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Another insurance denial. Another patient put at risk. We did everything right. My PA saw a patient with signs of a Deep Venous Thrombosis (a dangerous blood clot). We ordered an ultrasound, confirmed the diagnosis, and prescribed the medication to help prevent dangerous complications. But her insurance denied the...

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Elisabeth Potter MD

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168,110 görüntüleme • 1 yıl önce •via X (Twitter)

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Robert Padgett profil fotoğrafı
Robert Padgett1 yıl önce

RICO violations must be filed against health insurers who systematically deny meritorious claims.

Malarkey Roofing Products profil fotoğrafı
Malarkey Roofing Products1 yıl önce

Shingles are classified for impact resistance in two ways – the IBHS Hail Impact Study and by UL (Underwriters Laboratories). Highly rated shingles often qualify for insurance discounts (contact your insurance agent). More Info: #ImpactResistant #Roofing

Jarrod Couch, DO profil fotoğrafı
Jarrod Couch, DO1 yıl önce

One occurrence that happens every day—pateint goes to pick up e.g. lansoprazole, denied, goes home. Reason for denial is “we cover omeprazole instead” but they dont tell anyone. If you aren’t an proactive, have a good family, advocate doctor or pharmacist then you go without

Misha ✨🇨🇺🇪🇸🇺🇸 profil fotoğrafı
Misha ✨🇨🇺🇪🇸🇺🇸1 yıl önce

I love you for this. It’s very Joan of Arc. You’re putting yourself on the front line, at risk of dying first but you aren’t concerned for your own safety. You are amazing, please continue this fight.

Komal balaney profil fotoğrafı
Komal balaney1 yıl önce

Happens every day.. life saving drugs like xarelto and eliquis keep getting denied by insurance companies. So often patient goes on a Friday evening to a pharmacy and the medication is denied or needing a prior authorization. How can one do a PA on a weekend in so many instances we have had to send the patient to the ER to get a shot of Lovenox We are a first world country, but our healthcare is worse than a Third World country , where everything is a doctor‘s fault. There is no accountability from insurance companies. Patient have such limited knowledge and understanding of the insurance that they carry, human resources should explain benefits to the patient .. it shouldn’t be responsibility insurance company vendor to help the patient understand what product they have bought from them or or what their premiums are going towards? Why is it always a doctors responsibility to explain to the patient regarding insurance coverage and what their benefits cover? In a PCP’s office office visit the time is only 15 minutes .. I find myself explaining to the patient about what the insurance is going to cover.. Most PCPs are retiring early from the EMR burnout. We’re not tired of seeing patients, but we are exhausted with the admin of EMR and insurance admin burden.

JustMe 🇺🇸 profil fotoğrafı
JustMe 🇺🇸1 yıl önce

Being a pharmacist in retail, we get blamed a lot for denied claims like this. It is a broken system and Obamacare broke it. We did not have this problem before Obamacare. How do I know? I've been a pharmacist that long

Sotirios Papafragkou, MD, FACS profil fotoğrafı
Sotirios Papafragkou, MD, FACS1 yıl önce

Now, try dealing with all those denials being in private practice.

Elisabeth Potter MD profil fotoğrafı
Elisabeth Potter MD1 yıl önce

I am in private practice.

Warris Bokhari, MD profil fotoğrafı
Warris Bokhari, MD1 yıl önce

Does the patient need help overturning this? Happy to help.

S Ρ Λ Γ Τ Λ Π profil fotoğrafı
S Ρ Λ Γ Τ Λ Π1 yıl önce

So messed up. The entire insurance system needs to be retooled.

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Health Insurance company denies blood thinners medication for “a patient with a very large blood clot to her lungs” Blood clots so bad she’s “lucky to be alive” American doctor says it took so long to get the medication “she's lucky she's not dead at home right now” “She has a clear need for a medication. And we sent the prescription for the medication over, and the system is just so broken between the hospital and the pharmacy and how we deal with insurance companies, it's so broken, and it is wearing us out.”
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Health Insurance company denies blood thinners medication for “a patient with a very large blood clot to her lungs” Blood clots so bad she’s “lucky to be alive” American doctor says it took so long to get the medication “she's lucky she's not dead at home right now” “She has a clear need for a medication. And we sent the prescription for the medication over, and the system is just so broken between the hospital and the pharmacy and how we deal with insurance companies, it's so broken, and it is wearing us out.”

Wall Street Apes

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Board Certified OBGYN exposes what they must go through just to get one prescription approved by health insurance companies “This is what doctors are dealing with in 2025. So my patient needs a medication, an indicated medication for her condition. So I send the prescription to the commercial pharmacy - The pharmacist tells me that this medication needs a prior authorization and sends me a fax with a 1-800 number - The 1-800 number leads me to a pharmacy benefit manager that wants to ask my npi, my date of birth, the patient's information, what kind of the prescription is, how long do they need it for. Only to tell me at the end of the phone call that I actually have to call the patient's insurance company to authorize the prior authorization for the needed medication - So I call the patient's insurance company and once again, I have to verify my information, the patient's information, the prescription information, what the patient needs it for, only for the insurance company to tell me that this is not how they do prior authorization - So they're going to have to fax me some forms that I'm not allowed to do a prior authorization on the phone - So then the fax comes through and I fill it all out. The patient's information, my information, my npi, what the prescription is, how long they need it for, clinical documentation. And now we sit and wait and see if the powers that be think that the patient actually needs the medication” “I went to school. I went to undergraduate medical school, 4 years of OBGYN residency, then went back and did an integrative medicine fellowship, all for these people to dictate how my patient gets cared for. Please know that your healthcare providers are fighting for you day in and day out on things we don't get reimbursed for.” US Healthcare Insurance executives need to be thrown in prison for what they’ve done to our healthcare system
1:35

