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Does Billing Patient Portal Messages as E-Visits Affect Patient Messaging Volume?

Jay Holmgren, Ph.D., MHI, et al, published “Association BetweenBilling Patient Portal Messages Billing Patient Portal Messages as e-Visits and Patient Messaging Volume” online, in JAMA, on January 6, 2023. The purpose of the study was to analyze the utilization of clinician-initiated e-visit billing which expanded following the onset of the COVID-19 pandemic. The researchers sought to better understand the level at which clinicians adopted the revised billing protocols as they related to patient messaging behavior.

According to the study, amid the pandemic, patient messaging escalated by more than 50%, resulting in a considerable amount of unpaid clinician time. Therefore, the Centers for Medicare & Medicaid Services expanded telemedicine billing options to include “e-visits,” defined as separately occurring patient portal messages, involving decision-making, and, at least 5 minutes of clinician time, within a 7-day time frame. After the expansion, clinical organizations started employing operational systems to bill qualifying patient messages as e-visits.

After analyzing clinician-initiated e-visit billing at a large academic medical center, the study found a correlation between the implementation of clinician-initiated billing and an increase in e-visits, although adoption was low. While this study had some limitations, the researchers suggest that future investigations should consider total costs within different payment models, the impact that billing for messaging has on outcomes, health equity, and patient and clinician satisfaction.


For more information:

Read the study on the JAMA website.

View a list of resources that may be helpful in managing medical billing related to Lyme disease treatment.