FAQs

1. What is Second Medical Opinion?
2. Who should seek for second medical opinion?
3. What is AXA Assistance Second Medical Opinion Program?
4. What are the services for second medical opinion can AXA Assistance offer?
5. What are the common questions to ask through a second medical opinion?
6. How do I start to get a second medical opinion consultation?
7. What kind of medical records should I gather? What if my doctor refuses to participate in submitting the appropriate medical referral letter?
8. Who will have access to my medical records?
9. Who will render my second medical opinion?
10. How long is the process of the second medical opinion?

What is Second Medical Opinion?

In the early 1970s, Second Medical Opinion was a cost controlled tool used by insurance companies to reduce the number of overused and inappropriate surgeries. It was referred to as Second Surgical Opinion Program. Today, people often face various medical diagnoses that force them and their families to make serious life changing decisions. A second opinion can help assure an individual is comfortable and confidence with his or her diagnoses and prescribed course of treatments. Generally, there is a decade delay between research findings and translation of the findings into clinical practice. A second medical opinion can also serve as a tool to explore the latest clinical research findings available in the world that sometimes may not be considered for diagnosis or treatment option by some physicians.

Who should seek for second medical opinion?

In many circumstances, consulting a specialty expert for a second medical opinion for your health or medical condition is never a bad idea. When it comes to ensuring that you receive optimal care during your course of treatment, second medical opinion is not only warranted, but also necessary. Some common scenarios in which a second medical opinion is sought are:

• A clear medical diagnosis cannot be established; or unknown etiology (or medical cause) for your medical condition.
• Medical diagnoses that are considered as life threatening or potentially long-termed debilitating.
• Multiple treatment options are proposed with unclear risk and benefit analysis, as well as uncertain prognosis.
• New treatment option (less than 1 year old), new clinical trial treatment option, or surgery is proposed as a course of treatment.
• Lack of clarity in understanding and managing your medical condition under your treating physician’s supervision.
• Recurrence of symptoms or exacerbation of your medical condition after following your physician’s treatment prescription.
• No known treatment can be recommended for your medical condition.

What is AXA Assistance Second Medical Opinion Program?

When faced with a diagnosis of a complex medical problem AXA Assistance USA offers the comfort of a second medical opinion from a recognized expert in the field. A second opinion can help assure an individual is comfortable following a course of treatment for their diagnosis. AXA Assistance offers accessibility to world renowned expert opinions from top medical specialists at recognized centers of excellence.

Our medical staff provides guidance in these complex care decisions to bring peace of mind to our second medical opinion members. With your authorization, our doctors, nurses and nurse case managers are involved in reviewing the diagnosis and arranging for a second opinion with the appropriate expert.

The expert will prepare a formal written medical evaluation and recommendation for treatment on your behalf.

AXA Assistance USA’s Assistance Coordinators can provide additional assistance with coordination of medical appointments with the expert, organizing hospital admissions, making travel arrangements and lodging accommodations. We can also facilitate community support by arranging for members to speak with others.

What are the services for second medical opinion can AXA Assistance offer?

Services AXA Assistance provides are as followed:

• With member approval AXA Assistance USA will coordinate the collection of all relevant medical information from physician.
• AXA Assistance USA Medical Director and staff will review the medical records in order to arrange for the most appropriate specialist to administer a Second Medical Opinion. AXA Assistance USA can arrange for the patient’s medical record along with diagnostic test results to be reviewed by a medical expert at a Center of Excellence who will prepare a formal written medical evaluation and recommendation for treatment.
• At the request of the member AXA Assistance USA will assist in facilitating patient admissions and treatment from specialist whom provided Second Medical Opinion.
• AXA Assistance can arrange for travel, transportation and accommodation assistance for member should they choose to.
• We also offer access to community support. When you are a member of our Second Medical Opinion we will reach out to support groups in your area to obtain arrange for you to speak to other individuals who are under similar medical conditions.

What are the common questions to ask through a second medical opinion?

The common questions asked during a second medical opinion consultation are as followed, but not limited to what are listed here. AXA Assistance second medical opinion medical staffs can also assist you in asking the right questions based on your medical condition and concerns.

• Can you confirm my medical diagnosis based on the submitted medical report?
• Has all the appropriate diagnostic work been considered to properly diagnose my medical condition?
• What are my treatment options?
• What other treatment options can be recommended, which have not been proposed by my current physician?
• What are the potential complication/ risk/ benefit that I should anticipate with this treatment recommendation by my physician?
• What is my prognosis?

How do I start to get a second medical opinion consultation?

After you have enrolled online with the AXA Assistance Second Medical Opinion Program, you will be sent an e-mail with your enrollment identification number and a phone number to contact AXA Assistance USA. If you need to utilize the service, call that number and you will be connected to a trained agent who will help open up a case and get you started.

Once a case has been opened, our medical staff will contact you at your requested call back time to gather appropriate medical information to determine eligibility for a second medical opinion consultation. Once eligibility is approved, our medical staff will work with you and your appointed physician in gathering appropriate medical records to start the second medical opinion process.

What kind of medical records should I gather? What if my doctor refuses to participate in submitting the appropriate medical referral letter?

Our medical staff will email or fax you a list of the appropriate medical records to submit for the second medical opinion consultation. You can instruct your doctor to release selected medical records to AXA Assistance after you have signed the Release of Information (ROI), which will allow us to pursue the medical records directly from your appointed doctor.

If your doctor refuses to participate, the AXA Assistance medical staff will have to evaluate the eligibility to pursue this case with the medical information available for your case.
You will bear any cost related to obtaining and transferring your medical records to AXA Assistance for second medical opinion consultation.

Who will have access to my medical records?

The privacy and confidentiality of your medical records will be ensured following the Health Insurance Portability and Accountability Act (HIPAA) guidelines. AXA Assistance will ensure your medical records will only be reviewed by AXA Assistance medical staff and the consulting physician.

Who will render my second medical opinion?

AXA Assistance goes through a rigorous process in searching for the best match of an expert specialist to consult on your second medical opinion based on your medical condition. General guiding profiles of the expert we selected are as followed:

• Experienced physician who has been in practice within the field of his/her specialization for more than 5 years.
• Affiliation with a world Center of Excellence through current clinical practice, academia training and education, and any direct clinical and academia involvement.
• Validation of his/her expertise by academic and clinical peers in the same specialty.
• Recent and relevant medical publications in peer reviewed medical journals within the specialty medicine; and/or recent professional presentation at any of the medical professional continuing education conferences within the specialty medicine.
• Clinical research involvement within the specialty medicine.

How long is the process of the second medical opinion?

As soon as all the relevant and crucial medical records are fully submitted to AXA Assistance medical staff, AXA Assistance medical staffs will inform you the anticipated turnaround time based on the complexity of your medical condition and medical urgency of the second medical opinion requested. The turn around time for each case will not exceed beyond 15 business days, but generally ranging from 5 to 10 business days. Our medical staffs will contact you when the second medical report is ready to be delivered to you in your preferred method – email, fax, mail or by courier**.

** The cost of any courier service for the transfer of your medical records and the second medical opinion report will incur a charge to you.