Word: transplanting
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Dates: during 1990-1999
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...didn't ask that Hunter be sent to Chapel Hill, N.C., in the first place and why PHP's "authorization" was not a simple solution to the problem say a lot about managed-care coverage. O'Connor was unaware that his own company had a liver-transplant contract with UNC because it was really not his company that held such contracts in the first place. In the managed-care business, general-health insurers like PHP often farm out high-cost specialties like organ transplants to secondary insurers who "carve out" coverage of these procedures and do separate deals with hospitals...
...already cleared Duke to do Hunter's transplant, why move him at all? Because PHP's go-ahead was offered on its terms, which put a cap on the amount of money the insurer would pay Duke, no matter what the operation ended up costing. While neither side has been willing to reveal what those terms were, it's a good bet that the number was on the low end of what Duke was likely to spend; on average, Duke's bill for a liver transplant runs about...
Trotter and Betsy Tuttle, the transplant surgeon who would eventually operate on Hunter, were determined to do what was medically necessary. But on the business end, there was no agreement about payment...
...Saturday, Hunter slipped into a coma. Dr. Tuttle upgraded him to highest-priority status and put out a call through the organ-transplant network for a liver. Labor Day weekend, normally a period offering a bumper crop of organs because of holiday traffic deaths, came and went without a prospect. TUESDAY 10:00 A.M. Todd remains in a coma, his liver shot, his skin yellow to his toes. Retribution is in the air midmorning when Brown reaches Trotter, demanding to know why Hunter is not at UNC. Their conversation is "spirited," according to Trotter, "emotionally charged," according...
WEDNESDAY 10:05 A.M. Tuttle is in the OR, assisting in the Jacks "living-related" transplant, when word comes that a liver has been located on the West Coast and can be in Durham by evening. It arrives in a large styrofoam box, bathed in preservative inside a plastic bag--surprisingly mundane packaging for a gift of life. It is after 11 p.m. when Tuttle removes Hunter's shriveled liver and begins the delicate work of suturing all the various vessels and ducts from the new liver into Hunter's system. At 12:30 in the morning, the moment...