Board Certified OBGYN exposes what they must go through just to get one prescription approved by health insurance companies “This is what doctors are dealing with in 2025. So my patient needs a medication, an indicated medication for her condition. So I send the prescription to the commercial pharmacy - The pharmacist tells me that this medication needs a prior authorization and sends me a fax with a 1-800 number - The 1-800 number leads me to a pharmacy benefit manager that wants to ask my npi, my date of birth, the patient's information, what kind of the prescription is, how long do they need it for. Only to tell me at the end of the phone call that I actually have to call the patient's insurance company to authorize the prior authorization for the needed medication - So I call the patient's insurance company and once again, I have to verify my information, the patient's information, the prescription information, what the patient needs it for, only for the insurance company to tell me that this is not how they do prior authorization - So they're going to have to fax me some forms that I'm not allowed to do a prior authorization on the phone - So then the fax comes through and I fill it all out. The patient's information, my information, my npi, what the prescription is, how long they need it for, clinical documentation. And now we sit and wait and see if the powers that be think that the patient actually needs the medication” “I went to school. I went to undergraduate medical school, 4 years of OBGYN residency, then went back and did an integrative medicine fellowship, all for these people to dictate how my patient gets cared for. Please know that your healthcare providers are fighting for you day in and day out on things we don't get reimbursed for.” US Healthcare Insurance executives need to be thrown in prison for what they’ve done to our healthcare system

Wall Street Apes

415,021 görüntüleme • 1 yıl önce

American Surgeon shows the actual letter from UnitedHealthcare DENYING a patient in emergency condition from receiving care “This is a woman who was in the emergency room with pulmonary embolisms” “I think we all knew this would happen. I had another patient come in and share with me that UnitedHealthcare denied her inpatient's day. So this is a patient who had shortness of breath and some chest pain, and she just knew that something wasn't right in her body. She had a family history of blood clots and she'd had a deep flap surgery a couple of weeks ago. She went to the hospital and they saw her and they found that she had a life threatening condition known as pulmonary embolisms. So she was admitted to the hospital and taken care of really well by the doctors there. And they ordered all the right things. After a couple of days, she was discharged. She got a letter from UnitedHealthcare explaining that they didn't agree with the level of her care and that they would not cover it. So I'm gonna share some of the language of that letter with you, and I want you to know that my patient that we talked about previously who had her surgery denied had almost exactly the same letter shared. So there's some troubling things in this letter. I think this term is really interesting. United is saying they reviewed the request for inpatient admission. So let's all just pause and consider that. This is a woman who was in the emergency room with pulmonary embolisms, and the doctor wasn't really requesting anything. They were saying this patient needs to be in the hospital. But an insurance company sees this as a request, and that's part of this prior auth environment that we're living in. So I think it's important as patients and as physicians to just acknowledge that this is our reality now. Someone can think that there's a good medical decision for you and can write orders and wanna do the right thing for you, but your insurance company is seeing that as a request and deciding whether or not they wanna do it. One of the criteria that this insurance company used to decide whether or not to accept or deny this request was whether it's medically necessary. And it's so interesting that we're letting insurance companies and the doctors who work for insurance companies determine what's medically necessary and not just the doctor in front of the patient in the emergency room. So this is a really bold statement from UnitedHealthcare for my patient. They say you did not have to be admitted as an inpatient to the hospital for this care. I think we all need to just reflect on that. An insurance company is telling a patient and her doctor that they disagree with the plan of care to keep that patient safe. I know that this is boiling down to whether it's an inpatient admission or an observation admission, and that's really about money. But what I wanna point out to you is they're making medical decisions. This insurance company is actually weighing in and disagreeing with a doctor who made a medical decision to admit this patient for her safety. So this specific sentence, when a doctor or facility treats a patient above the recommended level of care, we cannot cover it. What the heck? That's what we do. We go above and beyond as physicians. It's clear that insurance companies don't, and they're actually saying it here.”
2:35

