Discuss the requirements for an SSO (second surgical opinion)
What will be an ideal response?
Answer:
A second opinion or confirmatory consultation is designed as a benefit to the patient by confirming the need for surgeries that have a reputation for being done needlessly. Normally, for an SSO benefit to be payable, the following requirements must be satisfied:
a. The second or third opinion physician must be totally uninvolved with the original recommending physician. Therefore, he or she cannot be part of the same medical group and will often be picked by the administrator, medical management firm, or payer.
b. The consultation must be completed before the scheduling of surgery.
c. The second opinion physician cannot perform the recommended surgery.
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