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Insurance Hell All insurance-related matters are here: Medicare, worker's compensation, appeals, denials, insights, wins, losses. PRICING is here too. Note: This forum has posts from 2006 forward. Older ones are in the Big File.

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Old 07-14-2016, 10:14 PM
RiverMiles RiverMiles is offline
Junior Member
Join Date: Jul 2016
Posts: 19
Default Can insurance company access a 2nd opinion I if I pay for it out of pocket

Does anyone know if it's possible to get a confidential 2nd opinion, meaning not available to insurance company, if the physician is paid directly by the patient?
Not trying to be "all cloak-and-dagger" or anything but I am well into an unpromising appeal and, frankly, I don't want to do anything that may unintentionally provide my PPO with anything they can use against me.
Thanks in advance for any input.
Nov-Dec 2015 - 10 miles in the kayak, a N. GA mt summit, a 12-mile day-trek.
Late Dec '15-Mar '16 - Years of "normal" tension in my neck became radiculopathy w/ neuro deficits / Standard conservative treatments. / MRI reveals C5-C7 unpleasantness.
Apr 18th, 2016 - 2LVL ADR scheduled for May 3rd!.......Apr 29th, 2016 - Surgery unscheduled by insurance co.
May 2016 to present - Appealing. Summit the couch daily; trek to restroom/kitchen as necessary.
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Old 05-10-2017, 02:16 AM
LumbarSpine LumbarSpine is offline
Join Date: May 2017
Posts: 44

This type of question comes up in the legal field, so let me tell you how they would handle it. The person asking for the opinion would make it very clear what opinion they wanted. The person providing the opinion would provide the wanted opinion if reasonable, otherwise he would say "I'm sorry, I can't help you with this matter," thereby avoiding anything damaging ever being said, much less put in writing.
* 40's, otherwise healthy, back pain for many years.
* DDD at L4/L5. Facet pain at same level.
* Multiple RF ablations, with inconsistent/marginal results.
* Single-level disc replacement with Dr. Clavel, Sept. 2017. Went well, recovery MUCH faster and less painful than anticipated. Now need to get active again and keep back in shape!
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privacy, second opinion

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