What Are "Virtual Second Opinions"?

by Jane Ashley

We’ve all been told the value of a second opinion. Even in “normal” circumstances, it seems like a rather daunting task to get a second opinion. There is usually expensive travel involved along with hotel and meal expenses. Plus, the copays involved and the logistics of getting our medical records sent to the facility where we’re getting our second opinion. Yet, we know, deep down within us, that a second opinion could save our lives.

Should I Get A Second Opinion

Amid the COVID-19 pandemic, how can we get a second opinion?

Many NCI-designated cancer centers offer a virtual online second opinion. NCI-designated means that the National Cancer Institute recognizes these institutions as providing cutting-edge cancer care. Currently, there are 71 centers located in 36 states with this designation.

You may be newly-diagnosed and want a second opinion before commencing treatment. You may be in treatment and not feel comfortable with your current treatment team. A second opinion helps patients find peace of mind. Cancer treatment requires a lot of trust on the part of the patient — we’re asked to submit ourselves to scary procedures and medications that have serious side effects. We need the reassurance that what’s being proposed or being done is the best possible way to treat our cancer.

The COVID-19 pandemic forces us to consider an option that we may not have known about — a virtual online second opinion (sometimes called a remote opinion).

What is a virtual online second opinion, and how does it work?

Patient’s medical records, including lab reports, mutation/genetic reports, and imaging reports are sent to the new facility. The facility where you will get your second opinion contracts with a third party company/health advisor that specializes in gathering necessary documents for remote second opinions.

Virtual Second Opinion

The patient usually submits questions similar to these:

What are my treatment options and their risks and benefits?
• Are there additional tests or imaging that I need?
• How will a suggested new treatment impact my quality of life?
• How likely would a new treatment lead to a better outcome?

Patients have many choices of institutions when they seek an online second opinion. Choose a facility that has extensive experience in your particular kind of cancer. This is especially important for patients who have a rare cancer type or genetic mutation. Choices include Baylor-Scott, Cleveland Clinic, City of Hope, Dana-Farber, Emory, Johns-Hopkins, Massachusetts General, Mayo, Memorial Sloan Kettering, Seattle Cancer Care Alliance, University of Colorado, and UCLA.

A remote second opinion is especially important for patients who live in rural areas or states where there is not an NCI-designed cancer center.
Once your medical records are received, specialists review your records and questions. They will confirm your diagnosis and provide a treatment plan. You may receive these recommendations via email or phone/video chat. Your second opinion may confirm the treatment recommended by your local oncology team or a different treatment plan will be recommended. Armed with a second opinion, a patient can talk to their oncologist about adjusting/changing their treatment plan and the pros and cons.

Copy Of Scans

Second opinion results are usually available in 10-to-14 days.

How much does a remote second opinion cost? Will my insurance cover it?

The cost usually ranges from $700 to $800 but can be as expensive as $2,000 for an online second opinion from Dana-Farber Cancer Institute.
Unfortunately, remote second opinions are usually not covered by private insurance, Medicare, or Medicaid. However, if you have a Health Savings Account (HSA) or Flexible Spending Account (FSA), you can use those funds to cover the cost. All facilities also accept credit cards.
However, considering that in-person second opinions are not generally possible during the COVID-19 pandemic because of travel restrictions and the risk to the patient, patients should call their insurance carrier and ask if they will cover the cost of a remote second opinion. You have nothing to lose.

The fee covers the cost of acquiring all of your documents. Several companies specialize in securing all necessary documents, test results, and imaging scans so that the patient or their family is not stressed or worried about how to secure the necessary medical records.

Considering the cost of travel and lodging plus meals, securing a second opinion in person is likely to be just as expensive – even though your insurance would cover the medical portion of an in-person second opinion.

Peace Of Mind

What if I can’t afford a remote second opinion?

Many patients can’t afford a virtual/remote second opinion. Some patients are physically unable to travel for an in-person second opinion. But don’t let the inability to obtain a second opinion deter you from finding peace of mind that you are getting the recommended treatment.

Patients can download the National Comprehensive Cancer Network (NCCN.org) treatment guidelines at no cost. The NCCN is a network of 31 top cancer treatment centers in the U.S. who share, at no cost, the most effective treatments for virtually every kind of cancer – treatment recommendations are provided for each stage and common genetic mutations within your cancer type. You can download this detailed guideline to ensure that you are getting the recommended care. No one walks alone in this journey.

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