Important Changes to Messaging for Medical Advice

The original intent of MyBMGChart messaging was to provide patients and their personal representatives with a simple tool for communicating non-urgent messages about existing problems. Over the past decade, health care providers across the nation have seen a dramatic increase both in the number of messages sent by their patients and the level of complexity of those messages.

By billing for medical advice messages, we are following other health care providers across the country in refocusing MyBMGChart messages to be used as originally intended – for non-urgent, simple messages about existing problems.

For many health care providers across the nation who have implemented a similar change, only 1-3% of messages were billed as Medical Advice Messages. Most messages will continue to not be billed.

If a message response requires the medical expertise of your provider and five minutes or more of their time, they will determine whether the message exchange should be billed to insurance.

If the message is billed to your insurance, you will receive a message back from your doctor along with a response to your question letting you know it will be billed. Even if a message is billed to insurance, many patients won’t have to pay an out-of-pocket cost. For those who do, these costs can vary by insurance plan.

Providers can bill your insurance for complex messages that require medical expertise and five minutes or more of their time. Examples of message responses that may be billed to your insurance include:

• Reviewing medical records
• Providing a diagnosis
• Assessing a new issue or symptom
• Adjusting medications
• Chronic disease check-ins or changes in a chronic condition
• Changing a treatment plan
• Referring to services, testing or imaging
• Other complex medical advice

We expect that most messages we receive and respond to WILL NOT be billed to insurance. Health care providers across the country that have launched similar programs have found that less than 3% of messages are billed.

If your provider deems your question is too complex to address properly via medical advice messaging, they may ask you to schedule an in person or telemedicine visit to address your concern. You will not be billed for this type of message.

In addition, you will not be billed if your provider initiates the MyBMGChart Messaging exchange (i.e., only provider responses as part of a MyBMGChart message exchange that you started may be billed).

Messages that we receive most often and will continue to not be billed, include:

• Scheduling appointments
• Requesting prescription refills
• Asking about an issue you saw your provider for in the last seven days, including in-person and virtual video visits
• Giving a quick update about your health to your provider
• Questions about most lab and imaging results that do not change your treatment plan
• Messages that only take a few minutes to answer

MyBMGChart messaging is great for simple questions about your care. However, over the past decade, we have seen a dramatic increase both in the number of messages sent to our providers and the level of complexity of the messages. Particularly, complex messages that require medical expertise are better suited for a face-to-face interaction with your provider, through an office visit or telehealth visit.

By billing patient insurance for complex messages that take provider time and medical expertise, we hope to reset the types of questions patients send via MyBMGChart and ensure that our providers have the appropriate time to spend on their response. Quick questions like appointment scheduling, prescription refills, and health updates will continue to not be billed.

Message responses that require medical expertise and five or more minutes of your provider’s time may be billed as medical advice messages.

Medical expertise means that your provider is using their medical training and decision-making to respond and make a recommendation, change to your treatment plan, or referral to a new specialist or service.

During the 5+ minutes that your provider is reviewing and responding to your message, they may:

• Open and review your medical record
• Check your current medications and make adjustments
• Review your specialty providers and appointments
• Provide recommendations, a diagnosis, or changes to your care plan

Only new, complex messages that take your provider’s time and medical expertise to respond to, including detailed reviews of your medical record, adjustments to your treatment plan, or referrals to additional services, may be billed.

If the message is about the same topic within 7 days, there will not be additional billing.

Buffalo Medical Group providers will not bill your insurance for their response if their response is not provided within 3 business days after you sent the message.

We are using a variety of notification methods to alert patients about this new process. All notifications will include a link to our website with information about billing practices. The notifications include:

• A patient’s MyBMGChart landing page will have a prominent box that explains the new change.
• Patients will receive an automated message in the MyBMGChart Message box, alerting them of our new approach.
• Patients should receive a message from their provider if a response to their message required five minutes or more of the provider’s time and expertise, resulting in a possible charge to their insurance.

Providers will review each MyBMGChart message they receive and determine whether their response requires medical expertise and 5 minutes or more to respond. In their response to your message, they will inform you if that response resulted in a bill being sent to your insurance.

We believe most MyBMGChart messages will NOT be billed to our patients, as similar health care providers who have launched this same approach have found that less than 3% of message responses are billed to patients’ insurance.

For those message responses that are billed to patient insurance, most patients will be charged their typical copay or deductible. The charge is typically lower than in-person and virtual video visits.

Our intention is not to reduce our patients’ communication with their providers but rather to ensure providers can spend appropriate time reviewing and responding to complex messages, and to ensure our patients’ needs are met in the appropriate care setting.

We will be closely monitoring the types of messages that are billed and will be adjusting our policies if we detect any trends that show inequities or barriers to care.

Any billing questions may be directed to our Customer Service specialists at (716) 630-2600.

Messaging providers has become a popular way to seek medical advice, especially with the recent demand for virtual health care options. As a result, in addition to covering in-person visits, insurance companies now cover:

• Video visits, including On-Demand Video Visits
• Telephone visits
• Medical advice messaging (through MyBMGChart)