A surgeon in Austin, Texas, was in the middle of a surgery when he received a call from the patient's insurance company.
Dr. Elizabeth Potter is a board-certified plastic surgeon who specializes in reconstructive surgery for women who have had breast cancer. Last year alone, she performed about 520 surgeries on cancer patients.
She recently shared a video of herself talking about the experience.
Medical costs for patients with private insurance are up to 300% higher than those with Medicare, report finds
“I just had two bilateral DIEP flap surgeries and two bilateral tissue expansion surgeries,” she said in the now-viral video.
(DIEP flap reconstruction uses skin, fat, and blood vessels from the patient's abdomen to reconstruct the breast.)
Texas surgeon Dr. Elizabeth Potter recently shared a video of herself talking about a call she received from an insurance company while operating on a patient. (Dr. Elizabeth Potter; @drelisabethpotter)
In one of the DIEP cases, Potter said, while the patient was asleep on the operating table, a nurse supervisor interrupted the doctor and received a call from the patient's insurance company, United Healthcare. It is said that he informed him.
The nurse who answered the phone said Mr. Potter was out of town because he was in surgery.
“And they said we need to get a message to her because we need to talk to her about this patient,” Potter told FOX News Digital. “So they wrote a note and brought it into the operating room, and I took a picture of it because I was like, I can't believe this is happening.”
Medical care is “overwhelmingly complex'' for the elderly, experts say, “the hurdles are increasing''
The note included the name and phone number of a person to call UnitedHealthcare, the patient's name and Dr. Potter's name. (The memo did not state that the caller requested an immediate response.)
“The nurse at the operating room front desk who took the call and wrote this note said the caller asked first for the patient and then for me,” Potter told Fox News Digital. .
“I made that decision and I support it. I think it was the right thing to do for the patient.”
“He said I was scrubbed.[to the] Or he asked the nurse to contact me in the operating room to relay a message. ”
Potter added: “The head nurse said she had never received a call like that in her career. She thought it must be important and took the message to the operating room. “I brought it to ,” he added.
Dr. Elizabeth Potter, a surgeon in Austin, Texas, was in the middle of a surgery when she received a call from a patient's insurance company. (Dr. Elizabeth Potter; @drelisabethpotter)
Potter said it was strange. insurance company She called the hospital's front desk, which was not staffed.
“They didn't call my office. They didn't call my cell phone. They didn't send an email. This was not a hospital billing department.”
Fearing that the insurance company would deny the patient service, Potter made the decision to stop the surgery midway through the procedure and call United back.
Boy facing blindness undergoes life-changing eye surgery: 'such a blessing'
The surgeon told Fox News Digital that United Healthcare did not ask her to leave the operating room or threaten to deny her an interview.
The patient survived because another surgeon and anesthesia team had completed the surgery.
Dr. Elizabeth Potter is a board-certified plastic surgeon in Texas who specializes in breast reconstruction for women who have had breast cancer. (Dr. Elizabeth Potter)
Potter said she was “scared” that her patients would wake up and find out that their insurance company had denied their claim because they didn't have the necessary information.
“I've seen people get stuck with $80,000 and $100,000 bills before,” she told FOX News Digital. “So I said to my partners, 'I'm going to make this call right away.'” (See her words) Click here for the video. )
“A diagnosis of breast cancer can be financially devastating, so insurance coverage is a critical part of caring for breast cancer patients.”
“If it had been a critical moment during surgery, I wouldn't have done it,” Potter clarified. “But I made that decision and I stand by it. I think it was the right thing to do for the patient.”
The insurance company said in a phone call that it needed to know the patient's diagnosis and the warrant for hospitalization, which Potter said she had already told him.
Woman discharged from hospital days after pig kidney transplant: 'second chance'
“And I was like, wait a minute, we're cleared for surgery. We've submitted all the clinical documentation. All the paperwork and phone calls are done. You have her diagnosis code. “You have everything for that matter,” she continued.
“Then they said, 'Actually, we don't have it, another department has it, but I need this right now,'” Potter said. “At that moment, there was a feeling that I was entitled to my time and information,” the surgeon added.
Click here to sign up for our health newsletter
Potter also noted that the caller did not have access to the patient's complete medical information, even though the procedure had already been pre-approved.
“I'm not sure if that person even understood that it was affecting the patients I was operating on,” Potter told FOX News Digital. “They were just thinking money and numbers I couldn't understand it at all.
Dr. Potter was “scared” that his patients would wake up and find out that their insurance company denied their claim because they didn't have the necessary information, the surgeon told Fox News Digital. (St. Petersburg)
“This is extremely frustrating and frankly unacceptable,” she told FOX News Digital. “Patients and providers deserve better than this. We should focus on care, not bureaucracy.”
Potter said she has always been “committed” to providing in-network care through insurance.
“A diagnosis of breast cancer can be financially devastating, so insurance coverage is a very important part of caring for breast cancer patients,” she told Fox News Digital.
CLICK HERE TO GET THE FOX NEWS APP
“I found that I needed to be hands-on and think about insurance, whether it covers treatment, and what patients are experiencing.”
Mr Potter stressed that he did not believe that insurance was “evil”, noting that there were some “really good things” about a business that valued people.
The surgeon found it odd that the insurance company called her at the front desk of a hospital where she was not an employee. (St. Petersburg)
“But this has evolved into something that is no longer dedicated to patient care. This is just a machine that runs and makes money, and they don't care about me as a health care provider,” she said. Ta.
Potter said many doctors are giving up and refusing to do business with insurance companies, choosing not to engage with them and instead paying patients upfront and getting reimbursed.
“Patients and healthcare providers deserve better than this.”
“I went to Washington, D.C., and fought to protect access. [breast] “I have testified before the state legislature on these issues,” she said.
She added: “It's becoming irreversible. And this week, this moment, it's like we've crossed the line. They're actually in the operating room.” Ta.
Health care or housing? More states are using Medicaid funds to help the homeless.
Fox News Digital has reached out to UnitedHealthcare for comment. The company released the following statement:
“There are no insurance-related circumstances that require a physician to withdraw from a procedure, and if a physician withdraws from a procedure, there is a potential safety risk.”
It added: “We have never requested or expected a physician to interrupt a patient's treatment to answer a phone call. We would like to understand why this unorthodox action was taken. We will continue to follow up with health care providers and hospitals.”
Separately, United Healthcare Group chiefs said Thursday that the company aims to “make high-quality, affordable health care more accessible while making it easier for patients and providers to navigate the health care system.” We continue to focus on that.” (St. Petersburg)
Separately, the head of United Healthcare Group said on Thursday that the company is confident of growing its business in fiscal 2025.
“UnitedHealthcare employees are committed to making high-quality, affordable health care more accessible to more people while making it easier for patients and providers to navigate the health care system. With our continued focus, we are well positioned for growth in 2025,” said Andrew Whitty, CEO. Thursday's financial report.
For more health articles, visit: www.foxnews.com/health
His optimistic remarks came on the heels of the shooting death of an insurance chief in New York City, sparking a heated debate about the role of the U.S. health insurance industry.
Fox News Digital's Daniella Genovese contributed reporting.
