Common use of Second Medical Opinion Clause in Contracts

Second Medical Opinion. Members who have questions about their diag- noses, or believe that additional information con- cerning their condition would be helpful in deter- mining the most appropriate plan of treatment, may request a referral from their Primary Care Physician to another Physician for a second medi- cal opinion. The Member’s Primary Care Physi- cian may also offer a referral to another Physician for a second opinion. If the second opinion involves care provided by the Member’s Primary Care Physician, the second opinion will be provided by a Physician within the same Medical Group/IPA. If the second opinion involves care received from a Specialist, the sec- ond opinion may be provided by any Blue Shield Specialist of the same or equivalent specialty. All second opinion consultations must be authorized by the Medical Group/IPA. State law requires that health plans disclose to Members, upon request, the timelines for respond- ing to a request for a second medical opinion. To request a copy of these timelines, you may call the Shield Concierge Department at the number pro- vided on the back page of this EOC.

Second Medical Opinion. Members who have questions about their diag- noses, or believe that additional information con- cerning their condition would be helpful in deter- mining the most appropriate plan of treatment, may request a referral from their Primary Care Physician to another Physician for a second medi- cal opinion. The Member’s Primary Care Physi- cian may also offer a referral to another Physician for a second opinion. If the second opinion involves care provided by the Member’s Primary Care Physician, the second opinion will be provided by a Physician within the same Medical Group/IPA. If the second opinion involves care received from a Specialist, the sec- ond opinion may be provided by any Blue Shield Specialist of the same or equivalent specialty. All second opinion consultations must be authorized by the Medical Group/IPA. State law requires that health plans disclose to Members, upon request, the timelines for respond- ing to a request for a second medical opinion. To request a copy of these timelines, you may call the Shield Concierge Customer Service Department at the number pro- vided on the back page of this EOC.