Process for Second Opinions or more?

You should ask your ins Co what they require. Mine does require a referral from my primary care physician, which she is very happy to give.  Some companies have different rules regarding deductibles, co-pays etc if you are going to be out of network. In the end you need to do whatever you need to do, but at least you’ll have all of the information. The last thing you need is more (bad) surprises.

I can generally be seen within a week or two of my doctor doing the referral. It can take a week or two to get medical records sent (and reviewed), and for the other provider to decide just what exactly they can do for you so they can set up your appointment accordingly. My insurance requires that I have certain tests done at home (CT’s and MRI’s), and that can also cause delays.

It is a process, but you will get there.

Best of luck to you,

Molly

You do not need your oncologist permission to get a second opinion, although many will actually encourage it.  But each center may have a different way of obtaining the consults.  Is your dad a surgical candidate?  If so you can google the liver/cholangiocarcinoma surgeons at each center and call their office to find out their policy.   If he is not a surgical candidate, search for medical oncologists at each place you want to go to and call their office and email them.  If you are traveling to NYC I would suggest Sloan, Mt Sinai and Columbia Presbyterian as they have all dealt with cholangio patients. You could probably try NYU also, although I have no experience with their doctors.  You should ask your main oncologist for copies of any labwork and scans, and pay for 2-3 extra copies of the scans (the actual images on disks) as you will need to send them to each oncologist/surgeon/center.  When Kathy was first diagnosed, her GI sent her to the surgeon at Sloan first (Dr. Jarnagin) who then set kathy up with an oncologist at sloan.  We told the oncologist we were seeking other surgical opinions and he did not mind at all.  We then called Fox Chase in Philly and saw their medical GI oncologist (forgot her name) who later presented Kathy to their tumor board and surgeons.  We also called Dr. Schwartz’s office at Mt Sinai (her eventual surgeon) and called Dr Kato (surgeon) at Columbia Presbyterian for 3rd and 4th opinions.  Each requested a copy of her labs and scans before seeing her. As for cost you will have to call your insurance to see who is in network and not, and if they cover second opinions. Kathy’s insurance initially did not cover Dr. Kato’s consult but eventually reimbursed us after a few phone calls. A second opinion can cost around 1000 dollars if not covered by insurance, but it was worth it for piece of mind.  Kathy still sees the med onc at Sloan who coordinates her treatment course with her surgeon at Mt Sinai.

Good luck