On April 10, 2025, several hours after finishing a hike in Sedona, Arizona, Jan Anderson started repeating herself.<\/p>\n
\u201cDid we hike this morning?\u201d she asked.<\/p>\n
\u201cYes, we hiked,\u201d said her husband, Steve Francks. \u201cAnd you did really well.\u201d<\/p>\n
But 15 seconds later, she asked the same question: \u201cDid we hike today?\u201d<\/p>\n
Anderson, 65, a retired finance executive, doesn\u2019t remember any of it. She can recall what happened that afternoon only because her husband started recording her on his cellphone.<\/p>\n
\u201cI was just on this nonstop loop,\u201d she said.<\/p>\n
Almost immediately, Francks knew something was wrong. \u201cJan was out of it,\u201d he said.<\/p>\n
He took her to an emergency room in Sedona, where staff initially thought she might be having a stroke. Because the facility wasn\u2019t fully equipped to evaluate or treat stroke patients, Francks said, she was airlifted to a Phoenix-area hospital, where she was admitted.<\/p>\n
It turned out she wasn\u2019t having a stroke. Her medical team eventually determined she was probably experiencing transient global amnesia<\/a>, a rare, temporary, and benign memory disorder.<\/p>\n The good news was that her symptoms didn\u2019t last long, and she has suffered no long-term effects from the episode. It took about 24 hours before she was able to start forming new memories, and she was discharged the next day. Anderson and Francks, who split their time between Sedona and Edmonds, Washington, returned to the Pacific Northwest a few weeks later.<\/p>\n Then the bill came.<\/p>\n The Medical Service<\/strong><\/p>\n The sudden confusion associated with transient global amnesia can also be a sign of a more common neurological condition, so it\u2019s important to rule out other possible causes \u2014 such as a stroke, for which timely emergency care can spell the difference between life and death.<\/p>\n Anderson\u2019s records show her care at Abrazo Health\u2019s Arrowhead Campus in Glendale, Arizona, included an electrocardiogram, which can detect underlying cardiac abnormalities, and imaging, which would rule out any vessel blockages that might cause a stroke. She also underwent various lab tests commonly used to diagnose a stroke.<\/p>\n The Bill<\/strong><\/p>\n $59,181:<\/strong> $35,302 for diagnostic\/therapeutic imaging, $8,147 for laboratory services, $8,146 for a special care unit, $5,532 for EKG services, and $2,054 for pharmacy. Anderson\u2019s first bill from Abrazo Health said she owed $15,312.43, citing an insurance adjustment of $43,868.57, even though her insurer had not covered any of the charges.<\/p>\n Anderson said her insurer covered separate charges for the ER and helicopter transfer.<\/p>\n The Billing Problem: Communication Breakdown<\/strong><\/p>\n The federal No Surprises Act bans out-of-network bills for most emergency services, even if those services are received at an out-of-network facility and are not preapproved by the insurer.<\/p>\n That means the cost of Anderson\u2019s hospital care should have been covered as though it were in-network. At the time, she was insured by Molina Healthcare, through a plan purchased on the federal Affordable Care Act marketplace.<\/p>\n But for a year, Molina declined to pay for her care in Glendale, at one point arguing that her hospital stay required authorization when, or even before, she was admitted.<\/p>\n \u201cI can\u2019t get anyone to resolve it,\u201d Anderson said. \u201cIt\u2019s almost $60,000 hanging over my head.\u201d<\/p>\n The first problem arose about two weeks after she was discharged, when Abrazo Health sent Anderson a bill indicating she was a self-pay patient.<\/p>\n The hospital didn\u2019t request her insurance information at any point during her stay, Francks said. He assumed, at the time, that his wife\u2019s financial paperwork had been transferred from the ER in Sedona. It had not.<\/p>\n She called the Glendale hospital and corrected the error.<\/p>\n Then, in late June, Anderson received notice from the hospital indicating she was not a Molina member.<\/p>\n \u201cYour insurance company notified our office that the patient was not a covered member for the services provided by Abrazo Arrowhead Campus on the above referenced service date(s),\u201d the notice said. It showed the total charges for her stay exceeded $59,000.<\/p>\n But when Anderson called Molina to confirm her coverage, she said, the insurance company assured her the claim was being processed.<\/p>\n That didn\u2019t mean Molina was willing to cover her hospital bill.<\/p>\n Anderson spent months trying to resolve the balance. She filed complaints with members of Congress, the Arizona Department of Insurance and Financial Institutions, and the Office of the Insurance Commissioner in Washington state.<\/p>\n Anderson has fully recovered from her bout of transient global amnesia, but a dispute over nearly $60,000 in hospital charges has been a source of stress for over a year. (M. Scott Brauer for KFF Health News)<\/p>\n In an October letter to Washington\u2019s insurance commissioner, an appeal and grievance specialist for Molina wrote that the claim was denied because \u201cinpatient stays require prior authorization, or notification at the time of admission. No notification of admission or prior authorization was received from the hospital, so the claim was denied.