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How to Get a Second Opinion for Your Child with Special Needs

Alethea Mshar
Special needs mom and Blogger
10/26/16  1:49 PM PST
second opinion

Seeking a second opinion for your child with complex medical needs? This savvy mom shares tips on how to get a second opinion without unnecessary delays.

 

As a mother of a child with complex medical needs, I have become adept at navigating referrals, paperwork, and whatever it takes to get my son the care he needs. Even after earning my stripes as a medical mama, I’ve found myself in need of a second opinion more than once, realizing that I was once again in new territory. Getting a second opinion was an area that had a steep learning curve for me. Having done it a few times, I can share some tips to help you get the process going and keep it moving so your child gets the care he needs without unnecessary delays.

 

Second Opinion: First Things First

If you need a second opinion from a specialist, start by going back to your primary doctor to let them know you need a second opinion. They will be able to guide you toward someone who accepts your insurance, and whose reputation they know. It will also give them an opportunity to get feedback on the specialist you have been seeing, so if there’s a problem they can avoid sending other children there. You may need to travel for your second opinion, so don’t be surprised if you’re sent to a major metropolitan area.

Support groups are also a great source of feedback about local specialists, so don’t be afraid to check in with your local advocacy group, nonprofit organization or a Facebook group for your child’s disease or disability.

Your insurance company can tell you which doctors are in your network, so calling and getting a list from them can help you narrow down the options if you have several to choose from.

A second opinion from the primary doctor can come from a doctor in the same practice if you’re comfortable with that. It can be tricky to get a pediatrician from another practice to see your child without transferring them to the practice, but you can always go to an urgent care center if needed.

 

Second Opinion: When the Process gets Stuck

Once you find a provider and get the referral for a second opinion, the process can get stuck before you actually get in to see them.

Your insurance provider might delay or deny coverage for the appointment. If this is the case, try calling the customer service line to get more information. Your pediatrician can also help you work with your insurance company to get past any obstacles that arise. When this has happened, I’ve been a squeaky wheel and called the customer service line daily until the issue was resolved. If insurance declines the second opinion altogether you can go through their appeal process. It’s wise to take notes along the way and clearly document your reasons for requesting the second opinion so that if and when this happens you’re prepared to move forward with the appeal without delay. If you go through all the channels and still cannot get approval, ask if there’s a doctor that they will approve for a second opinion.

Once you get through the referral and insurance approval and it’s time to make the appointment, it’s not uncommon to find that the specialist is not taking new appointments for months, or even years. If this is the case, ask if they have a waiting list and get on it. You can also speak with the office manager to request an exception. It’s a long shot, but it can’t hurt to ask.

 

Hang in There!

The second opinion process is tough. You’re questioning your child’s care and that’s never easy. Make sure you take good care of yourself and get support when you need it. You will get through the process, and you’re doing the right thing by your child, so rest well knowing you are on the right path.

 

Support organizations and advocacy groups for children with special needs:

Easter Seals

The Arc

Parents Helping Parents

Special Needs Alliance

 

More from Alethea Mshar:

Down Syndrome Awareness Month

The Superheroes of Childhood Cancer

Self-Care for Parents of Special Needs Children

 

Comments

2 Comments

  1. Carolene Chadwick
    Posted November 18, 2016 at 8:27 pm PST

    Looking for a support group for special needs adults that still need full time care from parents

  2. Posted November 21, 2016 at 8:10 am PST

    Hi Carolene, a few options come to mind, including online support groups where you can request to join, then have access to ask questions of other group members. A couple are The Daily Feed Online Support Group and Special Needs Community. Parents Helping Parents offers in-person and online support groups for adult children with developmental disabilities. Also, check your local Easter Seals for info on support groups. Hope that helps!

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