MyCare Changes to Billing for Messages
With MyCare Messaging, you can securely message your provider anytime, anywhere. Whether you have questions or need prescription refills, our user-friendly patient portal puts the power of healthcare communication at your fingertips.
Over the last several years, there has been a significant increase in the popularity of messaging healthcare providers to seek medical advice. While most messages sent through MyCare are free, and can be answered quickly and easily, there are some that that require more of a providers clinical time or expertise. For patients 18 and older, these messages may now be billed to your insurance.
Why are medical advice messages via MyCare being billed to insurance?
Insurance companies now recognize certain MyCare medical advice messages as billable services as virtual options have become a standard part of health care.
Additionally, our providers receive millions of messages each year, with many being new medical concerns and/or complex questions and would be better handled through a visit (virtual or in-person) so that we can provide the care our patients expect and deserve. We want to make sure our clinicians have the time they need to review and respond appropriately to your concerns, just as they would with an in-person or video visit.
What messages will NOT be billed?
If the message DOES NOT require your provider or a member of the care team to make a clinical assessment or medical decision in order to respond to your message, you will not be billed for the message exchange.
Examples include:
- Request for a prescription refill
- Message that leads to your provider recommending an appointment
- Asking a question about an issue you saw your provider for in the last seven days.
- Follow-up care related to a recent surgery (within the past 90 days) – with exceptions for some surgeries
- Updating your provider when no response is required
What messages can be billed?
If the message requires your provider or a member of the care team to make a clinical assessment or medical decision in order to respond to your message – or if it takes more than a few minutes for them to respond, typically five minutes or more – the provider may bill your insurance.
Examples include:
- A new symptom or medical concern
- Changes to your medication(s)
- Changes or question related to a chronic condition
- Request to complete a form
Instead, you may want to consider:
What to expect if your message is billed to insurance
Most messages will remain free. However, your provider will determine whether a message exchange should be billed to insurance based on the criteria outlined above. Patients will be notified through MyCare of a potential charge prior to sending the message, and must consent to billing first.
If a message is billed to insurance, it is important to note that different insurance plans cover different things. Here are a few examples of what you can expect:
| Insurance Plan | Cost of Insurance-Billable Charges for MyCare Messages |
| Medicare | There’s no out-of-pocket cost for most people. Some might have a small fee of $3 to $8. If you’re a Medicare patient with secondary insurance, you’ll owe $0. |
| Private Insurance | Some patients will have co-payments similar to those for in-person or video visits. If a deductible applies, the full amount will be charged. |
Reach out to your insurance provider to learn the specific out-of-pocket costs for your plan.
Rochester Regional Health offers financial assistance for our uninsured and our insured patients who need help paying deductibles, copays, and/or coinsurance amounts. If you'd like to talk with us about financial assistance options, please get in touch with the Billing Customer Service Department at (585) 922-1900. You can also view our Financial Assistance for more information.
How to message your healthcare provider
Getting in touch with your provider or care team is easy through MyCare. You can log in to MyCare in a web browser and start a conversation from your Communication Center or open the MyCare app and select "Messages." From there, follow the prompts.
When selecting a recipient, you'll see a list of providers available for you to message (the providers for whom you're currently a patient).
Sign up for MyCare
If you aren't currently signed up for MyCare, you can set up your MyCare account with your information and a personal activation code that you may have already received.
If you haven't been given a personalized code you can request one, and then continue with creating your account.