American Surgeon shows the actual letter from UnitedHealthcare DENYING a patient in emergency condition from receiving care “This is a woman who was in the emergency room with pulmonary embolisms” “I think we all knew this would happen. I had another patient come in and share with me that UnitedHealthcare denied her inpatient's day. So this is a patient who had shortness of breath and some chest pain, and she just knew that something wasn't right in her body. She had a family history of blood clots and she'd had a deep flap surgery a couple of weeks ago. She went to the hospital and they saw her and they found that she had a life threatening condition known as pulmonary embolisms. So she was admitted to the hospital and taken care of really well by the doctors there. And they ordered all the right things. After a couple of days, she was discharged. She got a letter from UnitedHealthcare explaining that they didn't agree with the level of her care and that they would not cover it. So I'm gonna share some of the language of that letter with you, and I want you to know that my patient that we talked about previously who had her surgery denied had almost exactly the same letter shared. So there's some troubling things in this letter. I think this term is really interesting. United is saying they reviewed the request for inpatient admission. So let's all just pause and consider that. This is a woman who was in the emergency room with pulmonary embolisms, and the doctor wasn't really requesting anything. They were saying this patient needs to be in the hospital. But an insurance company sees this as a request, and that's part of this prior auth environment that we're living in. So I think it's important as patients and as physicians to just acknowledge that this is our reality now. Someone can think that there's a good medical decision for you and can write orders and wanna do the right thing for you, but your insurance company is seeing that as a request and deciding whether or not they wanna do it. One of the criteria that this insurance company used to decide whether or not to accept or deny this request was whether it's medically necessary. And it's so interesting that we're letting insurance companies and the doctors who work for insurance companies determine what's medically necessary and not just the doctor in front of the patient in the emergency room. So this is a really bold statement from UnitedHealthcare for my patient. They say you did not have to be admitted as an inpatient to the hospital for this care. I think we all need to just reflect on that. An insurance company is telling a patient and her doctor that they disagree with the plan of care to keep that patient safe. I know that this is boiling down to whether it's an inpatient admission or an observation admission, and that's really about money. But what I wanna point out to you is they're making medical decisions. This insurance company is actually weighing in and disagreeing with a doctor who made a medical decision to admit this patient for her safety. So this specific sentence, when a doctor or facility treats a patient above the recommended level of care, we cannot cover it. What the heck? That's what we do. We go above and beyond as physicians. It's clear that insurance companies don't, and they're actually saying it here.”

Wall Street Apes

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This is Mel Thacker. She was an American surgeon, she quit After going through medical school and being a successful surgeon. She left the profession because of what US Heath Insurance Companies have done to healthcare “So I recently left my career as a surgeon, and I wanted to share that the primary reason I did that is because of moral injury — I felt powerless. I wanted to prescribe a very cheap medication to my patients, like Budesonide, and their insurance company would deny it, and the pharmacy would tell them it would cost them $300. And I couldn't tell which patients had the insurance that would do that and which ones didn't. That's just one tiny little example. But multiply that by thousands and thousands of encounters of interactions, of trying to either prescribe a medication or prescribe a treatment plan or do a surgery, and to just be met with roadblocks and layers of bureaucracy that are, quote, unquote, meant to keep healthcare costs down or a patient safe. But really, don't they just drive a wedge, multiple, multiple wedges between the physician and the patient And when we keep layering in these roadblocks, preventing the doctor and the patient from having an actual relationship, that's when we make mistakes. And so how do we fix this? We got to get business out of medicine. Healthcare needs to go back to relationship building, to trust. Trust between the physician and the patient. They need to be put on the pedestal. We need to start there. Not with the shareholders, not with all of the bureaucratic tasks that are meant to keep patients safe, but just increase costs.”
2:02

This is Mel Thacker. She was an American surgeon, she quit After going through medical school and being a successful surgeon. She left the profession because of what US Heath Insurance Companies have done to healthcare “So I recently left my career as a surgeon, and I wanted to share that the primary reason I did that is because of moral injury — I felt powerless. I wanted to prescribe a very cheap medication to my patients, like Budesonide, and their insurance company would deny it, and the pharmacy would tell them it would cost them $300. And I couldn't tell which patients had the insurance that would do that and which ones didn't. That's just one tiny little example. But multiply that by thousands and thousands of encounters of interactions, of trying to either prescribe a medication or prescribe a treatment plan or do a surgery, and to just be met with roadblocks and layers of bureaucracy that are, quote, unquote, meant to keep healthcare costs down or a patient safe. But really, don't they just drive a wedge, multiple, multiple wedges between the physician and the patient And when we keep layering in these roadblocks, preventing the doctor and the patient from having an actual relationship, that's when we make mistakes. And so how do we fix this? We got to get business out of medicine. Healthcare needs to go back to relationship building, to trust. Trust between the physician and the patient. They need to be put on the pedestal. We need to start there. Not with the shareholders, not with all of the bureaucratic tasks that are meant to keep patients safe, but just increase costs.”

Wall Street Apes

2,292,657 görüntüleme • 1 yıl önce

Dr. Caleb Masterson say health insurance companies are openly breaking laws in Alabama He explains some of his patients situations with insurance companies - “I had an insurance company tell a patient that no authorization for the procedure was required, the procedure was performed, and then the patient was denied the care because the procedure was never authorized. So the patient got charged the entire cost of the procedure” - “I had another patient who is supposed to be due an answer to an insurance claim within 30 days of submission. If they do not reply within 30 days, that's breaking Alabama law. And that claim is currently at the 65th day, so its insurance can be breaking the law.” - “Then I had an insurance company deny care to a patient that they had previously approved. So a patient qualified for surgery based on medical necessity, they had met all the criteria for surgery, they underwent surgery, then the patient had that surgery denied. The patient submitted that information to the insurance company and said, Hey, look, this was already pre-approved. And they said, We reversed our decision and the patient had to pay.”
1:06

Dr. Caleb Masterson say health insurance companies are openly breaking laws in Alabama He explains some of his patients situations with insurance companies - “I had an insurance company tell a patient that no authorization for the procedure was required, the procedure was performed, and then the patient was denied the care because the procedure was never authorized. So the patient got charged the entire cost of the procedure” - “I had another patient who is supposed to be due an answer to an insurance claim within 30 days of submission. If they do not reply within 30 days, that's breaking Alabama law. And that claim is currently at the 65th day, so its insurance can be breaking the law.” - “Then I had an insurance company deny care to a patient that they had previously approved. So a patient qualified for surgery based on medical necessity, they had met all the criteria for surgery, they underwent surgery, then the patient had that surgery denied. The patient submitted that information to the insurance company and said, Hey, look, this was already pre-approved. And they said, We reversed our decision and the patient had to pay.”

