• Posted April 7, 2025

Some Folks Hit With Fees for Using Health Care Message Portals

Don’t be surprised if you get a bill for that note your doctor sent you through his clinic’s patient portal.

About 1 in 7 patients have been billed for messages sent to them through a patient portal, according to a new study published April 4 in JAMA Health Forum.

“Even though we don’t know the exact dollar value of the charges these older adults paid, our findings raise questions about making sure out-of-pocket costs are not keeping vulnerable populations ... from using a potentially helpful technology,” lead author Dr. Terrence Liu, a primary care physician in the University of Michigan Department of Internal Medicine, said in a news release.

Today’s seniors can remember having to pick up the phone to ask a doctor a question, set up an appointment or ask for a prescription refill.

But these days such communications often take place through digital patient portals that most health systems and clinics now offer, researchers said.

More than 3 in 4 (76%) people 50 and older have at least one patient portal account, researchers found in a national survey of U.S. adults. Of them, two-thirds (65%) have sent a portal message in the past year.

And about 13% said they’ve had to fork over a co-pay or other charge for sending a message through a portal, results show.

That includes 17% of older adults with private insurance and 16% of low-income folks covered by Medicaid, researchers said.

“Portal messaging has become more common, and many patients find it useful, but we need to ensure that the cost-sharing for patients is appropriate and matches the value they get out of using portal messaging,” Liu said.

In general, insurance allows health care providers to bill if their reply takes five or more minutes to craft, researchers said.

This billing is part of the telehealth support that went into effect during the pandemic and was recently extended by Congress, researchers noted.

“As policymakers consider the long-term future of the telehealth rules that made it possible for providers to bill for patient portal messaging, we hope our findings inform policy that considers the needs of financially vulnerable populations,” Liu said.

More information

The National Institutes of Health has more on patient portals.

SOURCE: University of Michigan, news release, April 4, 2025