Patients may soon be billed for communicating with their health care providers via patient portals. Hospitals are increasingly instituting billing policies for responses to patient questions via patient portals or emails. As patients have become more comfortable communicating with their providers online, the use of patient portals has escalated, particularly with the increased use and acceptance of telemedicine during the COVID-19 pandemic. A 2022 study in the Journal of the American Medical Informatics Association found that clinicians' in-basket messages increased by a dramatic 157% from 2019 to 2021. Responding to patient requests has placed additional time burdens on clinicians. Billing is only being done for questions that require more than a few minutes to answer. However, some health advocates worry that these billing policies may lead to inequities in care, where those who cannot afford the fees will refrain from communicating with their provider.