International second opinion services

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What is the International Second Opinion Service?

As a Discovery Health Medical Scheme member, you have access to second opinion services from the Cleveland Clinic, an international medical centre in the United states, for life-threatening and life-changing conditions.

What is the value of the International Second Opinion Service?

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 getting 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 who are recognised worldwide as a leader in healthcare.

Who is Cleveland Clinic?

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.

What is The Clinic, by Cleveland Clinic?

The Clinic, by Cleveland Clinic offers medical second opinions either online or by email correspondence, 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 nephroblastoma, and unusual conditions in children like insulinoma.

What do you get?

We offer 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.

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 The Clinic.

Cover

As soon as the final medical report from The Clinic is received, Discovery Health Medical Scheme will reimburse you 50% of the amount paid to Cleveland Clinic.

This amount does not affect your benefits as the Scheme pays this amount.

Note for Executive Plan members:

We cover 100% of the cost of the second opinion service.

Steps to follow to access the second opinion service

Step 1

To access the second opinion service your treating doctor will request an online second opinion from a Cleveland Clinic physician specialist on your behalf.

Step 2

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

Cost

 

The cost for a second opinion from The Clinic is $1200. This fee is inclusive of a radiology and pathology review as well as a detailed opinion from the Specialist who provides a comprehensive report to your treating doctor.

Payment

 

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

Note for Executive Plan members: You will not need to pay upfront as the consultation is covered in full by the Scheme for your plan.

Step 3

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

Both Discovery Health Medical Scheme and The Clinic require consent forms to be completed.

The case manager will send you the consent forms, The Clinic terms and conditions and a cover letter that will assist you when completing the form. 

Please note:

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. 

Step 4

We will send the case details to The Clinic, by Cleveland Clinic 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.

Other important information

  • The Clinic, by Cleveland Clinic online second opinion service is not for treatment related to scheme exclusions.
  • The Clinic, by Cleveland Clinic service is for when a Discovery Health Medical Scheme member faces a life-threatening diagnosis or one that affects their 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. Please refer to Cleveland Clinic for additional information.
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