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When Cleveland Clinic said in November that it would begin billing patients for certain MyChart patient portal messages to doctors, it set off a fiery debate across the health care industry around hospital finances, patient access and physician burnout, Becker’s Payer Issues reports. Now at least seven other health systems nationwide have also started billing patients for some types of messages sent over patient portals, including those about new symptoms, prescription issues, and those that require extensive time from a clinician to review a patient's medical history.