Wall Street Apes

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A nine week delay in treatment changed this patient's life forever. She asked me to share her story. This patient has Crohn's disease and was doing well on a medication that controlled her disease. Then, because of an insurance-related delay, she lost access to that medication for nine weeks. During that time, she developed a rectovaginal fistula, an opening to form between her intestine and her vagina. She underwent multiple surgeries to try to repair it and they all failed. She now lives with a colostomy. This is why I push back when people describe delays in care as administrative issues. They are patient issues. By the time a medication is approved, an appeal is reviewed, or a policy is changed, the damage may already be done and the patient’s life might be impacted forever. You can fix a process but you cannot always undo the harm. Behind every delay is a person whose life may be permanently changed. We cannot keep treating timely access to care as optional when the consequences are this real.
1:44

A nine week delay in treatment changed this patient's life forever. She asked me to share her story. This patient has Crohn's disease and was doing well on a medication that controlled her disease. Then, because of an insurance-related delay, she lost access to that medication for nine weeks. During that time, she developed a rectovaginal fistula, an opening to form between her intestine and her vagina. She underwent multiple surgeries to try to repair it and they all failed. She now lives with a colostomy. This is why I push back when people describe delays in care as administrative issues. They are patient issues. By the time a medication is approved, an appeal is reviewed, or a policy is changed, the damage may already be done and the patient’s life might be impacted forever. You can fix a process but you cannot always undo the harm. Behind every delay is a person whose life may be permanently changed. We cannot keep treating timely access to care as optional when the consequences are this real.

Elisabeth Potter MD

30,273 görüntüleme • 16 gün önce

I had a conversation today with a fellow breast surgeon who shared that the large company she works for has decided they will no longer bill for preoperative counseling visits. I want you to sit with that for a moment. They’re no longer billing for the visit where a patient learns what to expect from surgery, where her incisions will be, what recovery might look like. Where she gets to ask questions, be heard, and feel truly prepared. To the company, it’s not “valuable.” But to the patient—and to her doctor—it absolutely is. When companies and insurance providers decide what matters in medicine, we risk losing the most human, most important parts of care. If we don’t protect these one-on-one visits, if we don’t call them what they are: essential, we will lose them. Let’s not wait until it’s too late.
1:55

I had a conversation today with a fellow breast surgeon who shared that the large company she works for has decided they will no longer bill for preoperative counseling visits. I want you to sit with that for a moment. They’re no longer billing for the visit where a patient learns what to expect from surgery, where her incisions will be, what recovery might look like. Where she gets to ask questions, be heard, and feel truly prepared. To the company, it’s not “valuable.” But to the patient—and to her doctor—it absolutely is. When companies and insurance providers decide what matters in medicine, we risk losing the most human, most important parts of care. If we don’t protect these one-on-one visits, if we don’t call them what they are: essential, we will lose them. Let’s not wait until it’s too late.

Elisabeth Potter MD

30,306 görüntüleme • 1 yıl önce

“The act of signing a denial is practicing medicine.” — Dr. Tracey Hurley If a physician makes a medical decision and that decision harms a patient, we are held accountable. That is how medicine works. Yet insurance companies make treatment decisions every day through denials and prior authorizations, without ever seeing the patient and without meaningful accountability when those decisions cause harm. In this powerful investigation, Erin Moriarty of 48 Hours examines how insurers are increasingly inserting themselves into medical decision making, often driven by profit rather than patient safety. Millions of Americans are paying high premiums, facing crushing deductibles, or being denied medically necessary tests and treatment. Even physicians who understand the system are forced to fight for care while patients are fighting for their lives. In this interview, Dr. Tracey Hurley shares what it looks like on the inside. You will hear how denials impact families, why prior authorization has become a tool for rationing care by inconvenience, and what happens when delays are treated as neutral instead of dangerous. This story matters. It shows what happens when insurance companies practice medicine without accountability. We owe it to the late Dr. Hurley and to every patient who did not have the time, energy, or resources to keep appealing. This should not be normal. I hope you will watch the full interview ( ) and share it. Change only happens when we stop accepting this system as inevitable. Thank you CBS, Erin Moriarty, and Sari Aviv for covering this story and bringing these voices forward.
2:44

“The act of signing a denial is practicing medicine.” — Dr. Tracey Hurley If a physician makes a medical decision and that decision harms a patient, we are held accountable. That is how medicine works. Yet insurance companies make treatment decisions every day through denials and prior authorizations, without ever seeing the patient and without meaningful accountability when those decisions cause harm. In this powerful investigation, Erin Moriarty of 48 Hours examines how insurers are increasingly inserting themselves into medical decision making, often driven by profit rather than patient safety. Millions of Americans are paying high premiums, facing crushing deductibles, or being denied medically necessary tests and treatment. Even physicians who understand the system are forced to fight for care while patients are fighting for their lives. In this interview, Dr. Tracey Hurley shares what it looks like on the inside. You will hear how denials impact families, why prior authorization has become a tool for rationing care by inconvenience, and what happens when delays are treated as neutral instead of dangerous. This story matters. It shows what happens when insurance companies practice medicine without accountability. We owe it to the late Dr. Hurley and to every patient who did not have the time, energy, or resources to keep appealing. This should not be normal. I hope you will watch the full interview ( ) and share it. Change only happens when we stop accepting this system as inevitable. Thank you CBS, Erin Moriarty, and Sari Aviv for covering this story and bringing these voices forward.

