The surgeon will share the history of calling the insurance provider during surgery
A surgeon in Austin, Texas was in the middle of an operation when she was alerted by a phone call from the patient’s insurance provider.
Dr. Elizabeth Potter is a board-certified plastic surgeon who specializes in reconstructive surgery for women with breast cancer. Last year alone, she performed nearly 520 surgeries on cancer patients.
She recently shared a video of herself talking about her experience.
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“I’ve just had two bilateral DIEP flap surgeries and two bilateral tissue expansion surgeries,” she said in the now-viral video.
(In DIEP flap reconstruction surgery, skin, fat and blood vessels from the patient’s abdominal area are used to construct the breast.)
Dr. Elizabeth Potter, a Texas surgeon, recently shared a video of herself about a phone call from an insurance company during a patient’s surgery. (Dr. Elisabeth Potter; @drelisabethpotter)
In one of the DIEP cases, while the patient was lying on the operating table, the doctor was interrupted by a nurse supervisor who received a call from the patient’s insurance company, UnitedHealthcare, Potter said.
The nurse who took the call said Potter was in surgery and would not be available.
“And they said we need to talk to her about this patient,” Potter told Fox News Digital. “So they wrote a note and brought it to the operating room and I took a picture of it, because I thought, I can’t believe this is happening.”
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The note listed the name and number of the person calling UnitedHealthcare along with the patient’s name and Dr. Potter’s name. (The memo did not indicate that the caller requested an immediate response.)
“The nurse at the OR’s front desk who took the call and wrote this note said the person on the phone asked first for the patient and then for me,” Potter told Fox News Digital.
“I made that judgment call and I stand by it — I think it’s the right thing to do for the patient.”
“He was told I was wheeled into (the) OR and asked to meet the nurse in the OR and give me the message.”
Potter added, “The nurse manager said she had never had a call like this before in her career. She brought the message to the OR thinking it must be important.”
Dr. Elizabeth Potter, a surgeon in Austin, Texas, was in the middle of an operation when she received a phone call from the patient’s insurance provider. (Dr. Elisabeth Potter; @drelisabethpotter)
It was strange, said Potter, this Insurance company She called the front desk of the hospital where she was not an employee.
“They didn’t call my office. They didn’t call my cell phone. They didn’t send me an email. This was not the billing department of the hospital.”
Fearing that the insurance company might deny the patient services, Potter decided to clear the middle surgery to return the call to United.
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The surgeon told Fox News Digital that UnitedHealthcare did not want her out of the operating room or threaten to deny coverage.
When the patient completed the procedure, he was fine with another surgeon and anesthesia team.
Dr. Elizabeth Potter is a board-certified plastic surgeon in Texas who specializes in breast reconstruction for women with breast cancer. (Dr. Elizabeth Potter)
Potter said she was “scared” when the patient woke up and realized the insurance company didn’t have the information they needed and was denying the claim.
“I’ve seen people get stuck with $80,000 or $100,000 bills before,” she told Fox News Digital. “And I said to my partners, ‘I’m going to make this call quick.'” (See her. Video here.)
“Insurance management is a very important part of caring for patients with breast cancer, because the diagnosis has a significant financial impact.”
“I wouldn’t have been there if it had been at a critical time during the surgery,” Potter said. “But I made that judgment call and I stand by it — I think it’s the right thing to do for the patient.”
On the phone, she explained that the insurance company needed to know the patient’s diagnosis and the reason for the patient’s stay, which Potter had previously said.
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“And I was like, wait a minute, we got approval for the surgery. We submitted all our clinical documents. We did all the paperwork, the phone calls, everything. You have her diagnosis codes, you have everything. From it,” she continued.
“And they said, ‘Actually, I don’t have it, another department has that, but I need this right now,'” Potter said. “At that moment, I felt entitled to my time and information,” the surgeon added.
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Although the procedure was pre-approved, Potter said, the person on the line could not access the patient’s full medical information.
“I’m not sure I even realized that that person had an impact on the patients I was operating on,” Potter told Fox News Digital. Money and numbers And they didn’t notice anything.”
Potter was “scared” when the patient woke up and found out the insurance company didn’t have the information they needed and was denying the claim, the surgeon told Fox News Digital. (iStock)
“It’s beyond annoying and frankly unacceptable,” she told Fox News Digital. “Patients and providers deserve better. We need to focus on care, not bureaucracy.”
Potter said she has always been “committed” to providing in-network care through insurance.
“Connecting with insurance is a very important part of caring for patients with breast cancer, because the diagnosis has a huge financial impact,” he told Fox News Digital.
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“I’ve learned that I really have to be directly involved and think about insurance and medical coverage and what my patients are going through.”
Potter emphasized that she doesn’t think insurance is “evil,” noting that there are some “great things” about businesses that take care of people.
It was odd, the surgeon felt, for the insurance company to call the front desk of a hospital where she wasn’t an employee. (iStock)
“But this has escalated into something that’s no longer patient care. It’s running a machine and making money, and they don’t care as a provider,” she said.
Many physicians are discouraged and unwilling to talk to insurance companies, to stay out of network and allow the patient to pay up front and get the money back, Potter explained.
“Patients and providers deserve better.”
“I went to Washington, D.C., and fought to prevent breast reconstruction,” she said. “I have testified in the state legislature on these issues.”
She added, “It’s becoming irreversible now. And at this moment, this week, we’ve crossed a line — they’re actually in the operating room.”
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Fox News Digital has reached out to UnitedHealthcare for comment. The company sent the following statement.
“There are no insurance-related conditions that require a physician to withdraw from surgery, and doing so creates safety risks.”
He continued, “We have not asked, nor would we ever expect, a physician to return the call to terminate a patient’s service, and we will follow up with the provider and the hospital to understand why these unusual actions occurred.”
Separately, the head of UnitedHealthcare Group said on Thursday that the company is “focused on making the health system easier for patients and providers to navigate and making high-quality, affordable health care more accessible.” (iStock)
Separately, the head of UnitedHealthcare Group said on Thursday that the company is confident of growing its business in fiscal 2025.
“The people of UnitedHealthcare are focused on making high-quality, affordable health care accessible to more people, making the health system easier for patients and providers to navigate, and better positioned for growth by 2025,” CEO Andrew Whitty said at the company. Earnings report on Thursday.
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The optimism comes shortly after the shooting death of the head of the insurance division in New York City, sparking a heated debate about the role of the health insurance industry in the United States.
Fox News Digital’s Daniela Genovese contributed reporting.
