Patients & Families

We know how important your health is to you. If you or your doctor would like greater certainty about your diagnosis or treatment plan, Online Second Opinions is here to help. Since 1997, we have offered the convenience and peace of mind that come with remote second opinions by the world-class specialists of Mass General Brigham.

The Harvard Connection

The Harvard Connection

Affiliates of the Mass General Brigham system include Harvard Medical School teaching hospitals.

The Best Of The Best

The Best Of The Best

The Mass General Brigham doctors providing second opinions are leaders in medicine, research and training.

Always There For You

Always There For You

Our case coordinators will guide you and your family through every step of the consultation process.

How it Works

Please see below for details on how to request and receive an online second opinion. If you have any questions, call 888-456-5003 (international callers: +016177249295) or email Our team is available between 8:30 a.m. and 5 p.m. ET, Monday through Friday.

Step 1
Step 1
Register and pay for our service

First, you will create a patient account, which involves providing basic background information (e.g., address and date of birth) as well as credit card information. You will then print our "referring physician letter," which has instructions for your doctor on how to submit a request for your online second opinion.

Step 2
Step 2
Your doctor requests the consultation

Ours is a physician-to-physician service. That means we require the primary doctor treating you to take part in the consultation process. He or she will visit our site, enter detailed information about your medical history and indicate what materials will be submitted as part of your consultation request.

Step 3
Step 3
Send in your medical records and test results

You or your doctor will gather and submit your medical records as well as relevant imaging and/or pathology reports. For an additional fee, you may use Health Advocate, a third-party service that will manage the collection and submission of these materials for you.

Step 4
Step 4
We review your diagnostic reports and assign your case to a specialist.

Our team will have a pathologist and/or radiologist review any diagnostic materials that you provide. We will then match your case with an expert specialist from within the Mass General Brigham system. Specialists typically complete a second opinion within 10 business days. Our case coordinators will keep you and your referring doctor updated on the status of your consultation throughout the process.

Step 5
Step 5
Receive your completed online second opinion

Our team will review and approve the consultative report and then post it on our website for your doctor to view. Once your doctor has reviewed it, you will receive an email informing you that the opinion is ready for you to view. You should discuss the contents of the specialist's opinion with your doctor.

Since 1997, Online Second Opinions (OSO) has provided thousands of patients globally with formal reviews of their imaging, pathology and medical records. We were the first service to deliver second opinions remotely—and continue to set the standard in the field of connected health.

Our team appreciates the concerns and doubts that certain medical diagnoses and treatment plans can cause. We offer reassurance by:

Identifying the most appropriate expert specialists in our network to comment on particular diagnoses

Conducting imaging and biopsy reviews to affirm, adjust or change original diagnoses

Confirming treatment plans, therapies and interventions—or recommending alternatives

Providing guidance on medication management and pain management strategies

With OSO, you can avoid the time and expense of traveling to receive the very best specialty consultation.

Plus, you and your doctor will have the confidence that comes with our diagnosis and treatment plan reviews, thus avoiding unnecessary testing and procedures. That means greater peace of mind for you and your loved ones.

World-renowned Hospitals

We are part of Mass General Brigham, one of the world's elite healthcare systems. The Mass General Brigham mission begins with delivering the highest-quality patient care possible.

Affiliated institutions include Brigham and Women's Hospital, Massachusetts General Hospital, the Spaulding Rehabilitation Network, the Dana-Farber Cancer Institute, McLean Hospital and Massachusetts Eye and Ear—all of which are affiliated with Harvard Medical School.

Each hospital hosts cutting-edge research, technologies and treatments, and is active in driving the future of medicine.

Access to Top Doctors

Mass General Brigham physicians are clinical and research leaders in their respective fields whose reputation and skills draw patients from around the globe.

Most also hold faculty positions at Harvard Medical School. No one else offers access to this level of physician expertise across such a wide range of specialties (nearly all adult and pediatric specialties in the Mass General Brigham network).