Elisabeth Potter MD

44,389 görüntüleme • 6 ay önce

INSANE 🚨 This surgeon has a patient who needs a “deep flap” surgery. Insurance denied it To appeal she had to speak to her patients insurance. “I actually asked, do you know what a deep flap is? THE DOCTOR SAID NO.” The insurance companies deciding if Americans get their procedures DONT EVEN KNOW what the procedures are. How is this okay?! THIS is the state of American healthcare… “You may remember I had a patient who needs a deep flap, and the insurance company denied an inpatient stay for her. So I had to schedule a peer to peer call and schedule time out of my day to ask for a conversation directly with someone who is my peer to discuss deep flap surgery and why that patient needed to be overnight. That call was scheduled for 11AM, and eleven came around 11: 30, 11: 45 and no call still. And then we emailed the insurance company because, of course, they don't give me the call number. They only let me receive the call. So finally at 12: 15, I received the call that was initially scheduled for 11. And the doctor who called me was not a surgeon. And I actually asked the doctor, do you know what a deep flap is? And the doctor said no. So that's where we are. My patient has insurance. She's seeing someone who's fellowship trained in microsurgery, me, to do her breast reconstruction, and I'm having to teach another doctor what a deep flap is in order to justify her overnight stay to navigate her insurance. This is completely ridiculous.”
1:12

INSANE 🚨 This surgeon has a patient who needs a “deep flap” surgery. Insurance denied it To appeal she had to speak to her patients insurance. “I actually asked, do you know what a deep flap is? THE DOCTOR SAID NO.” The insurance companies deciding if Americans get their procedures DONT EVEN KNOW what the procedures are. How is this okay?! THIS is the state of American healthcare… “You may remember I had a patient who needs a deep flap, and the insurance company denied an inpatient stay for her. So I had to schedule a peer to peer call and schedule time out of my day to ask for a conversation directly with someone who is my peer to discuss deep flap surgery and why that patient needed to be overnight. That call was scheduled for 11AM, and eleven came around 11: 30, 11: 45 and no call still. And then we emailed the insurance company because, of course, they don't give me the call number. They only let me receive the call. So finally at 12: 15, I received the call that was initially scheduled for 11. And the doctor who called me was not a surgeon. And I actually asked the doctor, do you know what a deep flap is? And the doctor said no. So that's where we are. My patient has insurance. She's seeing someone who's fellowship trained in microsurgery, me, to do her breast reconstruction, and I'm having to teach another doctor what a deep flap is in order to justify her overnight stay to navigate her insurance. This is completely ridiculous.”

Wall Street Apes

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American Healthcare worker speaks out about insurance companies “We had a patient that was so f*cking sick in the hospital” and the insurance company wanted them to send the patient home “For SEVEN WEEKS STRAIGHT, they gave us a last day of coverage, for seven weeks straight, we appealed to Medicare and won because Medicare thought it was unsafe for this patient to go home”
0:53

American Healthcare worker speaks out about insurance companies “We had a patient that was so f*cking sick in the hospital” and the insurance company wanted them to send the patient home “For SEVEN WEEKS STRAIGHT, they gave us a last day of coverage, for seven weeks straight, we appealed to Medicare and won because Medicare thought it was unsafe for this patient to go home”

Wall Street Apes

182,192 görüntüleme • 1 yıl önce

22-year-old patient just days away from a mastectomy denied by her insurance to see another Doctor, since her doctor is out of town. Last night, I got a late call from a breast surgeon here in Austin, TX. Her 22-year-old patient just days away from a mastectomy found out the plastic surgeon she had been seeing is out-of-network and her insurance doesn’t cover any out-of-network care. So now what? The breast surgeon called me and asked for a favor, knowing I take cases like this on, even if the payments are low…too low to cover the costs for me and my practice…because I think it’s the right thing to do. My team is doing everything we can to get her seen this week and to get her case approved. But here’s the thing: this isn’t a one-off. This is yet another example of how having insurance doesn’t mean you have access to care. These narrow networks are failing patients. This young woman has cancer now. She needs surgery now. And we don’t have the luxury of time to wait for policy change. The sad reality is I can’t afford to keep doing this for patients, even though I want to. We need a better system for patients and for the doctors trying to care for them. I believe we can fix this. But we need the help of the government. We need laws to change, and we don't have the luxury of time.
1:46

22-year-old patient just days away from a mastectomy denied by her insurance to see another Doctor, since her doctor is out of town. Last night, I got a late call from a breast surgeon here in Austin, TX. Her 22-year-old patient just days away from a mastectomy found out the plastic surgeon she had been seeing is out-of-network and her insurance doesn’t cover any out-of-network care. So now what? The breast surgeon called me and asked for a favor, knowing I take cases like this on, even if the payments are low…too low to cover the costs for me and my practice…because I think it’s the right thing to do. My team is doing everything we can to get her seen this week and to get her case approved. But here’s the thing: this isn’t a one-off. This is yet another example of how having insurance doesn’t mean you have access to care. These narrow networks are failing patients. This young woman has cancer now. She needs surgery now. And we don’t have the luxury of time to wait for policy change. The sad reality is I can’t afford to keep doing this for patients, even though I want to. We need a better system for patients and for the doctors trying to care for them. I believe we can fix this. But we need the help of the government. We need laws to change, and we don't have the luxury of time.

