For those patients where there are prolonged conversations via text where the provider gets involved with a back-and-forth discussion there may be a bill that is submitted to the insurance company. As of January 2021, Medicare and Commercial insurance companies are allowing these conversations as billable encounters.
As described above, simple questions or the doctor relaying lab results via spruce will not be submitted to insurance companies. Only conversations where there are prolonged back-and-forth discussions are subject to billing that are between a patient and their provider if this were to occur.