{"id":12819,"date":"2025-09-10T19:22:09","date_gmt":"2025-09-10T19:22:09","guid":{"rendered":"https:\/\/www.newsbeep.com\/ie\/12819\/"},"modified":"2025-09-10T19:22:09","modified_gmt":"2025-09-10T19:22:09","slug":"plastic-surgeon-goes-viral-for-taking-on-insurance-company-mid-surgery","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/ie\/12819\/","title":{"rendered":"Plastic Surgeon Goes Viral For Taking On Insurance Company Mid-Surgery"},"content":{"rendered":"

In between scrubbing in for surgeries, Dr. Elisabeth Potter, a Texas-based plastic surgeon who works with breast cancer patients, is fighting to pull back the curtain on the pitfalls of the health insurance industry. <\/p>\n

Potter specializes in a procedure that involves using fat and tissue from a patient\u2019s lower abdomen to rebuild breasts after a mastectomy or lumpectomy. Potter has performed the surgery, called a deep inferior epigastric perforator (DIEP) flap procedure, more than 1,000 times, and said she treats about 40% of women with breast cancer in central Texas. <\/p>\n

\"\u201cI'm\u201cI’m a safety net for women around the country, especially across the South, where they can’t find surgeons like me who will do surgeries through insurance,” Dr. Potter told HuffPost.<\/p>\n

Courtesy of Dr. Elisabeth Potter<\/p>\n

On social media, Potter shares videos that show the frustrating reality of navigating insurance coverage on behalf of her patients. <\/p>\n

\u201cWe\u2019ve behaved too predictably for a long time, and the fact that it\u2019s not normal for doctors and patients to get on social media and talk about the difficulties of health care says a lot,\u201d she told HuffPost. \u201cWe need to start speaking out so that there\u2019s 100 doctors like me or 1,000 doctors like me saying enough is enough.\u201d (For the full story, watch the video above.)<\/p>\n

In 2024, Potter opened RedBud Surgery Center in Austin in an effort to make breast reconstruction more accessible and affordable. She said surgeries can typically cost a patient anywhere from $60,000 to $200,000 out of pocket.<\/p>\n

\u201cMany women who are diagnosed with breast cancer and seek breast reconstruction go to see a cosmetic plastic surgeon who might only take cash or only does an implant type of reconstruction,\u201d Potter said. <\/p>\n

Patients could also go to a microsurgeon like Potter, who uses a specialized microscope to perform surgery on some of the body\u2019s most intricate structures like blood vessels and nerves. \u201cBut many [microsurgeons] are only out of network, meaning the patients will pay a penalty to go see them, or they actually charge cash,\u201d Potter said.<\/p>\n

Potter said owning RedBud also helps her bottom line. She can continue her work while taking less of a financial hit because RedBud collects the facility fees associated with a surgery \u2015 charges for essentials like an operating room, equipment and medical staff.<\/p>\n

\u201cI set out to prove a different case,\u201d Potter said. \u201cI set out to build a practice where I do accept insurance, where I don\u2019t penalize the patient for the system that we\u2019re in, right? So I accept insurance, and I do cases for free.\u201d<\/p>\n

Now Potter is raising money to \u201ckeep the lights on\u201d at RedBud. She said the problem is that UnitedHealthcare, Texas\u2019 second-largest insurer, won\u2019t currently accept the practice \u2014 an ambulatory surgery center, or ASC \u2014 into its network. That makes it hard for her to run a profitable practice and for patients to afford natural tissue reconstructive surgery.<\/p>\n

UnitedHealthcare told HuffPost there is already sufficient access to ambulatory and plastic surgery centers for its members in Travis County, Texas, even without RedBud. UHC told Potter it wasn\u2019t accepting any new ASCs back in October 2024.<\/p>\n

But Potter claims she\u2019s the only physician in the county performing the DIEP flap surgery outside of a hospital setting, where procedures are significantly more expensive. She believes UnitedHealthcare\u2019s actions are retaliation for her public criticism of them, though the company adamantly denies that.<\/p>\n

Potter went viral in January when she revealed she left surgery to take a call from UnitedHealthcare about a patient as they were on her operating table.<\/p>\n

\u201cIt\u2019s 2025, and insurance just keeps getting worse,\u201d she said in a video<\/a>, still wearing a surgical cap. Potter described how UHC\u2019s representative asked her to justify the patient\u2019s overnight stay, and she lamented that the health insurance industry was \u201cout of control.\u201d<\/p>\n

UnitedHealthcare demanded the videos be taken down and threatened legal action for defamation. In a statement to HuffPost, the company said: \u201cUnitedHealthcare did not ask \u2014 nor would it ever expect \u2014 a physician to interrupt patient care to return a phone call about a notification error or any other insurance matter.\u201d<\/p>\n

UHC said the call was not urgent and only happened because the hospital made an \u201cerroneous order of a separate inpatient stay.\u201d But Potter said she took the call, and left the patient in the care of a co-surgeon, because she was determined to advocate for her patient.<\/p>\n

\u201cI have patients all the time who get bills that are huge and have to live through the back and forth with insurance companies or hospitals in the midst of the financial devastation of a cancer diagnosis,\u201d she said. \u201cSo it was not a long leap to think they may try to not pay for this, and they may put this woman through even more harm, this woman on the table having mastectomies today, that they may put her through even more. And if I can take this call, if they\u2019re asking, let me take a call, and I can do that right now, and let\u2019s see if we can sort it out.\u201d<\/p>\n

UnitedHealthcare told HuffPost there were never any negotiations about RedBud joining its network, but Potter said ongoing communication with UHC went \u201cradio silent\u201d after she posted the video.<\/p>\n

At the time of this story\u2019s publication, UnitedHealthcare has not taken any legal action against Potter. She continues to share her experiences, including \u201cpeer-to-peer\u201d calls with UnitedHealthcare representatives. Potter said the calls are part of the appeal process if a service has been denied by an insurer, and a way for providers and insurers to \u201cget on the same page.\u201d<\/p>\n

\u201cBut that\u2019s not what it\u2019s like,\u201d she said. \u201cIt\u2019s like they\u2019re checking a box.\u201d<\/p>\n

Potter said she hopes her posts can help challenge insurance companies and hold them accountable. <\/p>\n

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We remain committed to providing you with the unflinching, fact-based journalism everyone deserves.<\/p>\n

Thank you again for your support along the way. We\u2019re truly grateful for readers like you! Your initial support helped get us here and bolstered our newsroom, which kept us strong during uncertain times. Now as we continue, we need your help more than ever. We hope you will join us once again<\/a>.<\/p>\n

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\u201cI think there\u2019s a really healthy thing happening now as part of this conversation, which is that patients and providers are on the same side\u2026We need to be honest about the harm that\u2019s being done by the financialization of medicine, and share that with our patients, so that we can all fight and push together,\u201d she said.<\/p>\n

Since the dispute with UnitedHealthcare began, Potter says RedBud has been accepted in-network by other insurers, including Aetna and Humana. She\u2019s also heard from patients and physicians alike who are cheering her on.<\/p>\n

\u201cEvery day, multiple times a day, another doctor reaches out and says, \u2018Thank you,\u2019\u201d she said. \u201cAnother retired doctor who left medicine because it was killing them morally reaches out and says, \u2018Please keep fighting.\u2019 Another patient who is encountering difficulties getting the care that they need reaches out and says, \u2018You know, I haven\u2019t seen someone fight like this or tell the truth before.\u2019\u201d<\/p>\n