Medical Care Through MyChart: Frequently Asked Questions

Send­ing your physi­cian or care provider a mes­sage may be a con­ve­nient way for you to receive med­ical advice or treat­ment. Patients who use our Duly Health and Care appli­ca­tion can send a mes­sage to a provider they have seen and will typ­i­cal­ly receive a reply in 1 – 3 busi­ness days. For some patients, this may be a quick and easy alter­na­tive to an in-per­­son or video visit.

What is the cost of med­ical care through MyChart messages?

Start­ing on Feb­ru­ary 20, 2024, if a response requires med­ical exper­tise and more than five min­utes of your physi­cian or care provider’s time, it may be billed to your insur­ance and the appro­pri­ate cost share will apply.

What mes­sages will be billed to my insurance?

If your physi­cian, nurse prac­ti­tion­er, physi­cian assis­tant or oth­er care provider is mak­ing a clin­i­cal assess­ment or med­ical deci­sion, order­ing a test, chang­ing med­ica­tion, or review­ing your med­ical his­to­ry to respond to your mes­sage – or it takes more than five min­utes to respond – the care provider may bill for the exchange.
Exam­ples of mes­sages that may be billed:

• A new issue or symp­tom requir­ing med­ical assess­ment or referral
• Adjust­ing or chang­ing medications
• Chron­ic dis­ease check-in
• Flare up or change in chron­ic condition
• Request to com­plete a med­ical form
• Exten­sive time review­ing your med­ical history

What mes­sages will not be billed to my insurance?

If your mes­sage does not require clin­i­cal eval­u­a­tion or med­ical advice from a physi­cian, nurse prac­ti­tion­er, physi­cian assis­tant or oth­er care provider, or if it can be answered quick­ly, you will not be charged for it.
Exam­ples of mes­sages that will not be billed:

• Mes­sages with­in 7 days of an appointment
• Request for a pre­scrip­tion refill
• Request to sched­ule an appointment
• Mes­sage that leads to your provider rec­om­mend­ing an appoint­ment (in per­son or video visit)
• Fol­low up care relat­ed to a recent surgery (with­in the past 90 days) – with excep­tions for some surgeries
• Update for your provider when no response is needed
• Mes­sage that only takes a few min­utes to answer

Why are you billing insurance/​patients for some messages?

E‑Visits have become a pop­u­lar way to seek med­ical advice. The pan­dem­ic has led to an increase in demand for vir­tu­al health options. Insur­ance com­pa­nies have rec­og­nized this and rec­og­nize vir­tu­al care as an impor­tant way for patients to receive med­ical advice. Most insur­ance com­pa­nies and Medicare now cover:

• In per­son visits
• Video vis­its
• Tele­phone visits
• Med­ical advice mes­sag­ing (through MyChart)

While the major­i­ty of mes­sages sent through MyChart are han­dled quick­ly by our physi­cians, care providers and staff and nev­er billed to insur­ance, those that require time and exper­tise meet the def­i­n­i­tion of vir­tu­al care and it makes sense to treat them as such.

The South Bend Clin­ic is com­mit­ted to pro­vid­ing our patients with excep­tion­al care, when and where it is needed.