Two Arizona mental-health providers say a state insurance investigator seemed to agree their grievances against Blue Cross Blue Shield of Arizona had merit — and then the cases were closed without any apparent action. Shannon Hendrickson of Juniper Path Psychology and Brianna Reinhold of Northern Lights Therapy filed several grievances against the insurer earlier in 2026, accusing the company of sending clawback requests they say caused chaos in their practices.
According to 12News, the two providers say they now want to know why a state employee appeared to validate their complaints but later took no apparent action. Arizona Department of Insurance investigator Steve Fekety communicated with both women by email and voicemail throughout the summer, and on June 24, Fekety reportedly told them the department would pursue a similar provider grievance against another insurer before taking the same action against Blue Cross.
Grievances Closed Without Explanation, Providers Say
Reinhold told 12News she filed multiple grievances. On October 6, Fekety reportedly told Reinhold the issue remained under review. Hendrickson emailed Fekety on October 20 asking for an update on her complaint and clarification of the legal and regulatory issues at stake, and she says she received no meaningful word about any contemplated or initiated action or the status of her case.
Hendrickson and Reinhold say the agency went quiet without resolving their grievances, and they’ve accused the Arizona Department of Insurance and Financial Institutions of sending contradictory messages about their cases. An Arizona Department of Insurance spokesperson said the department does not comment on open cases and lacks legal authority to resolve individual contract or claim disputes between insurers and providers. Department representative Kerri O’Brien said the agency instead monitors overall market conduct to ensure insurers comply with state law, and that potential violations are addressed directly with the insurer — though the department has not clarified whether it found any violations in these cases or how they were addressed.
What Arizona Law Requires of Insurers
Under Arizona Revised Statutes § 20-3102, health care insurers must establish an internal system for resolving payment disputes and other contractual grievances with providers, and the state director may review that system. Insurers must also maintain grievance records and provide the director a semiannual summary of grievances received, according to the statute's text.
Hendrickson's attorney has accused Blue Cross Blue Shield Arizona of assuming overpayments without reviewing necessary medical records and of exceeding the statute of limitations. Arizona Revised Statutes § 20-3102(J) addresses adjusting or requesting adjustment of a claim payment or denial more than one year after payment or denial, with fraud—not fraud or abuse—specified as an exception. Blue Cross alleged variances in Hendrickson's records, including session-timing issues and billing discrepancies dating back to 2022, though Hendrickson has said the company never demonstrated fraud, waste or abuse on her part, and she says she still has not been paid and her appeals have not been completed.
A Director With Ties to the Insurer He Now Regulates
Blue Cross Blue Shield Arizona CEO Pam Kehaly declined a 12News interview request in July.
Clawback Requests Disrupt a Therapy Practice
Reinhold operates Northern Lights Therapy. She stopped accepting Blue Cross Blue Shield even though the insurer covers roughly 70% of her clients, and has previously told Arizona's Family that 60% to 75% of her practice runs through Blue Cross clients. Hendrickson said she dropped Blue Cross and all insurance altogether about three months earlier.
Reinhold said one records request from Blue Cross sought BMI reports and documentation of a client's participation in weight-loss programs, even though the client in question was actually receiving care for grief over a loved one who had died. She said the mismatch suggested Blue Cross had used artificial intelligence to flag the case. Blue Cross has said it does use artificial intelligence for some functions but maintains that human oversight is involved in decision-making. The insurer's chief medical officer, Teresa Tadayon, has said requests for records substantiating a claim are an important safeguard, and that current reviews for alleged fraud and waste involve less than 1% of the nearly 12,000 behavioral health providers in its network.
Wider Access Concerns Across the Industry
Arizona's Family previously reported that the supervision requirements layered onto Blue Cross's billing rules — including a mandate that supervisors handle patient intake and set up a treatment plan before an associate can take over — have left some therapists warning they may have to cut ties with the insurer or close their practices altogether. Counselors told that outlet the changes were contributing to longer wait lists and fewer providers willing to accept Blue Cross Blue Shield insurance, even as the company said it had added access to more than 4,000 mental health providers in recent years.
Arizona was identified as one of four states where clinics filed complaints against insurers over the prior year, and 12News had reported on Reinhold's complaint back in June. Renee Hunt, a spokesperson for the insurer, has said Blue Cross Blue Shield Arizona is a nonprofit that does not answer to shareholders and that it seeks to protect members from rising health care costs; the company has said money not spent on fraudulent or inaccurate claims helps keep costs down for Arizona families, and that it reviews claims closely while growing its behavioral health network.
Clawbacks Are Squeezing Therapists Beyond Arizona
The dispute echoes an account reported by Georgia Public Broadcasting: one Georgia counselor said an insurer demanded repayment for roughly six months of sessions after determining it had paid under the wrong plan.
National claims data adds further context to providers' frustrations with insurers generally. A KFF analysis found that insurers offering qualified health plans on HealthCare.gov denied 19% of in-network claims and 37% of out-of-network claims in 2024, a combined average of 20% of all claims, with in-network denial rates ranging from 3% to 36% depending on the insurer. Fewer than 1% of denied claims were appealed that year, and insurers upheld 66% of the appeals they did review, even as marketplace enrollees filed at least 5,881 external appeals nationwide.