A Team That Cares

Our team includes highly committed case coordinators who bring years of experience working with specialists throughout the Mass General Brigham network. They are here to guide you and your family through every step of the consultation process.

With a dedication to customer service, they will do all they can to answer your questions and ensure the second opinion includes the precise information you and your referring physician need.

Here is a look at pricing for the services available through Online Second Opinions. Patients are responsible for all charges, and payment is due at the time of request.

Specialist Opinion

This is the base cost for a medical second opinion. We encourage you to provide specific questions that you would like the reviewing doctor to address in the consultation letter. Doing so is helpful to the reviewing doctor and ensures you and your referring doctor receive useful input and recommendations. Please note: There is an additional fee if you request an imaging and/or biopsy review, include more than four questions for the reviewing physician or use the Health Advocate medical record collection service. See below for details.

Imaging Review
$375 each

An imaging review involves an interpretation of imaging examinations, such as computed tomography (CT or CAT) scans or magnetic resonance imaging (MRI) scans. Pricing depends on how many different parts of the body are being reviewed. Each imaging site is considered a separate study.

Biopsy Review
$425 each

A biopsy review involves an interpretation of pathological specimens, which may take the form of slides or blocks. Pricing depends on how many different parts of the body are being reviewed. Each biopsy site is considered a separate study. Please note: There is an additional fee for reviews of blocks or unstained slides, or if special staining of slides is required for interpretation.

Health Advocate Medical Record Collection Service

In order to make the consultation process as easy as possible for you, we have partnered with Health Advocate. This third-party service will manage the collection and submission of all medical records and test results required for your second opinion.

Additional Charges

Submitting more than four questions (including multi-part questions) in your request will incur an additional fee. Clarification questions are allowed after a consultation, but there is an additional fee for follow-up questions.

Also, the following fees apply for medical records with more than 50 pages:

Pages Charge
51 - 75$25
76 - 100$50
101 - 125$75
126 - 150$100
151 - 175$125
176 - 200$150
201+Contact us to discuss

If you have any questions about costs, please contact us at

Online Second Opinions (OSO) works with specialists throughout the prestigious Mass General Brigham system to provide consultations. These doctors, among the best in the world in their fields, have typically earned multiple honors and awards. Many hold leadership positions in their hospitals and/or medical associations.

Furthermore, only Mass General Brigham physicians who are fully tenured and licensed as well as board-certified are eligible to consult through our service. Interns, residents and fellows cannot participate.

Please see below for an example of the quality and level of detail of a OSO consultation.

September 12, 2016
Jane Doe

Dear Referring Physician,

Thank you very much for your consultation regarding female patient, DOB: 1/25/1967. I have reviewed the medical records that were provided as well as the imaging. My findings and opinion regarding her case follows:(1)

Chief complaint: Bilateral forefoot pain(2)

History Provided:(3)

She has suffered with bilateral hallux valgus for a few years, however, in 2015 following a 3-day trekking holiday the condition worsened considerably.

Walking is limited and has declined markedly over the last 2 years.

She describes pain as chronic, although reluctant to take oral analgesia she prefers topical treatments, ice packs etc. Although provided with Orthotics, she was never advised to change them after wearing them of 6-7 months, and consequently her foot pain increased. She is now waiting for new ones, and expects them next week.

Generally, in good health, no associated health problems that may affect her hallux valgus.

She is awaiting new pair of orthotics, only to be worn with comfortable low heeled walking shoes. She is reluctant to take oral analgesia despite chronic pain; prefers topical remedies such as ice packs.

No pain when wearing house slippers, otherwise pain is experienced when wearing all types of other foot wear. She expresses concern that having to wear orthotics in the summer will only increase her foot pain, as she is unable to wear sandals.

The patient has been advised that if it is progressing it was likely to continue to do so and so she should consider surgery sooner rather than later as it will be a smaller operation with greater probability of success. Currently the patient doesn't feel it is bad enough to warrant surgery.


