Check your EOB – HB721 would make you pay THAT for an email from your doctor

f you have health insurance, you’re probably familiar with EOBs – explanation of benefits – statements.  They give you all the critical information regarding the costs of any care you get. They include what the doctor’s price is, what the negotiated rate (“Allowed Amount”) is with your insurer, how much you may owe, etc…

If you have a recent one, take it out.  I did.  A new bill, HB 721, would to mandate that you are charged the same amount for a video chat, phone call, or even an email as you are for an in-person doctor visit.

But let’s back up and understand these charges.

This EOB is for a recent routine visit to my family pediatrician. For the visit alone, I paid $160.11 out of pocket (thanks to my insurer for the $44.89 discount).  Included in that $160.11 are the costs the doctor incurred for my visit. This includes the rent on their office space (including a large and nice waiting area), the receptionist’s wages, the equipment that was used while I was there, janitorial services, water, electricity… running an office is expensive!

This is one of the reasons the NC Coalition for Fiscal Health is so excited about the promise of telemedicine or telehealth.  None of those facility costs exist in the world of virtual medicine, and so none of them should be passed along to the patient. In fact, many providers have found they can be profitable charging much less for a telehealth visit. Here’s a recent promotion from Mission Health offering a visit for only $25.

But HB 721 – oddly named “Increase Access to Telehealth Services” – would mandate that you pay the exact same amount for a telehealth visit as you do for an in-person visit. Despite not having access to the same facilities, staff, equipment, this law would mandate that insurers negotiate the same rates for telehealth visits as they do for in-person.

You don’t have to be an expert in economics or in health care to know that raising the cost of something does not “Increase Access.” In fact, it does the exact opposite.  We should be focusing on making sure rural areas in North Carolina have access to broadband Internet so those who live there can take advantage of some of these great, inexpensive telehealth services that already exist – not jacking up the price on those services for everyone else.

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