Wall Street Mav

92,506 görüntüleme • 11 ay önce

There is no algorithm that can replace the instincts of an experienced physician when faced with a patient in need. When the doctor who saw this patient in the Emergency Room examined her, spoke with her, and decided to admit her, I know that he did so because he knew best how to keep her safe. I am grateful. I am disturbed that her insurance company questioned that judgement and presumes to know better than the doctor in front of her. The following statement in the denial letter says so much about the current state of healthcare: “When a doctor or facility treats a patient above the recommended level of care, we cannot cover it.” This does not pass the sister test. I’ll take the best judgement of the doctor who was physically present at the bedside of a frightened patient over an insurance company’s algorithm every time. And I refuse to accept that this is the best we as a society can do.
2:20

There is no algorithm that can replace the instincts of an experienced physician when faced with a patient in need. When the doctor who saw this patient in the Emergency Room examined her, spoke with her, and decided to admit her, I know that he did so because he knew best how to keep her safe. I am grateful. I am disturbed that her insurance company questioned that judgement and presumes to know better than the doctor in front of her. The following statement in the denial letter says so much about the current state of healthcare: “When a doctor or facility treats a patient above the recommended level of care, we cannot cover it.” This does not pass the sister test. I’ll take the best judgement of the doctor who was physically present at the bedside of a frightened patient over an insurance company’s algorithm every time. And I refuse to accept that this is the best we as a society can do.

Elisabeth Potter MD

311,289 görüntüleme • 1 yıl önce

A Patient Cured Is A Customer Lost. ER Doctor Threatened With Termination For Prescribing Medicine Insurance Company Disagreed With Read that again. A big insurance company deciding medication, NOT DOCTORS and won’t let a hospital prescribe certain medication or they’ll be terminated “The reason I'm sitting here before you today is because there was a patient who had early SARS 2 and she was well enough to go home, which meant I, as the ER doctor, could prescribe something for her. She wasn't gonna go upstairs. I prescribed hydroxychloroquine and zinc and I think I gave her Zithromax as well and I didn't think anything of it. I happened to call her 2 days later, she was doing great. It was my first one. I got a phone call that I was going to be fired if I ever did that again And I was stunned. Who is the call from? The call is from the it came from the CEO of the hospital, who told my medical director to call me and I said, what's driving this? And he said, I don't think it works. I said, no problem. Don't prescribe it then. You practice as an individual, as do I. But why do you care what I'm practicing? I'm prescribing my patient. He said, well, you know, there's a big insurance company. It was Kaiser at this hospital and Kaiser put their foot down and told the hospital not to prescribe hydroxychloroquine.”
0:53

A Patient Cured Is A Customer Lost. ER Doctor Threatened With Termination For Prescribing Medicine Insurance Company Disagreed With Read that again. A big insurance company deciding medication, NOT DOCTORS and won’t let a hospital prescribe certain medication or they’ll be terminated “The reason I'm sitting here before you today is because there was a patient who had early SARS 2 and she was well enough to go home, which meant I, as the ER doctor, could prescribe something for her. She wasn't gonna go upstairs. I prescribed hydroxychloroquine and zinc and I think I gave her Zithromax as well and I didn't think anything of it. I happened to call her 2 days later, she was doing great. It was my first one. I got a phone call that I was going to be fired if I ever did that again And I was stunned. Who is the call from? The call is from the it came from the CEO of the hospital, who told my medical director to call me and I said, what's driving this? And he said, I don't think it works. I said, no problem. Don't prescribe it then. You practice as an individual, as do I. But why do you care what I'm practicing? I'm prescribing my patient. He said, well, you know, there's a big insurance company. It was Kaiser at this hospital and Kaiser put their foot down and told the hospital not to prescribe hydroxychloroquine.”

Wall Street Apes

346,050 görüntüleme • 1 yıl önce

This woman is a Board Certified Emergency Medicine Physician in America She says she’s seeing more and more doctors leave practicing medicine because what US Health Insurance companies are doing to healthcare She explains why, this is important information: “I believe what we are seeing with healthcare professionals is not just burnout, it's something far more insidious and painful. This is moral injury. — Moral injury. The pain of knowing what the right thing is for the patient, but being unable to do that because of systemic barriers. And over time, this wears you down. I have seen so many people leave the profession because it has eroded their sense of purpose, their love for the job. And we take a Hippocratic oath to do no harm. But in a system that doesn't place human health at the center, that becomes harder and harder to uphold. And that disconnect from what we are trained to do, from what we can actually do, creates a very painful wound. And when the healers themselves are wounded, when their hands are tied, when their clinical judgment is overruled, they don't just feel that defeat themselves, they that trickles down to the patient. — So when we see our providers juggling insurance company protocols, productivity metrics, hospital bureaucracy, the relentless pull of the electronic medical record, all of these things take the doctor away, the patient. If we really want to understand why the United States spends more on health care than any other nation, while delivering some of the worst outcomes, we need to start being honest. The system just isn't inefficient. It is deeply misaligned with care and having it be patient first” US Health Insurance companies are absolutely destroying American Healthcare and we all must keep sharing these important stories because something has to change
3:20