Radiographs that were provided consist of 3 views of each foot done in a weight bearing position. No fractures or dislocations are noted. Joint spaces appear well preserved. There is no soft tissue abnormality noted. There is a mild hallux valgus deformity of each foot. There appears to be a bipartite tibial sesamoid on the left. The sesamoids appeared to be well located underneath the first metatarsal head. There is some prominence to each medial eminence on the first metatarsals. Although I was not able to accurately measure the hallux valgus angle or the 1-2 intermetatarsal angle these do not seem much greater than values that have been determined in the normal, non-affected population.

Answers to Specific Questions:(5)

1. Is surgery needed?(6)

I do not believe that surgery is needed at this time. Perhaps the primary determinant for undergoing surgery is whether the patient feels that it is warranted given their current set of circumstances. The patient very clearly states that she "...doesn't feel it is bad enough to warrant surgery."

2. What is the recommended timeframe for the surgery?

It is quite possible that she will have worsening of the deformity with concomitant worsening of her pain and decrease in function. If this occurs reassessment of the value of surgical correction should be undertaken at that time.

3. Is it advisable to wait?


4. What are the risks a) if she has it now b) if she waits until she is more symptomatic?(7)

Some of the risks that surgery poses would be present whether it is performed now or in the future. These include but are not limited to wound healing complications, infection, nerve damage, blood vessel damage, failure to achieve correction, recurrence of deformity, joint stiffness, continuing pain and overcorrection of deformity. The complications might differ if she waits until she is more symptomatic if alternative methods of erection including soft tissue/bone fixation are used. These would be specific to the procedure that was used.

5. What other alternatives exist?

The alternatives that exist for the treatment of her problem include comfortable shoe wear with a wide toebox. Although I do not think that any one brand is superior to others I have found that Keen shoes are very effective in providing comfort in patients such as this. They have a large toebox and can be used for many different types of activities/active lifestyles. I would avoid fashionable shoes that have a narrow, tapered toebox with high heels.

In addition to altering shoe wear her current shoe wear might be able to be modified using a ball and ring shoe stretcher. The goal of this device is to stretch out the shoe upper material to better accommodate the medial eminence where most people have pain with hallux valgus deformity. These can be obtained on line for a quite modest price and can be used repeatedly and in all of the patient's shoe wear.

A silicone toe spacer can be placed between the first and second toes to realign the deformity and potentially provide her with some relief.

6. Based upon the history and images, what are your recommendations for the best patient outcome?

Currently, I would pursue non-operative means for controlling the patient's symptoms and to prevent progression of her deformity. If these fail to provide relief she may want to consider surgery when she feels that non-operative methods have been exhausted and that she has no alternative.


I do not advise her undergoing hallux valgus surgery at this time. I think that using the aforementioned non-operative methods could provide her with significant relief and allow her to participate in the activities that she would like to. If the deformity she has progresses and the feet become more painful she may want to consider surgery at that time. Unless there is a worsening of great magnitude in her deformity the surgical correction would not be that much more difficult to perform compared to the surgical procedures that could be considered currently.

Please do not hesitate to contact me in the future if there are additional questions or concerns. Thank you for the opportunity for providing treatment recommendations regarding this patient.


Orthopedic Physician

1 The specialist who wrote this consultation is an orthopedic surgeon who is medical director of his hospital's foot and ankle center.
2 This patient is dealing with a chronic foot problem.
3 The specialist provides a detailed summary of the information sent to him.
4 In this case, the specialist was asked to review radiologic examinations. He offers detailed observations on the condition of the patient's feet.
5 It's important for the patient and referring physician to include questions they would like addressed in the consultation. Here, the specialist answers the questions directly, ensuring the opinion contains useful input and actionable recommendations.
6 Every OSO consultation is written with the individual patient in mind. The patient in this case has concerns about undergoing surgery, which the specialist has considered in writing his opinion.
7 While the specialist says there is no immediate need for surgery, he also outlines possible risks of waiting. Below, he also highlights alternative treatments to consider. Armed with this information, the patient and her local doctor can make an informed decision on how best to proceed.
8 Keeping in mind the patient's concerns, the specialist does not recommend undergoing surgery at this time. He also notes that the decision to delay surgery should not have negative consequences, even if it proves necessary later on.

