International second opinion service with Cleveland Clinic MyConsult®

Discovery Health Medical Scheme has a profound promise to continue to deliver the best of care to all our members. We recognise that South African specialists offer exceptional quality of care through their high levels of expertise and knowledge.

Our experience tells us that there are times when a specialist may want to collaborate with other experts in a certain field of medicine, especially when their patients are facing life-threatening and life-changing conditions, particularly when this involves the use of new treatment modalities. In some cases, a patient may ask their specialist to assist them in obtaining a second opinion for these conditions and for those that impact the quality of their life. To make this possible, we have collaborated with Cleveland Clinic, an international medical centre in the United States, which is recognised worldwide as a leader in healthcare.

We are offering our members the opportunity to get an online second opinion from a Cleveland Clinic physician specialist. This value-added service is available for members on all Discovery Health Medical Scheme plans.

The cost for an online second opinion from Cleveland Clinic is $565. If a pathology review is required to complete the consultation, there will be an additional charge of $180. Once a case has been opened the member must pay the relevant second opinion fee to Discovery Health Medical Scheme within 10 days. When we receive the payment, we will reimburse the member 50% of the amount paid. This amount does not affect the member’s benefits as the Scheme pays this amount.

More about Cleveland Clinic and the service it offers through MyConsult®

Cleveland Clinic is a non-profit, multi-speciality academic and medical centre. The clinic integrates clinical and hospital care with research and education, which achieves optimal outcomes in the treatment of rare and complex conditions. They are recognised as leaders in providing second opinions especially in cases where there is limited expertise.

You can get a second opinion for more than 1 200 diagnoses

Cleveland Clinic MyConsult® offers online medical second opinions for more than 1 200 diagnoses. These diagnoses include conditions that impact a person’s quality of life, or more serious life-threatening conditions, including inborn errors of metabolism like Pompe disease, nephroblastoma, and unusual conditions in children like insulinoma.

The top 15 most requested diagnoses in the MyConsult® programme include:

1. Coronary artery disease	9. Breast cancer (medical management review)
2. Atrial fibrillation	10. Degenerative disc disease
3. Prostate cancer	11. Spinal stenosis with degenerative spondylolisthesis
4. Aortic stenosis	12. Cardiomyopathy
5. Mitral regurgitation	13. Aortic regurgitation
6. Lumbar disc herniation	14. Congestive heart failure
7. Kidney tumour	15. Lung cancer
8. Lumbar canal stenosis

The MyConsult® online second opinion service is not for treatment related to scheme exclusions

The MyConsult® service is for when a Discovery Health Medical Scheme member faces a life-threatening diagnosis or one that affects quality of life. The second opinion provides confirmation of the diagnosis and treatment recommendations. It does not include the actual treatment related to any of the conditions and treatments that are excluded from cover on the Discovery Health Medical Scheme.

Discovery Health will coordinate the online second opinion process for you

As a value-add service, Discovery Health will oversee the second opinion process on behalf of you and your treating doctor. From the initial case creation, a dedicated case manager will facilitate all the interactions between the treating doctor in South Africa and Cleveland Clinic MyConsult®.

These are the steps involved for you to access the second opinion service

Your treating doctor will request an online second opinion from a Cleveland Clinic’s physician specialist on your behalf

You need to pay Discovery Health Medical Scheme within 10 days for the second opinion process to start

The cost for an online second opinion from Cleveland Clinic is $565. If a pathology review is required to complete the consultation, there will be an additional charge of $180.

You need to pay the relevant amount that applies to your case within 10 days after your case is opened, and send the proof of payment to CLEVELAND_PAYMENTS@discovery.co.za. As soon as the final medical report from Cleveland Clinic is received, Discovery Health Medical Scheme will reimburse you 50% of the amount paid. This amount does not affect your benefits as the Scheme pays this amount.

If you are on the Executive Plan you will not need to pay upfront as the consultation is covered in full by the Scheme.

You must send signed consent forms when you send your proof of payment

Both Discovery Health Medical Scheme and Cleveland Clinic require consent forms to be completed. The case manager will send you the consent forms, Cleveland Clinic terms and conditions and a cover letter that will assist you when completing the form.

If we do not receive proof of payment and the completed consent forms within 10 days after the case has been logged on our system, we will close the case.

We will send the case details to a Cleveland Clinic MyConsult® physician specialist

Once our case manager receives the required documents, we will send the details of the case to a physician expert at Cleveland Clinic. The expert specialist at Cleveland Clinic will review the case and provide Discovery Health’s case manager with a detailed second opinion report including treatment recommendations. Our case manager will give the report to your doctor who will share the report and discuss the Cleveland Clinic physician’s recommendations with you.