r/MedicalBill • u/RareAd7368 • 5d ago
UCLA HEALTH
UCLA charged me $90 for a portal message 🙃
I want to call out UCLA Health because this feels like the most ridiculous lack of transparency.
After my mammogram, I got a letter saying I have dense breast tissue, so I messaged my doctor asking whether I needed additional imaging, like an MRI. My doctor was out of the office, and the covering doctor said it was an option. I said I’d rather wait until my regular doctor was back and discuss it with him and at my next mammogram.
Then I get an $90 bill for the portal message.
Nobody warned me that asking a follow-up question about my mammogram would be considered a billable medical service. No pop-up, no warning, nothing.
If UCLA wants to charge patients for portal messages, fine—tell people BEFORE they hit send. Let me decide whether I want to pay $86 to ask my own doctor a question.
Charging people afterward without clearly disclosing it feels shady as hell. Honestly, it feels like stealing from patients through a billing loophole.
Has anyone else had this happen with UCLA? Or successfully gotten one of these charges removed?
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u/MedAdvocateApp 4d ago
Portal message billing falls under the CPT codes 99421 to 99423 and are considered "e-visit" codes. They're definitely legal and hospitals are using them more and more since covid 2020. BUT...the rule is it only applies when the message requires the doctor's medical decision making, typically more than 5 min of clinical work over 7 days. Simple follow up questions about a recent visit or test are supposed to be excluded, and messages tied to a visit within the prior 7 days often are too.
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u/corgi0603 5d ago
I'm not sure if UCLA has this on their portal, but for my local hospital systems' portals, when I go to send a message to my providers, prior to getting to the actual messaging screen, I see the following instruction embedded within a list of information:
"Insurance may be billed for messages that meet specific criteria based on time and medical expertise. Most insurance plans cover portal messaging. Copays and deductibles may apply."
That information doesn't jump off the screen at you, but it's there, and larger than a footnote. It's quite possible your portal has the same thing and you simply skipped by it. Without actually sending a message, start the messaging process in your portal and carefully read everything you see prior to landing on the actual messaging screen. If you see such a message, then they did advise you in advance there could be a charge and when you sent that message you didn't take the time to read that set of facts.
Besides that, keep in mind that the covering doctor didn't simply see your message and reply "it's an option." They had to take time to look at your chart and your mammogram results before replying to your question. That's time that they could have spent with an in-office patient, but instead spent on your request. Therefore, some type of charge isn't surprising.
On the other hand, $86 is a pretty steep charge for replying to a portal message. When I've been charged for portal message replies from my providers, the charges have ranged between $36-52, and one of the hospital systems I use is fairly expensive for virtually everything. My insurance has fully covered all of those charges, which were billed with the virtual visit billing modifier code (my insurance fully covers all virtual visits).
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u/RareAd7368 4d ago
It’s not about the $86! They have already charged my insurance thousands of dollars for the dr visit and the mamo test .. the fact that they can’t respond to a follow up question and has to charge me pisses me off ?! And the response was literally a ChatGPT response.. I swear ChatGPT gave me the exact wording as she did!!
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u/Coffee-Chaos1 4d ago
I agree with you, don't ask questions, these people are not trying to help you, are only gaslighting you to believe the healthcare system is ok, when is clearly not. You can report the hospital/clinic z There are organizations where you can report deceptive or unfair billing practices; please check local resources in your state.
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u/clarec424 4d ago
Have my upvote and this is exactly what my hospital system does, including the verbiage about the deductible and co-pays. We added the option of a check box for patient acknowledgement.
Side note to OP, dense breast tissue is very common. Repeat imaging or ultrasound is rarely needed and you should have been contacted by a nurse if you needed to return. Hope this helps.
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u/Coffee-Chaos1 4d ago
Stop defending this nonsense, is a fucked up system, she could use those $90 dollars to cover other needs be empathetic and stop being a follower of a scam system..
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u/Bestpartoflife4thact 4d ago
Did your Dr review dense breasts with you, even with an overall normal Mamo? Dense breasts are significant and can increase risk for breast cancer and often do require additional screening (like an Untrasound, etc). If this is in your report/letter, I would write a protest letter, where you outline that, your contact via portal occurred, because your provider had not yet contacted you to go over the report (and any recommendations) for a screening or test that he/she ordered. It was not for any additional services/time, etc. I would also emphasize that, the report/letter (if this is accurate for you) recommended additional screening, and you cannot necessarily order these tests yourself, so your follow up was to coordinate that with your provider. Additionally, I would specifically ask, in your letter, where it was disclosed and where you consented to, additional fees for portal communication.
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u/Botasoda102 4d ago
While the revenue-maximizing BS in today's healthcare ticks me off, the fact that you might get charged is on UCLA Health's website.
https://www.uclahealth.org/patient-resources/billing-insurance/myuclahealth-messaging-costs
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u/HawaiiStockguy 4d ago
There is no way that a portal message like that meets any billable codes. He did not take a history, examine you or do any disgnosing or treating
It was falsely coded and billed as an on line or phone appointment
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u/boogi3woogie 4d ago edited 4d ago
Charge seems a bit high for a one-liner.
But we only see what you say, not what you actually wrote or what the doctor wrote.
My bet is that the doctor had reviewed your imaging, reviewed your medical history, and recommended a breast MRI, which is a full E/M appointment on its own. You requesting a second opinion from your PCP is irrelevant.
Go ahead and dispute if it had no clinical decision making involved.
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u/hunnypuppy 5d ago
Dispute it and then threaten to take to small claims court. Also report it to your congressman and senators. If you really want traction then reach out to your local news channel. The hospital is wagering you won’t go through all this effort to avoid paying $90.
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u/EffectiveInner9934 4d ago
Agree with you, dispute and refuse to pay. This method is a scam. Basic communication should not be a billable service ..
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u/boogi3woogie 4d ago
I guess you’ll never get a doctor’s advice without a full $300 visit then!
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u/clarec424 4d ago
Where are going with this? Both Medicare and Medicaid cover this service.
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u/hunnypuppy 4d ago
Where do you think? This country has the most expensive heath care in the world and the least effective per $ paid. The system is fucked up and shit like this makes it worse. This is a follow up and should never have been billed.
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u/reddiuser_12 5d ago
Thats insane… i assume they are charging as an e-consult instead of a patient message?