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Surgeon Battles Insurance Giant Over Patient Care Disruption
6 Aug
Summary
- Plastic surgeon interrupted surgery to take call from UnitedHealthcare
- Insurance company denied coverage for patient's overnight hospital stay
- Surgeon claims UnitedHealthcare is retaliating by excluding her clinic from network
In January 2025, Dr. Elisabeth Potter, a plastic surgeon in Texas, was midway through a breast reconstruction surgery when she received a call from a UnitedHealthcare representative. The insurance company wanted to discuss the patient on the operating table, even though the surgery itself had already been approved.
The UnitedHealthcare representative asked for the patient's diagnosis and justification for an overnight hospital stay. Dr. Potter said this "wake-up call" made her realize that insurers now have too much control over medical decisions. While she acknowledged it was her choice to step out of the surgery to take the call, she felt that in the current healthcare system, she has to comply when insurers "say 'jump.'"
After the incident, Dr. Potter claims UnitedHealthcare denied coverage for the patient's hospital stay, despite the surgery being approved. She also alleges the insurance giant is now retaliating against her by refusing to allow her clinic, the RedBud Surgery Center, to join their in-network provider list. Without in-network status, Dr. Potter says she likely won't be able to stay in business, as UnitedHealthcare is the second-largest insurer in Texas.
Dr. Potter has posted about the incident on social media, which has reached millions of views. Experts say her dispute is an example of the ongoing tension between healthcare providers and insurers, as the latter try to control costs by denying claims and imposing barriers to care.
