ComplaintsforDelta Dental of Colorado

• Initial Complaint

  05/08/2024

  Complaint Type:

  Billing Issues

  Status:

  Unanswered

  More info

  I've succesfully used Delta Dental for several years, but on January 1, 2024 I began a new policy with Delta Dental confirmed through Connect for Health Colorado. I assumed they would cancel the old policy when the new one took effect, but I continued to get billed $57.50 each month on my **** for the old policy despite the new policy being paid via my checking account. When I phoned them, they stated that they wouldn't cancel the old policy until September. This is highly frustrating as I'm STILL THEIR customer, just with a different account number.

• Initial Complaint

  04/29/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I submitted a claim 3 months ago to delta dental manager at delta dental said she would call me back and never did . Now my claim states denied indicating the dental office is not registered with NPI which is in fact not true. NPI1083871446 Is clearly listed for THE DENTAL WALK-IN CLINIC OF *********. As you can see they have 1.4 star reviews it tells you thr type of service offered and how dishonest this company is. I paid out of pocket for my services and could not be reimbursed

  Business response

  05/10/2024

  Dear ******************,

  Thank you for the information related to your provider office, The Dental ************** of *********. The *** ending in 1446 is associated with the location at ************************************. However, the *** submitted with the claim was not the same. That *** ended in 4419, which is not associated to the ******************* location and that is why your claim was denied. 

  We are in process of using the information you provided and apply to your claim so that processing can be completed. Your claim should be finalized in the next 10 days and any available benefits issued per the terms of your plan. 

  Should you have any questions, you may reach me at ********************.

  Best,

  ****************

  Delta Dental of Colorado

• Initial Complaint

  03/31/2024

  Complaint Type:

  Product Issues

  Status:

  Resolved

  More info

  I have been trying to get reimbursed for a check I tried to deposit from Delta Dental Colorado. The check was unable to be deposited due to an error on Delta Dental's side. I have been on numerous customer ********************** calls where they noted they would issue a replacement check. The check was issued on 9/19/23, and still I haven't received a replacement. In late January I even went to their headquarters with the documentation from my bank noting the funds were not deposited. I brought the cancelled check image as well. I have walked them through bank statements that showed the item was not deposited. They said they would research it. I heard nothing so I called customer ********************** and they said it was deposited. I again noted I tried to deposit it, but on 11/7 it was reversed as the check did not clear.There is no way to contact the *** to leave feedback online, so I figured I should try the BBB. I am not surprised to see their D- rating. Their customer ********************** is horrible. I would welcome any help you can provide.I have uploaded the letter from my bank and both sides of the check I attempted to deposit that ****** provided me.

  Business response

  04/03/2024

  April 3, 2024
  
  
  
  *******************************
  *****************************************************************-8995
  Email: ***************************************
  
  Case #:                21511427
  Claim #:               202326101692      
  Issue #:               1212207
  
  Dear ********************,
  
  This notice is in response to the complaint you submitted to the Better Business Bureau. Delta Dental of Colorado (DDCO) received this complaint on April 1, 2024.   We understand your complaint to be that your reimbursement check for $55.20 that you were unable to deposit, has not been re-issued, even after numerous attempts with DDCO to resolve the issue. Your desired resolution is a replacement check of $55.20.  We have investigated the complaint completely. 
  
  All of the available information related to your request has been thoroughly considered.  Based on review of that information, we have found that the initial reimbursement check was issued on September 19, 2023. Our records indicate the check was deposited and cleared our financial institution ***** Fargo, on November 7, 2023. However, the information you provided from your banking institution Bellco, indicates the same check on November 7, 2023, was returned unpaid by the bank on which it was drawn.
  
  There is a clear contradiction of information regarding this reimbursement check. We do not wish to put you in the middle of this situation,nor do we want you to have to wait for resolution before you receive the reimbursement to which you are entitled. As a result, DDCO will issue a new check in the amount of $55.20 to you at your updated and verified address in Colorado;it will be released Thursday, April 4, 2024. We will continue to work with ***** Fargo and Bellco to determine the status of this check and ensure all records are updated to reflect correct information.
  
  We sincerely apologize for the many missteps that occurred during your numerous attempts of trying to ensure your reimbursement check was re-issued and that it was valid. It is our goal here at Delta Dental of Colorado to provide the highest level of customer ********************** to all of our members.  In your case we fell far short of that goal and for that we offer our genuine apology.
  
  Thank you for bringing this matter to our attention.  We hope this outcome provides satisfactory explanation and resolution to your concerns expressed to both DDCO and the Better Business Bureau.  Should you have further questions, you may contact me at ********************.
  
  Best,
  
  *****************************
  Compliance and Program Integrity Analyst

  Customer response

  04/09/2024

   
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
  
  Sincerely,
  
  *******************************

  Customer response

  04/09/2024

  I should have noted how much I appreciate your help in getting this resolved!  I truly appreciate it!

