Remote Second-opinion Program for Adult Hydrocephalus
The goal of the Remote Second-opinion Program of the Adult Hydrocephalus Center at The Sandra and Malcolm Berman Brain & Spine Institute is to provide a limited second medical opinion for those who are either diagnosed with, or suspect that they have, adult hydrocephalus or normal pressure hydrocephalus. If you are over the age of 18, fit into one of the following categories, and are unable to travel to Sinai Hospital in Baltimore, our program may be able to help you.
Patient who has been diagnosed by a physician with normal pressure hydrocephalus and desires an expert to review your records and scans
Patient over age 65 who has been diagnosed with hydrocephalus
Young or middle-aged patient who has been diagnosed with hydrocephalus by a physician and desires an expert to review your records and scans
Patient who is already being treated for hydrocephalus
Services that we Provide
Review of patient history form. Those seeking our service should download and complete this form and send it with the requested documents, records, and scans.
Review of consultation reports from your primary care physician, neurologists, neurosurgeons, or other specialists for possible hydrocephalus
Review of MRI or CT scans (brain or spine)
Review of lab studies (blood studies, cerebrospinal fluid analysis, etc.) that have been done to evaluate for hydrocephalus
Review of neuropsychologic report for diagnostic purposes and for treatment and rehabilitation recommendations by a neuropsychologist
Who may Request a Remote Second Opinion
Patients themselves
Patients' family members, with signed permission of the patient
Patients' surrogate decisions makers, healthcare agents, or persons with durable power of attorney for healthcare decisions, provided that:
A copy of the patient's living will, advance directive, or assignment of durable power of attorney is sent to us, and
Evidence that the patient is not capable of making healthcare decisions is provided. This can be a copy of an evaluation by or a letter from a physician that affirms that the patient lacks decision-making capacity.
To respect patients' autonomy and privacy, under no circumstance will we provide a remote second opinion unless the criteria above are satisfied.
Fees
The fee for the second-opinion service is $400. This is an out-of-pocket expense that can be paid by credit card or personal check.
Health insurance coverage is not available for this service.
If neuropsychologic review is requested, an additional $200 fee will be required.
Payment will not be processed until the application is complete and all necessary forms have been received by our administrative coordinator.
The Remote Second Opinion will not be performed until payment has been verified.
Time Required to Provide a Report Our goal is to provide you and your physician with a written remote second-opinion report within 10 business days after verification of payment. Our office will notify you when verification is received, as well as if an unanticipated delay occurs in transcribing the report. A written report will be mailed to your address. If you authorize email transmission of the report, we will email the report to you in PDF format.
How to Request a Remote Second Opinion
To initiate the application process, please contact the Hydrocephalus Center Second-opinion Program at 410-601-1900.
Complete and return the following forms: a) Patient Intake Form b) Patient History Form c) Patient Disclaimer (signed by the patient or his/her legal representative) d) Payment Authorization (signed by the patient or his/her legal representative) e) If a physician is requesting the second opinion-Consultation Request Form
Send copies of all applicable medical records and reports, as well as actual MRI or CT scans (see checklist below).
For neuropsychology report review, send a copy of the report that you would like us to review, along with raw and standardized scores.
Send all medical information (reports, results, MRIs, etc.) and application materials via Fedex, UPS, DHL, or US Postal (certified, priority or express mail) to:
Adult Hydrocephalus Center Second-opinion Program Michel Mirowski Medical Office Building 5051 Greenspring Avenue, Suite 300A Baltimore MD 21209
Tel: 410-601-1900 // Fax: 410-601-1901
Forms and Documentation Checklist
Patient Intake Form Patient History Form Payment Authorization (signed by the patient or his/her legal representative) Patient Disclaimer (signed by the patient or his/her legal representative) Consultation Request Form (if a physician is requesting the second opinion) Consultation reports from neurologists/neurosurgeons that indicate possible hydrocephalus (hospital discharge summary or operative reports if appropriate). Current list of medications and dosing information Actual MRI and CT scans and written reports (NOT only the written reports) Lab studies (blood or cerebrospinal fluid) Neuropsychology reports (if review is desired)
NOTE We are unable to return reports or scans. Do not send originals. Please send copies.
If no alternative is possible and you must send originals, you will be responsible for the postage required to return the originals.
DISCLAIMER Remote second opinion is not a substitute for an evaluation by a physician. We cannot make the diagnosis of hydrocephalus solely upon the review of records and scans. However, we may be able to recommend whether a patient should have further testing for normal pressure hydrocephalus or other disorders, or whether they should have further testing for shunt function or malfunction.
We encourage patients who desire a second opinion from the physicians at the Adult Hydrocephalus Center to travel to our facility for a comprehensive evaluation.
If you are interested in obtaining a remote second opinion from a physician at the Adult Hydrocephalus Center, please call 410-601-1900.
