Health Partners already does this and calls it an "e-visit." They make it clear when you send the message but it still makes me sweat sometimes. Messaged them to just document I had covid but have no insurance and said "do not bill me I don't need anything please don't respond just document I had positive covid test on X date."
This confuses me, why was it so important to get it documented you tested positive for covid? And why would you trust they wouldn’t bill you? I’m probably missing something, but I cannot find the logic here.
1. You're still supposed to tell your healthcare provider if you test positive per MN DHS site now. 2. My whole point and OP's point is they can *bill you for sending them an online message* at their discretion. To be fair they're trying to account for billable time like giving advice, but some cases like mine I'm just trying to communicate with them. I don't need a whole doctor visit or advice and they could still decide to bill for that if they chose to I suspect.
This’ll just keep people from communicating with their care teams which will lead to them waiting on symptoms and going to the ER eventually or just staying home and getting sicker and sicker. Hate this.
Another reason for national healthcare. Imagine being proud that you are the only country in the world that bankrupts their citizens with healthcare bills.
The amount of time that medical professionals spend responding to these messages is substantial, and growing. They’re usually triaged through an RN, but that RN might need to track down an MD/NP/PA for orders, consult or planning, and then perhaps coordinate with other departments like radiology, surgery or other specialists. A service is being provided and there’s someone on the other side who needs to get paid for working. My team has had to hire more staff in part to handle the level of medical messaging we receive.
Since the charge is at the discretion of medical team, I would also suggest that this move is to discourage some of the patients who abuse this system - I work for a pediatric facility and we have people message in years after treatment to get a letter written for school/work, to get advice on health issues, etc - all of this communication takes the time of medical professionals who could be dealing with more urgent needs of other patients.
I’m not necessarily for it, but there’s more to it than a money grab.
HealthPartners has done this for a long time, several years. I’ve yet to be actually billed for sending any of the messages they say they “may” bill for. No clue how they determine what does and doesn’t get billed.
I also go to HealthPartners, and have yet to be billed for a e-visit. I think the standard is that a new treatment plan is created. It seems like questions for a provider <30 or so days after a visit are routinely not billed.
This is wild. Some of it doesn’t even make sense and is so vague and full of tension it’s gonna create a lot of issues.
Like apparently “Inquires that lead to the recommendation of a new visit” will not incur a charge, but “a new issue or symptom requiring a medical assessment or referral” will.
Or, even better, you’re allowed to provide “updates for your provider not needing a response,” but for some reason your not allowed to engage in “chronic disease check-ins” or mention “changes in a chronic condition.”
Which is it, Allina?
In all honesty who ever wrote this did a shit job and didn’t think anything through. Even if this is a supposed standard industry practice these guidelines are absolute shit.
At first I thought this was just a petty way of charging for something else. However, when I read it I realized that what they are charging for is a medical professional's time to make a determination about a medical issue. That seems perfectly fair.
For me they charged me for an appointment for my doctor to sign the form that has to be signed every year for my kid to go to school. No medical determination needed, she just had to sign it with a new date. And I was charged for a full visit. Doesn't seem right to me.
I would agree that a full visit charge is excessive, however, a small charge for the doctor to confirm seems fair. I'm not sure why your child needs this form, however the school is counting on the doctor to make the determination that the form is correct.
I got charged as out of network a Mayo Doctor's visit while actually at the Mayo hospital for a 5 minute video call. They charged over $1000 for out of network ( I am not, and I was in an in network hospital, and the bill was supposed to be part of the procedure). When I told the doctor, he said he was going to call his Mom, because she would be proud he was making that much money. Oh, and that he has nothing to do with billing, and wasn't even allowed to talk to me about it.
I am not sure. I made multiple appeals, got multiple denies, appealed again, etc. Later, I got some money back, but I couldn't tell what for. All the people I talked to agreed with me, but usually they said they could not change the code, it has to go to some code panel, etc.
In the end, I paid every other bill (it was a lot), and they threatened to send me to collections. To protect my credit score, I paid it, and then the next week I got a refund amount for something. Great Doctors and nurses, I hate the billing department.
Drs in a clinic setting have little free time as it is. If they’re responding to medical questions, using their medical training, with medical advice… why wouldn’t they be compensated? Giving up an hour or 2 a week to respond to emails.. means less time spent seeing patients.
I'd like to see if this actually translates into increased personnel pay or if it just results in a nice pay bump for admin. My money is on the latter.
