Billing patients for patient portal messages may have unintended consequences for both patients and physicians, a recent study found.
The study, published Oct. 15 in Annals of Internal Medicine, surveyed 13 patients and 16 primary care physicians from Cleveland Clinic. Patients had to have attended a primary care visit between June 2021 and April 2023 and have sent their provider a secure message.
"Based on our findings, health systems may want to review the advantages and disadvantages of similar policies before deciding on an appropriate implementation strategy," the study authors wrote.
Here are four things to know:
1. The analysis found patients called the office more frequently rather than use messaging to avoid being billed. Initially, patients said they viewed billing negatively, but said they understand that it could be abused by some patients.
2. Physicians said they hoped billing for messages would lead to a reduction in the number of messages received per day, but that they also wished systems would give them appropriate time to respond to messages.
3. Physicians said they were concerned that billing for messages could hinder open communication between patients and physicians.
4. Patients and physicians expressed concerns over how and when to bill for messages. Patients said they were not sure how long their message would take for a physician to answer, and physicians said they were confused about how to bill patients for messages, especially when multiple actions were required to answer it. Some physicians said they bill based on the medical decision making involved, as opposed to time to respond. Others said they received messages from patients asking not to be billed and were "cognizant of patients with difficult socioeconomic circumstances and would choose not to bill them."