This woman is a Board Certified Emergency Medicine Physician in America She says she’s seeing more and more doctors leave practicing medicine because what US Health Insurance companies are doing to healthcare She explains why, this is important information: “I believe what we are seeing with healthcare professionals is not just burnout, it's something far more insidious and painful. This is moral injury. — Moral injury. The pain of knowing what the right thing is for the patient, but being unable to do that because of systemic barriers. And over time, this wears you down. I have seen so many people leave the profession because it has eroded their sense of purpose, their love for the job. And we take a Hippocratic oath to do no harm. But in a system that doesn't place human health at the center, that becomes harder and harder to uphold. And that disconnect from what we are trained to do, from what we can actually do, creates a very painful wound. And when the healers themselves are wounded, when their hands are tied, when their clinical judgment is overruled, they don't just feel that defeat themselves, they that trickles down to the patient. — So when we see our providers juggling insurance company protocols, productivity metrics, hospital bureaucracy, the relentless pull of the electronic medical record, all of these things take the doctor away, the patient. If we really want to understand why the United States spends more on health care than any other nation, while delivering some of the worst outcomes, we need to start being honest. The system just isn't inefficient. It is deeply misaligned with care and having it be patient first” US Health Insurance companies are absolutely destroying American Healthcare and we all must keep sharing these important stories because something has to change

Wall Street Apes

223,295 görüntüleme • 1 yıl önce

This is an EXCELLENT video American nurse films herself trying to get approval for a medication a patient needs from a US Health Insurance Company This is a real inside look at what it’s actually like trying to get an approval “Being an outpatient nurse in America means spending several hours a week convincing insurance companies that patients need the medications prescribed to them… constantly giving you the run around to see how long you’re willing to play the game” This video is a MUST WATCH. We desperately beed health care reform in America
1:11

This is an EXCELLENT video American nurse films herself trying to get approval for a medication a patient needs from a US Health Insurance Company This is a real inside look at what it’s actually like trying to get an approval “Being an outpatient nurse in America means spending several hours a week convincing insurance companies that patients need the medications prescribed to them… constantly giving you the run around to see how long you’re willing to play the game” This video is a MUST WATCH. We desperately beed health care reform in America

Wall Street Apes

598,775 görüntüleme • 1 yıl önce

Insurance companies do not want you to fully understand this story. Because if you do, you will understand exactly how American healthcare needs to change. When my patient Rachel needed breast reconstruction, her insurance company required that I operate at a hospital that was not equipped to provide the safest care for her recovery. Rachel has spent over 20 years in healthcare as a nurse and nurse practitioner. She understands hospitals. And despite that, she was deeply traumatized by what she experienced. On Monday morning in Austin, she showed up for surgery and was turned away because the operating rooms were not safe to use. We pleaded with her insurance company to allow her surgery to be performed at @redbudsurgerycenter, a center designed specifically for breast reconstruction. They refused. On Tuesday, we went to a different hospital. The nurses were skilled, compassionate, and doing their best. But they did not have the tools or systems to support this kind of recovery. Rachel spent the night advocating for herself because she could tell things were not right. IV access issues. Monitoring gaps. Basic safety checks missed. Things patients should never have to catch on their own. Rachel asked me to share her story because when doctors and patients are forced into unsafe situations with no ability to choose better care, something is very wrong. After more than a decade of caring for people affected by breast cancer, I built a surgery center specifically for this work. It is CMS certified. It exists for patient safety. And yet, like so many Americans, Rachel’s insurance company decided where she was allowed to receive care. Insurance companies are no longer just making payment decisions. They are making medical decisions. We cannot change what happened to Rachel. But we can listen, learn, and do better for the next patient. Because the next person may not know how to advocate the way she did. And that is how people get hurt.
2:57

Insurance companies do not want you to fully understand this story. Because if you do, you will understand exactly how American healthcare needs to change. When my patient Rachel needed breast reconstruction, her insurance company required that I operate at a hospital that was not equipped to provide the safest care for her recovery. Rachel has spent over 20 years in healthcare as a nurse and nurse practitioner. She understands hospitals. And despite that, she was deeply traumatized by what she experienced. On Monday morning in Austin, she showed up for surgery and was turned away because the operating rooms were not safe to use. We pleaded with her insurance company to allow her surgery to be performed at @redbudsurgerycenter, a center designed specifically for breast reconstruction. They refused. On Tuesday, we went to a different hospital. The nurses were skilled, compassionate, and doing their best. But they did not have the tools or systems to support this kind of recovery. Rachel spent the night advocating for herself because she could tell things were not right. IV access issues. Monitoring gaps. Basic safety checks missed. Things patients should never have to catch on their own. Rachel asked me to share her story because when doctors and patients are forced into unsafe situations with no ability to choose better care, something is very wrong. After more than a decade of caring for people affected by breast cancer, I built a surgery center specifically for this work. It is CMS certified. It exists for patient safety. And yet, like so many Americans, Rachel’s insurance company decided where she was allowed to receive care. Insurance companies are no longer just making payment decisions. They are making medical decisions. We cannot change what happened to Rachel. But we can listen, learn, and do better for the next patient. Because the next person may not know how to advocate the way she did. And that is how people get hurt.

