Aetna/CIGNA Discover the Internet

Medicare has about 7,500 specific tasks it pays doctors to perform.  E-mail is not among them.  Ditto for most Blue Cross plans, all the employer plans and most commercial insurers.  But wait…..are Aetna and CIGNA really entering the 21st century?

Reimbursable e-mail is not like garden-variety e-mail, however.  It has to have a CPT code, a diagnosis, a record of time spent – in short, all the same forms, activities, categories and even payment rates as 20th century, face-to-face consultations.  It’s sort of like constructing a state of the art operating room so that shamans can practice bloodletting with leeches.

Comments (6)

Trackback URL | Comments RSS Feed

  1. Phil Pfeiffer says:

    It’s about time, I use only fax and e-mail with my physician( eliminates secretary and nurse), I’m sure the clinic does not seek reimbursement! My past, RN, CRNA, Hospital Administrator, Geriatric Nurse and now retired. Phil

  2. Jerry Keller says:

    I want to follow this from the cost/benefit analysis after one year. Must be less expensive to converse with an MD who knows me prior to seeing an ER doc who does not! Sounds like a new “covered service” in the making!

  3. Pam S. says:

    Okay. So how should email consultations be compensated?

  4. john goodman says:

    Reply to Pam: Obviously you need to read the vignettes in our state health care reform handbook

  5. Jack Culver says:

    We will definitely see more interaction remotely and new systems emerging as stated at

  6. Devon Herrick says:

    Past surveys have found that 90% of patients would like the ability to email their physician. Yet, insurers were initially reluctant because online consultations might encourage enrollees to over-utilize consultations for trivial reasons. Some doctors were also concerned because of the technical requirements for security and privacy (and they wanted to make sure they got paid).

    Kaiser Permanente has begun to offer secure email messaging between doctors and patients for some of their enrollees in Hawaii. They may also offer this in California. Kaiser found that patients actually substitute online visits for in-office visits. More costly in-office visits fell by one-quarter once enrollees could email their doctor. As I recall, the online visits were also less costly in terms of tests, etc.

    Hawaii consists of numerous islands — some of which are largely rural. Secure email message between doctors and patients has really helped enrollees who would otherwise have to take a ferry or a flight to see their doctor.