\u201d<\/p>\n It continued: \u201cMolina covers out of network emergency services but since this was an inpatient admission authorization is required.\u201d<\/p>\n Nicole Broadhurst, who focuses on medical billing issues as CEO of a Tennessee patient advocacy group<\/a>, said this dispute appears to rest between the insurer and the medical provider.<\/p>\n She said that Anderson\u2019s insurance information should have been transferred between the first ER and the Glendale hospital. Since it wasn\u2019t, Broadhurst said, Anderson shouldn\u2019t be held liable for her hospital bill. (Broadhurst was not involved in efforts to resolve Anderson\u2019s billing dispute.)<\/p>\n Unfortunately, Broadhurst said, these situations are \u201cnot uncommon, even though we have the No Surprises Act.\u201d<\/p>\n The Resolution<\/strong><\/p>\n Anderson said she was told by Abrazo Health for months that it was working with Molina to resolve the bill. She said she was also told that even if Molina did not cover the full cost of her hospital care, she would not be liable for the balance \u2014 but she never received that assurance in writing.<\/p>\n Meanwhile, Molina continued to uphold its decision to deny payment.<\/p>\n After KFF Health News contacted the insurer and the hospital with questions about her case, Molina told Anderson it had launched an internal review of her claim, and a revenue director with Abrazo Health told her the company was \u201ctreating this as a high-priority matter,\u201d she recalled.<\/p>\n Anderson said the revenue director for the health system assured her that if Molina continued to deny payment, \u201cthe balance will be written off on the hospital\u2019s end,\u201d she said. \u201cI will not be responsible for any balance\u201d \u2014 not even the $15,312.43 the hospital initially billed her after the hospitalization.<\/p>\n Linda Nofer, a spokesperson for Abrazo Health, would not answer questions about Anderson\u2019s bill. In a statement, she said the hospital system is \u201ccommitted to working closely with our patients to resolve billing questions and concerns.\u201d<\/p>\n Molina spokesperson Caroline Zubieta would not discuss or respond to questions about Anderson\u2019s case on the record.<\/p>\n The Takeaway<\/strong><\/p>\n The flurry of insurance paperwork and medical bills patients receive after a hospital stay can be overwhelming \u2014 and may sometimes appear contradictory.<\/p>\n Broadhurst said it\u2019s important for patients to focus on the \u201cpatient responsibility\u201d portion of an insurance document called an explanation of benefits.<\/p>\n Patients should not pay a bill if their explanation of benefits indicates they aren\u2019t responsible for the amount charged.<\/p>\n In this case, Anderson had received a bill from the hospital saying she owed money. And her explanation of benefits from Molina confirmed she\u2019d racked up more than $59,000 in hospital charges.<\/p>\n But that document also indicated her patient liability was \u201c$0.00.\u201d Anderson said the hospital was not pressuring her to pay the $15,312.43 bill or any of the charges tied to her account, but she was worried she would eventually owe a large sum because the charges remained unresolved for more than a year.<\/p>\n \u201cThe question I kept asking them was, \u2018How much am I going to owe?\u2019\u201d said Anderson, who is now insured by Medicare. \u201cIt could be anywhere from that $15,000 adjusted amount to the full balance of $59,000.\u201d<\/p>\n Broadhurst said she tells patients facing similar situations to \u201csend the hospital a copy of the EOB and ask them to correct the account to $0 patient responsibility.\u201d<\/p>\n \u201cEven if no one is actively trying to collect, I\u2019d still push for written closure so it doesn\u2019t keep hanging over them,\u201d she said.<\/p>\n (M. Scott Brauer for KFF Health News)<\/p>\n Bill of the Month is a crowdsourced investigation by KFF Health News<\/a> and The Washington Post\u2019s Well+Being<\/a> that dissects and explains medical bills.\u00a0Since 2018, this series has helped many patients and readers get their medical bills reduced, and it has been cited in statehouses, at the U.S. Capitol, and at the White House. Do you have a confusing or outrageous medical bill you want to share? Tell us about it<\/a>!<\/em><\/p>\n<\/div>\n KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. Learn more about KFF<\/a>.<\/em><\/p>\n This <a target=”_blank” href=”https:\/\/kffhealthnews.org\/health-care-costs\/amnesia-arizona-hospital-prior-authorization-bill-of-the-month-may-2026\/”>article<\/a><\/a>; first appeared on <a target=”_blank” href=”https:\/\/kffhealthnews.org”>KFF<\/a> Health News<\/a> and is republished here under a <a target=”_blank” href=”https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/”>Creative<\/a> Commons Attribution-NonCommercial-NoDerivatives 4.0 International License<\/a>.<img src=”https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/8\/2023\/04\/kffhealthnews-icon.png?w=150"<\/a>; style=”width:1em;height:1em;margin-left:10px;”><\/p>\n
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