Understanding EOB denials/non-payments (UHC)

My (pregnant) wife was notified by her new doctor of an unexpected bill from a lab that did some testing for her. We just reviewed all of her claims during the pregnancy and found a total of 8 claims that raised a flag for us; 4 were denied, 4 were some form of non-payment for the procedure or tests. We're trying to understand what some of the explanations mean, but we are both super anxious and stressing out because the totals add up to around $30k assuming we end up having to pay for all of them.

Plan is UHC Oxford, if that helps.

The explanations given are:

(2) Benefits for this service are denied. We sent a letter to the provider asking for additional information. We have not received a response. (FWA040) Genetic testing for both my wife and I that was suggested by a 'counselor' at the hospital that we had other testing performed at. Wife was told that we should expect this to be denied and that we should be billed a smaller amount (2) Benefits for this service are denied. The service or supply is not covered under the terms of your plan because it has not been proven to be effective for your condition. To be considered for coverage, you or your provider must submit scientific evidence that shows this service is safe and effective for your condition. (MCR095) These are both vitamin D deficiency tests (my wife was deficient and then began taking supplements prior to the second test) (2) This service is not eligible for payment. Your network provider was required to obtain authorization before you received this service. An authorization was not received. Participating providers may not bill the Member for this service. (CAD253) (2) This service is not eligible for payment. The participating provider does not have the proper accreditation required to be credentialed to perform this service. Participating providers may not bill the Member for this service. (CAD960)

Regarding the second point – my wife has stopped seeing the doctor who performed these tests because he has been a no-show for the last 3 consecutive appointments with no explanation and has generally been absent as a provider. My wife's concern is that he will either not respond at all, or not in a timely manner and we would be left footing these bills.

The bottom two sound like health insurance jargon for 'your doctor can't charge you for these' but that's what I'm ultimately trying to understand. Any help would be greatly appreciated.

submitted by /u/Poogles86
[comments]