In an effort to recoup some of the costs associated with patient phone calls, some medical clinics are now charging patients for phone calls, Nebraska's Channel 6 News reports.

At Complete Children's Care in Lincoln, Neb., for example, patients have been notified that a $20 "telephone care" charge will apply to certain calls lasting longer than five minutes. The charge would not apply to a call that results in an appointment within 24 hours, nor to a call that's following up on a visit from the previous week.

While some parents find the fees ridiculous, health experts from FierceHealthcare's Healthcare Leader Idea Exchange group on LinkedIn have expressed varying opinions on the issue. A primary-care physician from the New York-area supports the idea, noting that attorneys have long charged their clients for phone calls without any argument.

"As a long time primary care doc, I am in favor of reimbursement for calls over a certain length, and in certain defined categories," he commented. However, he added, "I really doubt that we will ever see this."

Others argued that telephone services already are built in to the fee schedules for other physician services, such as office visits, and therefore not separately billable for most government and commercial insurers. However, a the chairman of a Southern-based telemedicine company pointed out to fellow Healthcare Leader Idea Exchange members that telemedicine is indeed covered by Medicare and most major insurers. 

The big question, then, seems to rest in determining the line between calls that are part of the service included with office-based care and those that constitute televisits.

Meanwhile, also in Nebraska, the 10-office Children's Physician network has found a way to reduce call volume by 15 percent without needing to charge patients extra. Through Children's Connect, an online service for which parents can register through their doctor's office, "[parents] can, at their leisure, send in a question, put in a request and [have the office] respond back to them."

"We can respond to things as they arise," said pediatrician John Andresen, MD. "But at the same time if we're busy doing something else, we don't feel interrupted. We don't feel like we're putting that patient off."

To learn more:
- see this piece from WOWT.com
- read the related discussion on LinkedIn

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