For the most part, Keyanna Jones and her husband thought they knew what to expect when their daughter Chloë had eye surgery last fall.
Even Chloë, who was in kindergarten, had a good understanding of how things would go that day. Before the procedure,a hospital worker gave her a coloring book that explained the steps of the surgery – a procedure to correct a condition that could have eventually interfered with her vision.
“Chloë is very smart,” Jones said. “She reads at almost a third-grade level now, and she’s only 6.”
Jones did her homework,too. With no pediatric ophthalmologists near their home in Wentzville, Missouri, who would take their insurance, she asked the insurer to cover Chloë’s out-of-network care as if it were in-network. The insurer agreed to let her see an out-of-network specialist.
Chloë made it through surgery without a hitch. Jones said her daughter enjoyed a few popsicles at the hospital before going home.
“ I slept with her every night as she was so worried she would wake up and not be able to see,” she said. “But it healed beautifully, and she was absolutely ready to go back to school.”
Then the bill came.
The Medical Procedure
Chloë was born with a droopy left eyelid, a condition known as ptosis. To correct the problem, an ophthalmologist surgically lifts the eyelid, preventing it from disrupting the patient’s line of sight.
Ophthalmologists, unlike optometrists and opticians, hold medical degrees and can provide advanced eye care, including surgery.
The Final Bill
$15,188, including $10,382 for the procedure and $2,730 for anesthesia. Initially, insurance paid just $1,775.79, leaving the Jones family owing $13,412.21 – until Chloë’s uncle, who had recently finished his term as a state senator, asked a colleague to look into it.
The Problem: Phantom Insurance Approval?
months before Chloë inhaled bubblegum-scented anesthetic at Cardinal Glennon Children’s Hospital in St. louis,Jones discovered that it can be hard to find a pediatric ophthalmologist. The doctor recommended by Chloë’s pediatrician wasn’t contracted with their insurer, UnitedHealthcare, and the closest in-network specialist was in Wisconsin, hundreds of miles away.
So Jones requested what’s called a network gap exception, under which the insurer would cover the recommended doctor’s services as in-network.Before the surgery was scheduled, she received a letter saying UnitedHealthcare had approved her request “becuase currently there isn’t a doctor, health care professional, or facility in your area to provide these services.” The letter listed several medical billing codes for eye services and said they would be covered “at the network level.”
About a week later, the insurer sent a prior authorization letter approvin# A $10,000 Hospital Bill Vanishes After a Reporter Asks Questions
By Sarah Jane Smith, KFF Health News
August 26, 2025 15:55:05
When Chloë Jones, 10, needed emergency surgery to repair a broken arm after a fall at a playground, her family braced for a hefty medical bill. They weren’t wrong. The hospital charged $10,000. But after a local news reporter started asking questions, the bill disappeared.Chloë’s mother,Lakisha Jones of Memphis,Tennessee,has UnitedHealthcare insurance through her employer. She said she thought her insurance covered emergency care.However, the hospital, Methodist Le Bonheur Healthcare, initially billed her the full $10,000, claiming the emergency room visit was not covered under her plan.
“I was shocked,” Lakisha Jones said. “I just didn’t know what to do.”
She called the hospital and her insurance company repeatedly,trying to understand why she was responsible for the entire amount. she received little clarity.
“It was just a lot of back and forth,” she said. “Everyone kept telling me to call someone else.”
Enter WMC Action News 5 reporter Justin Fitzwater. Lakisha Jones contacted him after feeling stuck in a bureaucratic maze. Fitzwater, who regularly reports on issues with medical billing, investigated.
“These situations happen all the time,” Fitzwater said. “People get these huge bills, and they don’t know where to turn. Frequently enough, it’s just a matter of someone making a phone call and asking the right questions.”
Fitzwater’s team contacted both the hospital and UnitedHealthcare,seeking an description for the bill. He said he didn’t push for special treatment, just answers.
“we just wanted to understand why this bill wasn’t being covered,” he said. “We wanted to know what was going on so that everybody can be at peace and move on with their lives,” he said in an interview. “We just did what we do every day.”
After Fitzwater’s staff contacted the hospital and the insurer,representatives from both separately called Jones and notified her that UnitedHealthcare had paid the bill in full.
Chloë’s family paid nothing for her procedure – not even a copay.
