A surgeon shares the story of an insurance provider who called during surgery

A surgeon in Austin, Texas, was in the middle of an operation when he received a phone call from the patient’s insurance company.

Dr. Elisabeth Potter is a board-certified plastic surgeon who specializes in reconstructing women with this disease. breast cancer. Last year alone, he performed about 520 operations for cancer patients.

She recently shared a video of herself talking about the experience.

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“I’ve now had two bilateral DIEP flap surgeries and two bilateral tissue expanders,” she said in the now-viral video.

(DIEP flap surgery reconstruction uses skin, fat, and blood vessels from the patient’s abdomen to reconstruct the breasts.)

Texas surgeon Dr. Elisabeth Potter recently shared a video of herself talking about a phone call from her insurance company during a patient’s surgery. (Dr. Elisabeth Potter; @drelisabethpotter)

In one of the DIEP cases, Potter said, while the patient was lying on the operating table, a nurse interrupted the doctor to report a call from the patient’s insurance company, UnitedHealthcare.

The nurse who took the call said it was Potter in surgery and is not available.

“And they said I need to get a message to him because we need to talk to him 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 can’t believe this is happening.”

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The patient’s name and Dr. Along with Potter’s name was the name and number of a person to call at UnitedHealthcare. (The recording did not indicate that the caller demanded an immediate response.)

“The nurse who took the call and wrote this note said the person on the phone wanted the patient first and then me,” Potter told Fox News Digital.

“I made that judgment call and I stand by it — I think it was the right thing to do for the patient.”

“They told him I was taken to the OR and he asked the nurse to call me in the OR and give the message.”

Potter added, “The nurse manager said he had never received a call like this in his career. He thought it was important and relayed the message to the OR.”

Dr. Elisabeth Potter, a surgeon in Austin, Texas, was in the middle of an operation when she received a phone call from the patient’s insurance company. (Dr. Elisabeth Potter; @drelisabethpotter)

Potter said it was strange insurance company called the front office of the hospital, where there are no employees.

“They didn’t call my office. They didn’t call my cell phone. They didn’t send me a letter. It wasn’t the hospital’s accounting department.”

Fearing that the insurance company might deny the patient service, Potter decided to cancel mid-surgery to return the call to United.

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The surgeon told Fox News Digital that UnitedHealthcare did not ask him to leave the operating room or threaten to deny him coverage.

With another surgeon and anesthesia team completing the procedure, the patient was safe.

Dr. Elisabeth Potter is a board-certified plastic surgeon in Texas specializing in breast reconstruction for women who have had breast cancer. (Dr. Elizabeth Potter)

Potter said he was “scared” the patient would wake up and find out the insurance company didn’t have the information they needed and would deny the claim.

“I’ve seen it before, where people get stuck with $80,000 or $100,000 in bills,” he told Fox News Digital. “So I said to my partners, ‘I’m going to make this call real quick.'” (Watch it. video here.)

“Dealing with insurance is a really important part of caring for patients with breast cancer because a diagnosis is financially devastating.”

“I wouldn’t have done it if it was at a critical moment during the operation,” Potter said. “But I made that judgment call and I stand by it — I think it was the right thing to do for the patient.”

On the phone, the insurance company said they needed to know the patient’s diagnosis and justification for staying inpatient, something Potter has already reported, he said.

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“And I said, wait a minute, we’ve cleared the surgery. We’ve submitted all our clinical records. We’ve done all the paperwork, the phone calls, everything. You have his diagnosis codes, you have them all from him,” he continued.

“And they said, ‘Actually, I don’t have it, another department has it, but I need it now,'” Potter said.

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Potter also noted that the person on the line does not have access to the patient’s full use medical informationdespite prior approval of the procedure.

“I’m not sure that man realized he was affecting the patients I was operating on,” Potter told Fox News Digital. “They were just thinking money and numbers and they didn’t understand anything.”

The surgeon told Fox News Digital that Potter was “scared” that the patient would wake up and find that the insurance company said they didn’t have the information they needed and would deny the claim. (iStock)

“It’s beyond frustrating and frankly, it’s unacceptable,” he told Fox News Digital. “Patients and providers deserve better than this. We need to focus on care, not bureaucracy.”

Potter noted that he has always been “committed” to providing in-network care through insurance.

“Dealing with insurance is a really important part of caring for injured patients breast cancer, because the diagnosis is financially devastating,” he told Fox News Digital.

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“I found that I had to really deal directly and think about insurance and whether they would cover the treatments and what my patients were going through.”

Potter emphasized that he doesn’t think insurance is “bad,” noting that there are some “really good things” in businesses that care about people.

Ironically, the surgeon felt the insurance company calling the front desk of a hospital where he was not an employee. (iStock)

“But it has become something that is no longer dedicated patient care. It’s just a machine that works and makes money, and they’re not interested in me as a provider,” he said.

Potter noted that many doctors have refused to deal with insurance companies, allowing them to stay out of network and handle patient upfront payment and reimbursement.

“Patients and providers deserve better than this.”

“I’m gone Washington, DCI’ve fought to protect access to (breast) reconstruction,” she said. “I’ve testified in the state legislature on these issues.”

He added: “It’s just irreversible. And this moment, this week, it’s like 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 is no insurance coverage for a doctor to deviate from surgery, and if they do, it creates potential safety risks.”

It continued: “We did not want and would not expect a physician to interrupt patient care to answer a call, and we will be contacting the provider and the hospital to understand why these unusual actions were taken.”

Separately, the head of UnitedHealthcare said Thursday that the company is “focused on making high-quality, affordable health care more accessible while simplifying the health care system for patients and providers.” (iStock)

Separately, the head of the UnitedHealthcare group said on Thursday that the company is confident it can grow its business in fiscal 2025.

“The people of UnitedHealthcare are focused on making high-quality, affordable health care available to more people, while making the health care system easier for patients and providers to navigate, positioning us well for growth in 2025,” said Andrew Witty, the company’s CEO. Thursday’s earnings report.

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His optimism comes shortly after the shooting death of an insurance chief in New York, sparking a heated conversation about the role of the health insurance industry in the United States.

Fox News Digital’s Daniella Genovese contributed to the report.