deductibles or plans that don't cover the messages could pay anywhere from $33 to $50.

Those with specific questions are asked to reach out to their insurance providers for more information. "Thank you for your partnership and patience as we make this change," Cleveland Clinic wrote.

The news from Cleveland Clinic took some patients by surprise. 

Cynthia Pullin told 3News she has been a patient at Cleveland Clinic since 2019 and relies on messaging through MyChart to compliment her care. "This has been a good way for me to ask them questions that I needed answers to. Yes, sometimes I have to wait a couple of days and that's been fine with me so far," she says.

Pullin adds that she has multiple medical conditions and is already faced with enough out-of-pocket costs. "Healthcare is out of control now, it's so hard to afford all the healthcare that you need and to have that added on is just ridiculous," she says. "It's very frustrating, it doesn't seem right to me."

3News reached out to Cleveland's two other major health systems on Monday to see if they had similar plans for their patient messaging services.

University Hospitals tells 3News that it is currently discussing "similar changes" depending on the physician's time required to complete a patient's request. For example, if a requests requires "more than a simple response, the message may be elevated to a billable encounter. Some examples may include detailed chart review, research regarding a specific issue, communication with other caregivers or additional questions or communication with the patient."

UH adds that this feature could take the place of a scheduled virtual or in-person appointment. "While a charge may apply, it is just one more option we are offering to keep our community well." The change to UH's patient messenger service is being considered for sometime next year.

Meanwhile, MetroHealth says at this time they are not planning to bill for patient messaging, "however, we always continue to evaluate."

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