Elisabeth Potter MD

44,697 görüntüleme • 5 ay önce

Medical Doctor in New York sharing her experience with her personal health insurance coverage She estimates she’s pays about $5,000 per year for coverage and hasn’t used it in at least 3 years So after paying $15k, she went to the doctor one time, was charged $300 out of pocket for a regular visit and then the insurance company denied her medication “I had a singular office visit for one complaint. My insurance didn't cover the entirety of that visit. It cost me an additional $300 to include some lab work. But not only that, so now I'm out, we'll say $5,000 (for the year) plus $300 out of pocket. That wasn't covered for this office visit because I haven't used health insurance the rest of the year. My insurance denied the medication that was prescribed to me” “So I paid all that money to health insurance. I can't actually get what I need and I as a physician see these stories a million times a day” “It's just absolutely absurd that we are allowing the insurance companies and the healthcare system to function this way.”
1:37

Medical Doctor in New York sharing her experience with her personal health insurance coverage She estimates she’s pays about $5,000 per year for coverage and hasn’t used it in at least 3 years So after paying $15k, she went to the doctor one time, was charged $300 out of pocket for a regular visit and then the insurance company denied her medication “I had a singular office visit for one complaint. My insurance didn't cover the entirety of that visit. It cost me an additional $300 to include some lab work. But not only that, so now I'm out, we'll say $5,000 (for the year) plus $300 out of pocket. That wasn't covered for this office visit because I haven't used health insurance the rest of the year. My insurance denied the medication that was prescribed to me” “So I paid all that money to health insurance. I can't actually get what I need and I as a physician see these stories a million times a day” “It's just absolutely absurd that we are allowing the insurance companies and the healthcare system to function this way.”

Wall Street Apes

1,701,887 görüntüleme • 11 ay önce

US Health Insurance keeps getting worse and worse American had to call her husband crying after speaking with her health insurance - She has a current doctor who prescribed a medication she needs - Her health insurance says because of the medication, she needs to go see a “higher doctor” and have the new more expensive doctor prescribe it - She now has to make additional appointments and tests to get this medication that’s already prescribed by her current doctor - Her insurance says she can’t use her current pharmacy that she uses with all her other prescriptions - Insurance says this medication isn’t even partially covered until her full deductible has been met - She now must go through all of this just to get her medication prescribed again, they won’t cover the cost, so she has to pay $1,095 for a 30 day supply every month “I think we all know what a scam the health insurance realm is. It's taking advantage of people, it's greed and the like it's the epitome of greed and evil” “I think the American people are waking up to that it is such a scam. And it's so evil. like my heart, like I started crying because my heart just breaks for the families that like have to go through, you know, like if your child has cancer or something, could you imagine the battles back and forth? — I'm just beyond frustrated. I'm beyond like annoyed with this whole system. And I know I'm not the only one.”
5:55

US Health Insurance keeps getting worse and worse American had to call her husband crying after speaking with her health insurance - She has a current doctor who prescribed a medication she needs - Her health insurance says because of the medication, she needs to go see a “higher doctor” and have the new more expensive doctor prescribe it - She now has to make additional appointments and tests to get this medication that’s already prescribed by her current doctor - Her insurance says she can’t use her current pharmacy that she uses with all her other prescriptions - Insurance says this medication isn’t even partially covered until her full deductible has been met - She now must go through all of this just to get her medication prescribed again, they won’t cover the cost, so she has to pay $1,095 for a 30 day supply every month “I think we all know what a scam the health insurance realm is. It's taking advantage of people, it's greed and the like it's the epitome of greed and evil” “I think the American people are waking up to that it is such a scam. And it's so evil. like my heart, like I started crying because my heart just breaks for the families that like have to go through, you know, like if your child has cancer or something, could you imagine the battles back and forth? — I'm just beyond frustrated. I'm beyond like annoyed with this whole system. And I know I'm not the only one.”

Wall Street Apes

45,322 görüntüleme • 11 ay önce

You may have seen the headlines this morning with yet another paper showing that women who have an earlier menopause are at a higher risk of dementia. This is something we have known for decades now and it’s because oestradiol has protective effects all around the body - including the brain - so when a women has an earlier menopause, she is without her hormones for a longer period of time which leads to this increased risk. The paper I am discussing here talks more about the science behind this and I would really recommend you all read it. I will share a link in my story now. It is crucial we do more research in this area and allow more women to have access to hormones if that is what they want.
2:05

You may have seen the headlines this morning with yet another paper showing that women who have an earlier menopause are at a higher risk of dementia. This is something we have known for decades now and it’s because oestradiol has protective effects all around the body - including the brain - so when a women has an earlier menopause, she is without her hormones for a longer period of time which leads to this increased risk. The paper I am discussing here talks more about the science behind this and I would really recommend you all read it. I will share a link in my story now. It is crucial we do more research in this area and allow more women to have access to hormones if that is what they want.

Dr Louise Newson

49,948 görüntüleme • 2 yıl önce

This is hard to watch, I hope this gets the attention it deserves This woman is a “Transitions of Care Clinical Pharmacist, I discharge patients from a hospital” This grown woman breaks down and cries because health insurance companies keep denying cancer patients pain meds “How bad does somebody's freaking pain have to be before the insurance companies will cover this medication for these patients? Ridiculous. Who's holding these insurance companies liable for this?” Everyone should watch this video. When is enough enough with US Heath Insurance companies?
2:28

This is hard to watch, I hope this gets the attention it deserves This woman is a “Transitions of Care Clinical Pharmacist, I discharge patients from a hospital” This grown woman breaks down and cries because health insurance companies keep denying cancer patients pain meds “How bad does somebody's freaking pain have to be before the insurance companies will cover this medication for these patients? Ridiculous. Who's holding these insurance companies liable for this?” Everyone should watch this video. When is enough enough with US Heath Insurance companies?

Wall Street Apes

457,225 görüntüleme • 1 yıl önce