Help! New to American health insurance, got a claim!

Hello Reddit!

I recently moved to the USA from Northern Ireland for college. Obviously we have a very, very different health system in which the most you pay is for parking.

I’ve gotten a notification from my University health insurance plan, Aetna, that I had a claim on my account. I log in, and it’s $1,277 for an MRI I had done as a result of cluster headaches. They’re telling me that it’s because the place it was done is “out of network”.

First off, this MRI was done via a referral from my Neuro, who is in my network. Second, I never met the doctor listed as being out of network on my claim. So how was I supposed to check to see if this was in this mysterious network they’re talking about? I understand the concept of out of pocket maximums and all that, but I can’t see how this could possibly be out of network when it was a scan referral by a neurologist in a radiology center across the street? Help?

Can I dispute this claim? I’m bringing this here before I bring it to my mom because it’s guaranteed she’ll get angry. I can show you my claim if you want (with identifying info scored out). I have no idea how to navigate this so I really need a full walkthrough. This is a lot of money.

Information that’s maybe relevant is that I’m on the Aetna student health insurance plan from the University of Arizona. The neuro is Center for Neurosciences. The radio is Radiology Lmtd. This was a scan done in November, billed December. I can send you snips from the claim if needed.

submitted by /u/FeldsparPorphyrr
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Hello Reddit! I recently moved to the USA from Northern Ireland for college. Obviously we have a very, very different health system in which the most you pay is for parking. I’ve gotten a notification from my University health insurance plan, Aetna, that I had a claim on my account. I log in, and it’s $1,277 for an MRI I had done as a result of cluster headaches. They’re telling me that it’s because the place it was done is “out of network”. First off, this MRI was done via a referral from my Neuro, who is in my network. Second, I never met the doctor listed as being out of network on my claim. So how was I supposed to check to see if this was in this mysterious network they’re talking about? I understand the concept of out of pocket maximums and all that, but I can’t see how this could possibly be out of network when it was a scan referral by a neurologist in a radiology center across the street? Help? Can I dispute this claim? I’m bringing this here before I bring it to my mom because it’s guaranteed she’ll get angry. I can show you my claim if you want (with identifying info scored out). I have no idea how to navigate this so I really need a full walkthrough. This is a lot of money. Information that’s maybe relevant is that I’m on the Aetna student health insurance plan from the University of Arizona. The neuro is Center for Neurosciences. The radio is Radiology Lmtd. This was a scan done in November, billed December. I can send you snips from the claim if needed.
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