During surgery, surgeon recounts encounter with insurance provider.

During surgery in Austin, Texas, a surgeon received a phone call from the patient's insurance provider.

Dr. Elisabeth Potter is a board-certified plastic surgeon who specializes in reconstructing breasts for women who have undergone breast cancer surgery. In the past year, she performed approximately 520 surgeries on cancer patients.

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

She stated in a viral video that she recently completed two bilateral DIEP flap surgeries and two bilateral tissue expander surgeries.

Abdominal skin, fat, and blood vessels are used to reconstruct breasts in DIEP flap surgery.

While the patient was asleep on the operating table, the doctor received an interruption from a nurse supervisor informing her that a call had come in from UnitedHealthcare, the patient's insurance company, Potter said.

The nurse on the call stated that Potter was undergoing surgery and unavailable.

"Potter informed Planet Chronicle Digital that they wrote a note to convey a message to the patient, as they needed to discuss the matter with her. They then brought the note into the operating room and took a picture of it, as Potter was astonished by the situation."

The caller was provided with the name and number of the person to contact at UnitedHealthcare, along with the patient's name and Dr. Potter's name.

Potter told Planet Chronicle Digital that the nurse who took the call and wrote the note said that the person on the phone first asked for the patient and then for me.

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

"The nurse informed him that I was scrubbed in and he requested that I be contacted in the OR and given a message."

The nurse manager had never received a call like that before, so she thought it must be important and brought the message to the OR.

Strange, Potter remarked, was that the insurance company had contacted the hospital's front desk, despite her not being an employee there.

"The hospital's billing department did not contact me via phone, email, or office call."

To avoid the insurance company denying the patient's service, Potter decided to interrupt the surgery to call United.

The surgeon clarified to Planet Chronicle Digital that UnitedHealthcare did not mandate her departure from the operating room or threaten to withhold coverage.

The procedure was completed by another surgeon and the anesthesia team, ensuring the patient's safety.

Potter was "worried" that the patient would wake up and discover that the insurance company lacked the necessary information and would reject the claim, she stated.

"I've witnessed this situation before, when individuals face bills of $80,000 or $100,000," she stated to Planet Chronicle Digital. "Therefore, I quickly made the call to my partners." (Watch her video here.)

"Dealing with insurance is a really important part of taking care of patients affected by breast cancer, because the diagnosis is financially devastating."

"Potter stated that if the situation had been critical during surgery, he wouldn't have made the decision he did. However, he made that decision and believes it was the right thing to do for the patient."

Potter had already communicated the patient's diagnosis and the justification for the inpatient stay, which the insurance company needed to know on the phone.

We received authorization for the surgery, submitted all clinical documentation, and completed all paperwork, phone calls, and other necessary tasks. You now have her diagnosis codes and all the required information.

Potter said, "And they said, 'I don't have it, another department does, but I need it now,'" while the surgeon added, "There was a sense of entitlement to my time and to the information in that moment."

Despite the procedure being pre-approved, the person on the line lacked access to the patient's complete medical information.

"Potter told Planet Chronicle Digital that he was unsure if the person realized they affected the patients he was operating on, as they were solely focused on money and numbers and lacked comprehension."

"She told Planet Chronicle Digital that it's unacceptable and frustrating for patients and providers, and we should prioritize care over bureaucracy."

Potter has consistently been committed to delivering care within the network through insurance.

The financial devastation caused by breast cancer diagnosis makes dealing with insurance a crucial aspect of patient care, as she explained to Planet Chronicle Digital.

"I've discovered that I need to engage directly and consider insurance coverage and the treatments my patients are experiencing."

Potter stated that she believes insurance is not "evil," and that there are positive aspects to businesses that prioritize their customers' well-being.

"However, this has evolved into something that no longer prioritizes patient care. It's simply a machine generating revenue, with no regard for me as a healthcare provider," she stated.

According to Potter, many physicians have abandoned the insurance industry and opt to remain out-of-network, requiring patients to pay upfront and handle reimbursement on their own.

"Patients and providers deserve better than this."

"She said, "I have testified in the state legislature about protecting access to breast reconstruction.""

She added, 'It's just getting undoable. This moment, this week, was like we've crossed a line - they're actually in the operating room.'

UnitedHealthcare responded to Planet Chronicle Digital's inquiry with the following statement.

"If a physician were to step out of surgery for insurance-related reasons, it would create potential safety risks."

We did not anticipate a physician interrupting patient care to respond to a call, and we will investigate the reasons behind these unusual actions.

On Thursday, the head of UnitedHealthcare group stated that the company is optimistic about expanding its business in the upcoming fiscal year 2025.

In the earnings report on Thursday, CEO Andrew Witty stated that UnitedHealthcare's people are committed to increasing access to high-quality, affordable health care and simplifying the health system for patients and providers, which will benefit the company's growth in 2025.

For more Health articles, visit planetchronicle.net/health

The shooting of the head of its insurance unit in New York City sparked a heated discussion about the role of the health insurance industry in the United States, and his optimism emerged shortly after.

Planet Chronicle Digital's Daniella Genovese contributed reporting.