Patients and families who have received consultations through Online Second Opinions (OSO) express how our service has touched their lives.

"The online consult gave me the information I needed to approach my radiation oncologist and ask for another opinion from another medical oncologist. I am currently on my fourth of five days of my first round of chemo at a hospital in Indianapolis. We are using the same chemo meds suggested by the online consult. Thank you. This has been a wonderful service."

"I had gotten two opinions here in New York, and they were quite different. Your specialist's opinion was consistent with the information I had received from one of the two sources and helped me choose what I believe is a better approach for my situation. I am told that my cancer is rare, which makes my choices more complicated. Since most oncologists seemto work primarily from the pathology, it made sense to take advantage of the opportunity to consult with an expert at Dana-Farber without having to travel there."

"This service is a lifesaver. We do not have a sarcoma center in our state. The information provided by your specialist gave me the strength and further support to approach an oncologist in our state to insist on the proper treatments. Thank you!"

"Your service was wonderful. The staff's follow-up and follow-through were far superior than what my family received from any facility local to our home. Though the outcome was not good for my father, your superb professionalism and attention to detail were far superior to the care my father had received elsewhere."

"I was extremely satisfied with my POSO case coordinator. She was very caring and empathetic — a great asset to the program. She is an excellent communicator — something you don't always find in modern medicine. Plus, she offered her availability by phone or email should any additional questions come up. I am now much more accepting of my condition and have a more positive outlook, even though it is a degenerative condition."

Get Started

You are only a few steps away from getting the answers you need. Create a patient account to begin the process.

Meet Our Specialists

We offer access to Mass General Brigham doctors across nearly all adult and pediatric specialties.

Online Second Opinions cannot offer all or some of its services to residents of certain U.S. states, U.S. territories and countries. If you live in one of these locations, our website will inform you before you begin the registration process that your case cannot proceed.

U.S. States and Territories

The following U.S. states and territories prohibit the rendering of second opinions over state lines.

U.S. States/Territories Prohibited





New Mexico



Virgin Islands


The following U.S. states do not allow certain diagnostic reports to be shared across state lines.

Pathology prohibited



Radiology prohibited


New Hampshire

North Carolina

Both pathology and radiology prohibited


American Samoa

Federated States of Micronesia


Marshall Islands

New Jersey

Northern Mariana Islands


Rhode Island

South Carolina


West Virginia


Our service is not available to residents of countries that are subject to sanctions by the U.S. Government, including:

Countries Prohibited



Burma (Myanmar)

Central African Republic


Democratic Republic of Korea (North Korea)

Democratic Republic of the Congo










South Sudan

State of Palestine


Syrian Arab Republic (Syria)





Have a question? Review the FAQ below. If you are still looking for answers, contact us.

Does my referring doctor need to participate in the consultation process? If so, why?

Yes. Having your doctor participate is a legal requirement for a variety of reasons. For example, Online Second Opinions (OSO) must adhere to Health Insurance Portability and Accountability Act (HIPAA) rules and state licensure laws, all of which are designed to protect patient privacy. In addition, many U.S. state laws prohibit the practice of medicine across state lines unless it is between doctors and in the form of a consultative opinion. Finally, many of the reports written by our specialists contain medical terminology, so it is important that your doctor first reviews the second opinion and then discusses its content with you.

Will my doctor be insulted that I am seeking a second opinion?

Your doctor should not be insulted, as seeking a second opinion is common practice in most countries. If he or she is insulted, you should stress that you are simply trying to gather all the information you need to make an informed decision about your health. It is not always an easy conversation, but one worth having.