• Initial Complaint

  02/22/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Resolved

  More info

  Have not paid claims check. Have called 10 times since December. Have been promised three times they were sending a check. Was given a check number. Given conflicting information every call. Assured I would receive the check on three occasions then was told it wasn't coming. On the last discussion was told again it was being resent and may take 30 days. Have already been told this twice. Losing faith and tired of waiting. Need some sort of resolution of conclusion to this. Have recorded all conversations.

  Business response

  03/01/2024

  March 1, 2024
  
  
  
  *****************************
  ****************************;
  ******* **  28601
  E-mail: *************************
  
  Subject:               reimbursement for Dental Services from 2022
  Case:                   21334247
  Issue:                   1151914                                                          
  
  Dear ********************,
  
  This notice is in response to the complaint you submitted to the Better Business Bureau, which was received on February 22, 2024. We understand your complaint to be that you have not been reimbursed for dental services completed in 2022. We have investigated the complaint completely.
  
  All the available information related to your request has been researched.Our records show that you had treatment completed 8/5/2022, 8/10/2022, and 8/15/2022 and claims were received and processed by Delta Dental of Colorado (DDCO). See attached for details.
  
  On January 4, 2024, you called our Customer ********************** department indicating you had not received the checks, and that your address has changed from what was provided to DDCO by your employer. You would be contacting your human resources department to make the necessary changes.
  
  Analysis confirms that the initial checks were indeed mailed to your previous address, all were returned to DDCO as undeliverable and voided.All three checks were reissued on January 23, 2024. However, updates to your address had not yet been received by DDCO and the reissued checks were erroneously sent to you your prior address again.
  
  Finally on February 23, 2024, DDCO received an update to your file correcting your address. The three previous checks were processed on one reimbursement check. This replacement check was drafted February 29, 2024, and will be issued March 5, 2024; for tracking purposes, the check number is 401719338.
  
  Should you have questions, you may reach me at ********************.
  
  Sincerely,
  
  *****************************
  Compliance and Program Integrity Analyst

  Customer response

  03/04/2024

   
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
  
  Sincerely,
  
  *****************************

• Initial Complaint

  02/22/2024

  Complaint Type:

  Order Issues

  Status:

  Answered

  More info

  Rec'd letter noting $68 due although I had paid $34 in Jan and $34 in Feb.. Called for explanation and was informed my policy was cancelled at the end of 2023 without notice or explanation. Asked if that was the case then why the letter demanding additional payment. Agent could not explain.

  Business response

  03/01/2024

  March 1, 2024
  
  
  
  *****************************
  4800 ************
  **********************************
  E-mail: *******************
  
  Subject:               Cancellation of policy and premium refund
  Case:                   21331586
  Issue:                  1151915                                                          
  
  Dear ******************,
  
  This notice is in response to the complaint you submitted to the Better Business Bureau, which was received on February 22, 2024. We understand your complaint to be that you received a notice for payment due of $68.00,even though you paid that total amount in January and February 2024. In addition, your policy was cancelled at the end of 2023 without notice or explanation. We have investigated the complaint completely.
  
  All the available information related to your request has been researched.Your initial enrollment was via Connect for Health Colorado. Continued eligibility is dependent on your renewal/re-enrollment with Connect for Health as well. Notification from Connect for Health Colorado was sent to you via email indicating than your 2023 health plan would expire on December 31, ******** that you may re-enroll beginning November 1, 2023. A copy of that communication is provided.
  
  Our records also indicate that you submitted premium payment of $34.00 for January 2024 and February 2024. As your plan had cancelled at the end of 2023, these payments resulted in a credit balance of -$68.00. This credit was reflected on the billing statement issued to you on February 13,2023. The Amount Due was not $68.00, but rather negative $68.00, meaning you had a credit of $68.00 on your account. The credit has been processed and the total credit amount of $68.00 will be issued to you on the next check run,which is March 7, 2024. 
  
  We trust the above explanation brings satisfactory resolution to the issues raised with the Better Business Bureau and DDCO. Should you have further questions, you may reach me at ********************.
  
  Sincerely,
  
  *****************************
  Compliance and Program Integrity Analyst

• Initial Complaint

  02/06/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  Delta dental of Colorado is such a terrible company! Scammers and liars working there. I cant believe lies they have been telling me for 2 months! I have changed my plan in mid December through connect for health and they have promised to get it changed by ******* 1st.Nothing was changed same plan, same charges. Called them 4 times over the month of ******* and each employee was very rude and told me to wait and that they see changes and it takes time to reflect on my account. Well, wasnt it a big lie? Called last time on February 6th at 10am MT because my account still reflected my old information BUT THIS TIME THEY CHARGED FOR TWO MONTHS (******* and February) at the price of new plan when I still had old one. The old one was $14, the new one is $40, so yes they charged my $80 for the plan I still dont have! Representative as always was very rude and unhelpful, he said to wait AGAIN it takes ***** business days to reflect the changes because my changes were accepted by them ******* 29th! Almost 2 months later!Why was I charged new amount for ******* then? I want my money back. I also want my nerves back because dealing with this company leaves with nothing but constant frustration. I wish there would be other good alternative on the market, I would switch immediately.

