Abstracts by keywords: medical indications
The collective agreement regulations for statutory health insurance were supplemented in 2019 to include second opinion procedures. If an insured person is planning to have an operation on the palatine or pharyngeal tonsils (tonsillectomy, tonsillotomy), a hysterectomy, a joint endoscopy of the shoulder (shoulder arthroscopy), an implantation of a knee endoprosthesis, an amputation for diabetic foot syndrome or an operation on the spine , then in addition to the doctor who gave the indication (first opinion), you can also ask a second doctor for medical advice (§ 27b SGB V; Federal Joint Committee 2022). In issue 03/2022 of the “Monitor Healthcare Research” it was already possible to analyze billing data and catchment areas for selected indications in the Hesse health insurance area. The presumed influences and incentives on service provision and utilization were identified (Hartweg/Suk 2022). But in addition to these collective agreement offers, many health insurance companies have now also established their own second opinion procedures. These second opinion procedures are the focus of this article.