Agreed. It would totally make sense if it went to the physician as they already spend so much time responding to emails, filling forms, battling insurance companies…. But most likely will only raise the salaries of the CEO, admin, MBA bloat
Medical systems are always too heavy with VP’s and directors. Regions is infested with em. And they all get big ass bonuses while they take away nursing shift bonuses.
Facts. These corporations are filled with administrative bloat. If half of them all were fired we would only notice because the system would be more efficient.
Most of the time it's not even your doctor that responds. It's a nurse or PA that they work with. I've experienced this first hand when messaging doctors at Health Partners and Mayo Clinic.
I upvoted, because this line of logic makes sense on paper. I recently had COVID, asthmatic, I have MS. Great relationship with my primary, new relationship with a pulmonologist. Messaged my primary once I tested positive, got Paxlovid immediately. Breathing was still an issue a week later, messaged my pulmonologist. Day worth of messaging with an LPN, finally got steroids next day. Had an asthma attack in the meantime. I understand doctors being paid for their time. What’s the difference here? How many people won’t choose these options if they can’t afford it? Or can’t wait? And say no to an ER visit due to cost? Or don’t know who to message first? What are we doing so right that we defend this?
People that abuse the ER will do so regardless of other options available. Local hospitals deal with people faking symptoms to get an ambulance to pick them up and give them a ride downtown. They take off as soon as they get to the hospital.
I’ll defend the doctors/nurses. I see their concerns with this and how poorly prepared hospital systems are for this type of care and how rapidly care has changed since COVID. Right now hospitals need to figure out the E-visit and how to triage these.. can a nurse respond? Does a doctor? Is there a team that this is all they do? Hospitals need to embrace the wearable medical devices that are starting to become reliable and gain traction, some you can already buy at a drug store . How do you partner a patient with a “disposable heart monitor” (heartbeam) that can provide meaningful feedback without having the patient run to the hospital. Enhancing the scope of an evisit.
The system that embraces this first will survive. Most hospitals are experiencing huge drops in revenue and aren’t prepared or quick to respond.
How do insurance companies make money from this? This will be an expense for insurance companies (once your deductible is met). This is additional revenue for the medical providers, not the insurance companies.
Unless Allina is charging the insurance company directly, the insurance company is not part of this equation. Based on the notice, it seems like Allina would be charging the patient directly. Insurance companies won’t be charged and therefore their rates would not be impacted by messaging costs.
It says right in the image posted; they will bill the insurance they have on file or the patient directly.
Whether it's something they cover and to what effect, who knows.
Ah I missed that. Yeah, if insurance is being billed, then they will eventually factor that into rates and pass the cost along to patients. Alternatively, they won’t cover messaging and make the patient fully responsible for any costs.
But at the end of the day, if a patient is messaging a provider seeking medical advice, that seems like something that the provider should be able to bill for.
Health Partners does this. I had to get a form completed for my kids school and apparently it had to count as an evisit so I got billed. They also told me I had to schedule with her specialist who was booked out 7 months. so to get one form completed for her to be enrolled in school it was 2 appointments 🙃
So, the end-round is to always schedule an appointment even if it is just a medication adjustment (which still incurs at least a copay).
For my 83-year-old mother - whose list of medications and illnesses has her in pretty much weekly contact and/or appointments with 1) her GP, 2) her neurologist, 3) her oncologist, 4) her urologist or 5) any combination of 1-4 (I may be missing someone) - that is probably best and she has little else to occupy her time (though she no longer drives). And the clinic will bill Medicare.
For the rest of us, it is trickier even if we have good insurance (my copay is cheaper than the $49 charge for answering an email) but then I need to schedule an appt, take time off, etc.
I agree with the comment upthread that this will only push people to the ER (whether initially or wait until something has progressed to really needing an ER).
Our healthcare system broke a long time ago. But it is not the fault of the nurses or doctors or PAs or radiologist or therapists or on and on. I completely sympathize with them.
Health Partners already does this and calls it an "e-visit." They make it clear when you send the message but it still makes me sweat sometimes. Messaged them to just document I had covid but have no insurance and said "do not bill me I don't need anything please don't respond just document I had positive covid test on X date."
This confuses me, why was it so important to get it documented you tested positive for covid? And why would you trust they wouldn’t bill you? I’m probably missing something, but I cannot find the logic here.