How much does your service cost?

The base cost for a medical second opinion is $950. Additional charges apply in certain cases, such as if a formal imaging or biopsy review is performed by our radiologists or pathologists. See this page for more details.

Will my health insurance plan or Medicare cover the cost of the online second opinion?

Patients are responsible for all charges, and payment is due at the time of request. Our team cannot file a claim with your insurance carrier or provide a procedure (CPT) code for this service.

How do you choose the specialist who will review my records and provide the report?

Our team includes case coordinators with years of experience recruiting and working with physicians at all Mass General Brigham hospitals. The case coordinators leverage their experience — and physician input — to identify the best qualified specialist based on your medical situation and the questions that you and your doctor submit. This collaboration is yet another OSO advantage.

How do I get started, and what are the steps in the process?

The first step is to register and enter your credit card information. See this page for more details.

Can I request a particular Mass General Brigham specialist to review my records?

While we make every effort to accommodate requests in these cases, we cannot guarantee that a particular doctor will be available to review your records. Regardless of which doctor reviews your case, you can be confident that he or she has highly specialized expertise.

English is not my doctor's first language. Do I need to have my records professionally translated?

Yes. Medical translation is a challenging task performed by professional translators who have an exceptional understanding of both medical terminology and the many nuances of the languages involved. Having your records professionally translated helps our specialists provide the most accurate and relevant information possible in their reports—and is critical to ensuring patient safety.

How can I get my records professionally translated?

While we do not endorse any particular translation companies, we have had good results with Interpreters Associates Inc. ( or

I have all of my records ready. May I send them to you?

You may send your records to us. However, we cannot proceed with your case until your referring doctor registers with OSO and enters your case.

Once my records are submitted, how long should I expect to wait for the report?

Our specialists typically complete a second opinion within 10 business days. Our case coordinators will keep you and your referring doctor updated on the status of your consult throughout the process.

What do I do if I have follow-up questions?

You and your doctor may submit questions aimed at clarifying information contained in a second opinion. However, there is an additional fee for follow-up questions. See this page for more details.

Can I meet, speak with or email the specialist who reviews my records?

You may not do so as part of the OSO consultation process (although when requesting the consult, we encourage you and your doctor to submit questions that you would like the specialist to answer). If you would like to schedule an appointment with the specialist subsequent to the OSO consultation, please contact us. We will be happy to help.

Can I get a prescription through your service?

No, as we are not a pharmacy. An opinion may include suggested medications, treatments and/or therapies. However, the patient’s local doctor is responsible for writing all prescriptions.

Why can't people from my state use your service?

Roughly 10 U.S. states prohibit the rendering of second opinions over state lines. If you live in one of those states, our website will inform you before you begin the registration process that your case cannot proceed. Our service is not available to residents of countries that are subject to sanctions by the U.S. government.

Can I request an online second opinion for a loved one?

Yes, although you must fill out a form before doing so. Please contact us for more information.

Do you offer an option for rapid turnaround of a consult?

We try to accommodate urgent requests, but it depends on the availability of our specialists and how quickly we can access your medical records. An additional fee may apply.

Do you offer consults via Skype or other videoconferencing services?

Not at this time, although we will introduce videoconferencing in the near future.

What is Mass General Brigham?

Mass General Brigham is a not-for-profit healthcare delivery network based in Boston, Massachusetts. Member institutions include prestigious Harvard Medical School teaching hospitals, including Brigham & Women's Hospital and Massachusetts General Hospital, which co-founded Mass General Brigham in 1994.

What is Mass General Brigham Connected Health?

Mass General Brigham Connected Health, which manages OSO, is a leading force in the use of technology to deliver care outside of hospitals and doctor's offices. Applying personal health technologies, including remote monitoring, mobile health, personal health trackers and sensors, its people are creating new solutions for empowering individuals and providers to better manage health and wellness.