MINNETONKA, MN/USA - MAY 29, 2016: UnitedHealthcare corporate headquarters exterior and sign. UnitedHealth Group Inc. is an American diversified managed health care company. Credit: wolterke/Adobe Stock;
A surgeon who had to take an urgent call in the middle of a procedure to answer an insurance coverage question is facing legal repercussions after posting about her experience on social media.
“There’s a post making its rounds across social media, showcasing a physician that had to leave an active surgery in order to take a call from an insurance company,” said Dr. Dana Corriel, founder of the website SoMeDocs. “The call, the doctor explains, was to get coverage for an overnight stay for the patient on the operating table, which the doctor says she was forced to take. The doctor exclaims her frustration at having to do this for a surgery that was already approved by the insurance company. Dr. Elisabeth Potter explains that she had to scrub out mid-surgery to call UnitedHealthcare, only to find that the person on the line didn’t even have access to the patient’s full medical information, despite the procedure already being preapproved.”
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In her original video, Potter said she was performing a procedure in which surgeons transplant one area of the body into another to create breasts, according to patient advocate Jessica Baladad.
“Since sharing her story on social media and through multiple press outlets, Dr. Potter received a cease-and-desist letter from UnitedHealth demanding she issue a public apology and remove her video(s),” patient advocate Jessica Baladad said. “Attorneys representing UnitedHealth have resorted to gaslighting Dr. Potter, stating in their letter, ‘On the morning of the surgery, your office incorrectly ordered an inpatient hospital stay when you meant to order an outpatient observation stay.... Had you submitted a notification for observation care, no call would have occurred.’”
Potter responded that she had requested an overnight stay for medical reasons and that it was not an error on her part.
“Dr. Potter is a highly respected surgeon and is now being harassed with legal threats simply for exposing the dangerous reality of insurance interference,” Baladad said. “UnitedHealthcare has no leg to stand on, and their assertions are beyond absurd.”
Reaction to the situation on social media has been mixed.
“The only reason for the call was the facility billing for inpatient stay and not observation following surgery,” Dr. Joe Rose posted on LinkedIn. “Per the legal note to the surgeon (four pages I read earlier today), they never called her away from surgery and admonished her for leaving the patient. United typically records all phone calls. If they are able to prove she purposely misled thousands and defamed the company to the tune of more death threats, she will get sued, and she'll likely lose. I get the anger. I'm a practicing physician as well. However, get the facts first.”
Gina Catalano, an executive coach and organizational development consultant, disagreed. “It is outrageous,” she wrote on LinkedIn. “Physicians should determine what is best for their patient, not the insurance companies.”
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Alan Goforth
Alan Goforth is a freelance writer in suburban Kansas City. In addition to freelancing for several publications, he has written a dozen books about sports and other topics.