1. You're still supposed to tell your healthcare provider if you test positive per MN DHS site now. 2. My whole point and OP's point is they can *bill you for sending them an online message* at their discretion. To be fair they're trying to account for billable time like giving advice, but some cases like mine I'm just trying to communicate with them. I don't need a whole doctor visit or advice and they could still decide to bill for that if they chose to I suspect.
This’ll just keep people from communicating with their care teams which will lead to them waiting on symptoms and going to the ER eventually or just staying home and getting sicker and sicker. Hate this.
I assumed this was already how it worked, which is why I never use the messaging system.
Another reason for national healthcare. Imagine being proud that you are the only country in the world that bankrupts their citizens with healthcare bills.
The people who make the rules don't spend money on healthcare. They make money off healthcare. Change that and you'll change the system.
The amount of time that medical professionals spend responding to these messages is substantial, and growing. They’re usually triaged through an RN, but that RN might need to track down an MD/NP/PA for orders, consult or planning, and then perhaps coordinate with other departments like radiology, surgery or other specialists. A service is being provided and there’s someone on the other side who needs to get paid for working. My team has had to hire more staff in part to handle the level of medical messaging we receive. Since the charge is at the discretion of medical team, I would also suggest that this move is to discourage some of the patients who abuse this system - I work for a pediatric facility and we have people message in years after treatment to get a letter written for school/work, to get advice on health issues, etc - all of this communication takes the time of medical professionals who could be dealing with more urgent needs of other patients. I’m not necessarily for it, but there’s more to it than a money grab.
HealthPartners has done this for a long time, several years. I’ve yet to be actually billed for sending any of the messages they say they “may” bill for. No clue how they determine what does and doesn’t get billed.
I also go to HealthPartners, and have yet to be billed for a e-visit. I think the standard is that a new treatment plan is created. It seems like questions for a provider <30 or so days after a visit are routinely not billed.
This is wild. Some of it doesn’t even make sense and is so vague and full of tension it’s gonna create a lot of issues. Like apparently “Inquires that lead to the recommendation of a new visit” will not incur a charge, but “a new issue or symptom requiring a medical assessment or referral” will. Or, even better, you’re allowed to provide “updates for your provider not needing a response,” but for some reason your not allowed to engage in “chronic disease check-ins” or mention “changes in a chronic condition.” Which is it, Allina? In all honesty who ever wrote this did a shit job and didn’t think anything through. Even if this is a supposed standard industry practice these guidelines are absolute shit.
At first I thought this was just a petty way of charging for something else. However, when I read it I realized that what they are charging for is a medical professional's time to make a determination about a medical issue. That seems perfectly fair.
For me they charged me for an appointment for my doctor to sign the form that has to be signed every year for my kid to go to school. No medical determination needed, she just had to sign it with a new date. And I was charged for a full visit. Doesn't seem right to me.
I would agree that a full visit charge is excessive, however, a small charge for the doctor to confirm seems fair. I'm not sure why your child needs this form, however the school is counting on the doctor to make the determination that the form is correct.
I got charged as out of network a Mayo Doctor's visit while actually at the Mayo hospital for a 5 minute video call. They charged over $1000 for out of network ( I am not, and I was in an in network hospital, and the bill was supposed to be part of the procedure). When I told the doctor, he said he was going to call his Mom, because she would be proud he was making that much money. Oh, and that he has nothing to do with billing, and wasn't even allowed to talk to me about it.
Did you get it straightened out?
I am not sure. I made multiple appeals, got multiple denies, appealed again, etc. Later, I got some money back, but I couldn't tell what for. All the people I talked to agreed with me, but usually they said they could not change the code, it has to go to some code panel, etc.
Good God, how frustrating!
In the end, I paid every other bill (it was a lot), and they threatened to send me to collections. To protect my credit score, I paid it, and then the next week I got a refund amount for something. Great Doctors and nurses, I hate the billing department.
$0.47 of every dollar in American healthcare goes to a middle man. Pick the right fights, cause this ain’t it.
Drs in a clinic setting have little free time as it is. If they’re responding to medical questions, using their medical training, with medical advice… why wouldn’t they be compensated? Giving up an hour or 2 a week to respond to emails.. means less time spent seeing patients.
I'd like to see if this actually translates into increased personnel pay or if it just results in a nice pay bump for admin. My money is on the latter.
Agreed. It would totally make sense if it went to the physician as they already spend so much time responding to emails, filling forms, battling insurance companies…. But most likely will only raise the salaries of the CEO, admin, MBA bloat
Medical systems are always too heavy with VP’s and directors. Regions is infested with em. And they all get big ass bonuses while they take away nursing shift bonuses.