  Business response

  02/16/2024

  February 16, 2024
  
  
  
  ***************************
  E-mail: ***************************
  
  Case:                    21253981
  Issue:                    1112148
  Subject:                Change of plan
  
  Dear ********************,
  
  This notice is in response to the complaint you submitted to the Better Business Bureau, which was received on February 6,2024. We understand your complaint is regarding a delay in processing a change to your dental plan and excess premium charges. You are disputing $80.00 and stated, I want my money back. Your request and all relevant information have been referred to me for research and reply. 
  
  Your record at Delta Dental of Colorado (DDCO) has been thoroughly reviewed and we found the following.
  $13.75 is the premium for the Family Value Plan, which was your initial enrollment with DDCO
  $37.25 is the premium for the Comprehensive Plan, which you requested to change to mid-December
  12/13/2023 via Connect for Health Colorado, you requested to change your plan
  1/19/2024, DDCO processed your request to change plans
  
  Your billing history is outlined below.
  $13.75 processed on ******* 12, 2024, for ******* coverage in the Family Value Plan
  $60.75 processed on February 2, 2024, for ******* coverage in the Family Value Plan and February coverage in the Comprehensive plan.
  $23.50 for the difference in ******* premium between the Family Value Plan and Comprehensive Plan (plan changed 1/19/2024) and $37.50 for February premium.
  $74.50 total premium processed for ******* and February coverage for the Comprehensive Plan, $37.50 per month for two months coverage in 2024.
  
  Premium for two months of coverage in the Comprehensive Plan, effective ******* 2024 has been correctly processed. The monthly premium of $37.50 for two months of coverage is $74.50, which is the amount you have been charged and DDCO has processed. Your request to change your plan was updated twenty-three business days (not including holidays and weekends) after the enrollment information was updated from Family Value Plan to the ******************** Plan. 
  
  Per your complaint, the amount indicated that you are disputing is $80.00. Please specify your desired settlement. Do you want to terminate your plan effective 1/1/2024 and receive a full refund of $74.50? Or do you want to retain coverage and receive a refund of $23.50 for the premium difference that was processed for ******* coverage, when you did not have access to benefits in the Comprehensive Plan until 1/19/2024? Upon receipt of your preferred resolution, your record will be updated, and the appropriate refund processed.
  
  I hope this notice brings satisfactory explanation and resolution to the concerns you have raised with the Better Business Bureau and Delta Dental.  However, should you have questions or if you want to discuss further, you may reach me at ********************.
  
  Sincerely,
  
  *****************************
  Compliance and Program Integrity Analyst

  Customer response

  02/23/2024

   
   Complaint: 21253981
  
  I am rejecting this response because:
  I appreciate your clarification on this matter, but its just a words of some stranger on the internet. I want my invoice for all what you told me to proof that II had coverage from when you say it was. Please see screenshots attached with the error on your website when I try to get A CORRECT INVOICE. Additionally, I have attached screenshots of requirements for reimbursement.
  And obviously I want reimbursement for the period that I didnt have correct coverage, what answer was expected here? Please take the extra money that you fraudulently charged!
  I Have been calling you since ******* to make it right, so you can fix my account that incorrectly reflects my plan, my invoice for February that doesnt work, my invoice for ******* that doesnt reflect correct payment. Its end of February and your company and your employees still cant make it right. Incredible. Even for you it took several weeks to reply.
  
  Sincerely,
  
  ***************************

  Business response

  03/06/2024

  Dear ********************,
  
  Dear ********************,

  Thank you for taking the time to speak with us on Monday, March 4, 2024, regarding your situation. We are still in the process of reconciling the credits,charges, and payments to your account.  As soon as this is completed, we will send details to the email address on file. Per your request, we are providing a certificate of coverage indicating you are enrolled in a dental plan with Delta Dental. It also includes the subscriber's name, plan name, policy number, effective date, etc. Since we are still making adjustments to your account, the monthly billing statements are not yet accurate, and we do not want to provide inaccurate information to you.
  
  As Delta Dental cannot provide accurate billing statements for reimbursement of your monthly dental premium, we would like to issue that reimbursement directly to you from us. However, we will continue to work on your account to make it accurate based on the plan you have enrolled in, the applicable premium and any credits that have been afforded to you as a result of delayed eligibility. Current charges for enrollment January through March 2024 in your dental plan total $88.25, please see below for a breakdown of charges. This amount will be issued to you within the week.
  
