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A representative from the insurance company had called the hospital, she said, about the patients insurance claim.
Courtesy of Elisabeth Potter, MD
(While Dr. Potter stepped out, the patient was under the care of a co-surgeon.)
Had [they] not made that error, UnitedHealthcare would not have reached out.
In early FebruaryAllurereached out to UnitedHealthcare for comment on Dr. Potters social media posts as the story was developing.
There was no need for any further clarification or communication.
Our inquiry to the hospital was due to an erroneous order of a separate inpatient stay request.
The hospital has acknowledged this error.
I was truthful in my video.
Insurance is out of control, Dr. Potter tellsAllurein a statement.
I will also exercise that right to speak out to protect patients and providers everywhere.
We have all had enough.
The amount of work required to get care covered by insurers requires hiring additional staff.
The additional work as the physician is oppressive and uncompensated.
I will exercise my right to speak out… We have all had enough.
We even see denials after surgery with a pre-op authorization.
But wait… whatisthe relationship betweenplastic surgeryand insurance?
Cosmetic procedures likeimplantsand facelifts generally arent covered by insurance and must be paid out of pocket.
Insurance companies have the lobbyists.
The insurance companies are relatively entrenched in terms of the systems that exist.
There are denials, appeals…
So nothing is ever really that easy.
It is a little bit opaque.
And then they decide if they’re going to cover it or not?
She explains, a 100% of what I did years ago, thats how it would be done.
If you cut acancerout, youve got to close it [up].
Whats really problematic, says Dr. Hollenbeck, is when a procedure is denied after the surgery.
Its pretty rare that people go after the patient in those situations.
But for a lot of plastic surgeons working with insurance companies is par for the course.
This routine administrative procedurewhile essential for ensuring appropriate use of resourcescan sometimes be misinterpreted as intrusive.
And its worth noting that theres a lot of red tape and governmental regulations with insurance as a whole.
Typically, the insurance realm is incredibly complicated, and it’s complicated on purpose, Dr. Williams explains.
And it’s largely becausein fairness to the insurance companiesthere’s tons of regulations around it.
It can limit access, it can jeopardize patient safety.
And from a physician standpoint, we always want the process to be easier and more transparent.
This is a systemic issue, adds Dr. Williams: It is not necessarily about one particular insurer.
One challenge is that insurance companies have the lobbyists.
The insurance companies are relatively entrenched in terms of the systems that exist.
But the law doesnt say how long somebody should stay in the hospital, Dr. Hollenbeck points out.
We continue to advocate for our patients.
Dr. Doft thinks Dr. Potters story went viral because so many have been affected by health insurance.
Dr. Williams notes that insurance companies don’t always get it wrong and can be great with patients.
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