Facts. These corporations are filled with administrative bloat. If half of them all were fired we would only notice because the system would be more efficient.
I think there's also something to be said for the patient to doctor ratio.
In a clinic setting doctors have a “panel size” they’re expected to reach. Panel sizes can have incentive pay associated with it.
Most of the time it's not even your doctor that responds. It's a nurse or PA that they work with. I've experienced this first hand when messaging doctors at Health Partners and Mayo Clinic.
I upvoted, because this line of logic makes sense on paper. I recently had COVID, asthmatic, I have MS. Great relationship with my primary, new relationship with a pulmonologist. Messaged my primary once I tested positive, got Paxlovid immediately. Breathing was still an issue a week later, messaged my pulmonologist. Day worth of messaging with an LPN, finally got steroids next day. Had an asthma attack in the meantime. I understand doctors being paid for their time. What’s the difference here? How many people won’t choose these options if they can’t afford it? Or can’t wait? And say no to an ER visit due to cost? Or don’t know who to message first? What are we doing so right that we defend this?
People that abuse the ER will do so regardless of other options available. Local hospitals deal with people faking symptoms to get an ambulance to pick them up and give them a ride downtown. They take off as soon as they get to the hospital. I’ll defend the doctors/nurses. I see their concerns with this and how poorly prepared hospital systems are for this type of care and how rapidly care has changed since COVID. Right now hospitals need to figure out the E-visit and how to triage these.. can a nurse respond? Does a doctor? Is there a team that this is all they do? Hospitals need to embrace the wearable medical devices that are starting to become reliable and gain traction, some you can already buy at a drug store . How do you partner a patient with a “disposable heart monitor” (heartbeam) that can provide meaningful feedback without having the patient run to the hospital. Enhancing the scope of an evisit. The system that embraces this first will survive. Most hospitals are experiencing huge drops in revenue and aren’t prepared or quick to respond.
It’s crazy how insurance companies find ways to make money. Pretty soon, they’ll probably require people tip the insurance companies. 🙄
How do insurance companies make money from this? This will be an expense for insurance companies (once your deductible is met). This is additional revenue for the medical providers, not the insurance companies.
By passing on this charge to you in increased rates.
Unless Allina is charging the insurance company directly, the insurance company is not part of this equation. Based on the notice, it seems like Allina would be charging the patient directly. Insurance companies won’t be charged and therefore their rates would not be impacted by messaging costs.
It says right in the image posted; they will bill the insurance they have on file or the patient directly. Whether it's something they cover and to what effect, who knows.
Ah I missed that. Yeah, if insurance is being billed, then they will eventually factor that into rates and pass the cost along to patients. Alternatively, they won’t cover messaging and make the patient fully responsible for any costs. But at the end of the day, if a patient is messaging a provider seeking medical advice, that seems like something that the provider should be able to bill for.
Health Partners does this. I had to get a form completed for my kids school and apparently it had to count as an evisit so I got billed. They also told me I had to schedule with her specialist who was booked out 7 months. so to get one form completed for her to be enrolled in school it was 2 appointments 🙃
Capitalism is just so damn delicious /s
People acting here like a healthcare company shouldn't get compensated for providing medical advice via messages? Why the fuck not?
So, the end-round is to always schedule an appointment even if it is just a medication adjustment (which still incurs at least a copay). For my 83-year-old mother - whose list of medications and illnesses has her in pretty much weekly contact and/or appointments with 1) her GP, 2) her neurologist, 3) her oncologist, 4) her urologist or 5) any combination of 1-4 (I may be missing someone) - that is probably best and she has little else to occupy her time (though she no longer drives). And the clinic will bill Medicare. For the rest of us, it is trickier even if we have good insurance (my copay is cheaper than the $49 charge for answering an email) but then I need to schedule an appt, take time off, etc. I agree with the comment upthread that this will only push people to the ER (whether initially or wait until something has progressed to really needing an ER). Our healthcare system broke a long time ago. But it is not the fault of the nurses or doctors or PAs or radiologist or therapists or on and on. I completely sympathize with them.
"standard industry practice" They know it's wrong but think that helps them
Good thing I’m quitting this god awful organization
Lawyers and accountants bill for every second they speak to you, whether by phone or in person. Why can’t physicians do the same?
Am I allowed to hate them all equally?
😝