Surgeon Exposes How Health Insurance Tricks You Into Overpaying | Dr. Elisabeth Potter

Surgeon Exposes How Health Insurance Tricks You Into Overpaying | Dr. Elisabeth Potter

When Dr. Elisabeth Potter scrubbed out of surgery to take a call from UnitedHealthcare, she had no idea it would change her life. The patient in question was already under anesthesia, mid-mastectomy, and the insurer wanted her to justify an overnight hospital stay on the spot. They denied it anyway, and the patient was billed $100,000. Potter's video about that moment was watched by more than 26 million people, and it was followed by a cease-and-desist letter from a powerful Washington, D.C. law firm demanding she retract everything. In this episode, Louisa sits down with the Austin-based reconstructive microsurgeon to unpack what really happens between a diagnosis and the care patients actually receive. She explains why she believes denial is a strategy, how prior authorizations, peer-to-peer calls, and appeals work in practice, and why roughly 1 in 5 in-network recommendations on some Affordable Care Act plans are rejected. She shares why a procedure she has performed for 14 years is still labelled "experimental," the year-long fight to get one young woman a mastectomy, and why a single billing code values a muscle-sacrificing TRAM flap the same as the muscle-sparing DIEP flap she specializes in. You'll also hear what DIEP flap reconstruction involves and why she prefers it to implants for many patients, the personal cost of standing up to an insurance giant, including draining her savings and risking bankruptcy to keep her practice open, and the advocacy that followed, from a rally in Washington, D.C. to the Speak Free Act and the Patients Deserve Price Tags Act. She reveals how one hospital quoted a patient $240,000 for a surgery she could perform for $17,000, and lays out exactly what patients can do right now: record every appointment, demand an itemized estimate, and appeal everything. Finally, she delivers the truth she feels morally obligated to tell every American: insurance isn't what you think it is, and you don't actually need it to get good care. 🤝 Sponsor The Neuro Experience: https://open.substack.com/pub/neuroathletics/p/sponsor-tne Reduce your risk of Alzheimer's with my science-backed protocol for women 30+: https://go.neuroathletics.com.au/youtube-sales-page Subscribe to The Neuro Experience for evidence-based conversations at the intersection of brain science, longevity, and performance. Thank you to our sponsors: Rho Nutrition: https://rhonutrition.com - Use code NEURO for 20% off liposomal glutathione Timeline (Mitopure): https://timeline.com/NEURO - Get 20% off when you subscribe and save I'm Louisa Nicola — clinical neurophysiologist, Alzheimer's prevention specialist, and founder of Neuro Athletics. My mission is to translate cutting-edge neuroscience into actionable strategies for cognitive longevity, peak performance, and brain disease prevention. If you're committed to optimizing your brain, reducing Alzheimer's risk, and staying mentally sharp for life, you're in the right place. Stay sharp. Stay informed. Join thousands who subscribe to the Neuro Athletics Newsletter → https://bit.ly/3ewI5P0 Instagram: https://www.instagram.com/louisanicola_/ Twitter: https://twitter.com/louisa

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Episoder(437)

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