Need advice on seeking a 'second opinion'.

I think you have a legitimate reason to be wanting a second opinion. I would explain that to the insurance company…how could they argue with it? You have the proof. At least try it. Also, I’m not sure where you are, but the Childrens Hospital in Pittsburgh is really, really, really, really good.

I don’t know. Hopefully one or more of our resident medical professionals will have more direct knowledge. But the insurance company may look at it either as an added expense or good insurance against something else going wrong and costing even more. I wouldn’t avoid asking out of fear of what they will say. Ask in such a way that they clearly understand the first botched job, your concern that it may continue to go from bad to worse if left in the same hands, and don’t be shy about hinting how much it might cost them if it goes badly.

I will be hoping all gets resolved soon.

My daughter is 18 months old and was diagnosed with Galactosemia at birth. Though she has not required any surgeries for her condition, Childrens Hospital Of Philadelphia has been a great help to inform us more of what her condition entails… Insurance companies don’t usually care as long as the hospital accepts the type of insurance. They’re obviously not going to cover travel costs, though… That’d be really nice if they did. I live in Pennsylvania, but CHOP is still about 75 miles away from me. We have to go down there every 6 months.

@deni – Thank you. I was hoping we would not be seen as being off base for wanting someone else to look at it. We are over in Washington state, but, I know that we will most likely be heading to the east coast for all of this. I will look into that hospital, thank you!

If you are just going to an OV with your arms loaded with info, mris, it should be fine if you are not in an HMO.

Travelling costs not covered. Wishing you the best.

@jazmina88 – Thank you! We have a Blue Cross PPO plan.

@andreaxjean – Sorry about your daughter, it is sure hard to see little ones with unfortunate conditions! :( My son is 14 months… such a fun/busy age! Best of luck with your daughter.

@88_Jenn Thanks. I’m praying for your son so he gets the surgery he deserves! I hope all goes well and you find the right doctor.

Also, you should never feel bad about seeking a second opinion. Any doctor worth her M.D. will understand, and often will appreciate the additional point of view that a second doctor will provide. My father is a Surgeon, when he was practicing General and Vascular surgery he would frequently consult with other doctors on tricky situations. I can assure you that your son’s doctors care a lot more about your son’s health than they do about their own pride.

Best wishes for your son.

@andreaxjean – Thank you very much!

@gorillapaws – Thank you. That is a very good point.

Our current surgeon has said multiple times that it is one of the worst cases she’s had, which makes me really think that he should be seen by someone else after what happened the first time.

A second opinion is just a consult – or more likely, an “office visit”. So long as it’s with a doctor in network, and they normally cover it with the doctor you have now, then you should be fine. Your insurance doesn’t know exactly what’s said during those visits, and it’s allowed for you to change doctors so they have no way of knowing that you aren’t just shopping around. When you go to see a doctor, they check off various codes on this form:http://downloads.aapc.com/superbill-icd9.pdf . They’ll check off an office visit (most likely 99205 since it’ll be a new patient), as well as any procedures or shots or x-rays or blood draws they do (note: that they do RIGHT THEN. If you schedule it for another time, that’ll have it’s own superbill.) Then that’s what they give to the insurance, and what they check determines if the insurance will pay for it. You are totally within your plan to get a second opinion. If you have any more worries, call up your insurance and ask them to make sure it’s ok.

Most insurance companies do allow and pay for a second opinion. after my auto accident, the company sent me to “their” doctor and would not pay for any other physician. i was not satisfied with “their” doctor, so i contacted my personal insurance and explained that i was being typically ignored with “their” doctor and i needed a second opinion, concerning my neck injury. my insurance did allow this and paid for it.

All you have to do is ask “your” insurance agent.

@john65pennington But that’s your auto insurance. Health insurance is different. Especially if it’s BCBS PPO.