  Jan        $13.75
  Feb        $37.25
  Mar        $37.25
  TOTAL   $88.25
  
  Your next billing statement will be issued later this month and should include premium for coverage in March 2024 and April 2024. By then,your entire account should be reconciled and accurate. Billing for May 2024 and future should be on a monthly schedule.
  
  I hope this notice brings a satisfactory explanation and resolution to the concerns you have raised with the Better Business Bureau and Delta Dental.  

  Sincerely,

  *****************************
  Compliance and Program Integrity Analyst

• Initial Complaint

  01/29/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Resolved

  More info

  I am insured by Delta Dental of Colorado. While I cannot locate a policy number, my Group Number is ***********. On November 9, 2023, I filed a complaint with Delta Dental regarding one of their in-network contracted dental providers. Delta Dental did not respond. I sent a reminder letter on December 15, 2023, to follow up on said complaint and request an update, to which Delta Dental also failed to respond. At this time, I request an update on said complaint.

  Business response

  02/08/2024

  February 8, ****
  
  
  
  *************************
  ****************
  ********* ** 79336-2827
  E-mail: *********************
  
  Subject:               Status of Complaint Submitted to Delta Dental of Colorado
  Case:                   21213114
  Issue:                  1113003                                                          
  
  Dear ******************,
  
  This notice is in response to the complaint you submitted to the Better Business Bureau, which was received on January 29, ****. We understand your complaint to be lack of response to the original complaint submitted to Delta Dental of Colorado (DDCO) on November 9, 2023. We have investigated the complaint completely.
  
  All the available information related to your request has been considered. The initial complaint received at DDCO has been processed.Notification of the determination was issued on February 2, ****, to the email address you provided; a copy of that notice is attached for your reference.
  
  We have determined that an overpayment has occurred for the treatment you received at ************************* Services. A refund of $218.00 is owed to you from the office. The refund should be processed to you directly from the office no later than February 16, ****. Please note, if the office disagrees with the determination, they have the right to dispute the determination within 10 days of the issuance of the letter which is February 12, ****. As of this writing, no such dispute has been received.
  
  Should you have questions, you may reach me at ********************.
  
  Sincerely,
  
  *****************************
  Compliance and Program Integrity Analyst

  Customer response

  02/09/2024

   
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
  
  Sincerely,
  
  *************************

• Initial Complaint

  01/24/2024

  Complaint Type:

  Order Issues

  Status:

  Resolved

  More info

  Policy number 07720842617:I've contacted them SIX times to request a cancellation of my policy due to moving out of state. After the first 2x, I was told I can use my benefits in my new state. After that, I wrote back FOUR more times stating that while that *** be the case, I can get cheaper benefits in my new location and again requesting they cancel my plan and refund the THREE monthly payments that were made while waiting for them to respond to these requests. I've NOT heard back from any of the last four messages.

  Business response

  02/01/2024

  February 1, ****
  
  
  
  *************************
  E-mail: *************************
  
  Subject:               Termination of policy 502 Enhanced Plan
  Case:                   21194376
  Issue:                  1087939                                                          
  
  Dear ******************,
  
  This notice is in response to the complaint you submitted to the Better Business Bureau, which was received on January 24, ****. We understand your complaint to be your desire to cancel your benefit plan as a result of your move out of state. We have investigated the complaint completely.
  
  All the available information related to your request has been considered. Per the terms of the contract with the each 12-month contract year;our plan year is May 1 through April 30. However, the plan also includes a provision which indicates that the plan only covers Colorado residents. As such, upon notification of moving out of Colorado, your policy is approved for early termination due to your non-resident status.
  
  The effective date for the approved early termination is the last day of the month in which we received your request. As we received your notice of cancellation November 21, 2023, your plan is eligible for termination on November 30, 2023. See attachment for the applicable section of your contract.
  
  Since your premium of $153.00 has been processed for coverage in December 2023, January **** and February ****, a refund for these months will be processed and $153.00 will be credited to your card on file.  
  
  Should you have questions, you may reach me at ********************.
  
  Sincerely,
  
  *****************************
  Compliance and Program Integrity Analyst

  Customer response

  02/12/2024

   
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
  
  Sincerely,
  
  *************************

• Initial Complaint

  01/21/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Resolved

  More info

  I attempted to reach out to Delta Dental last week to discuss matters related to pre-determination of benefits and was told that the information was on online which it is not. Then the information that I get in the mail tells me that tooth number 19 is not covered for a crown which is not the case. Under my current plan I have never had a crown on this tooth. It should also be noted that the plan also runs from July 1 to June 31 despite what is listed with Delta Dental. This claim should not even have to be appealed on the basis that this business should not that the plan year starts on July 1 with the State of Colorado. This dispute should not have to count towards an appeal with Delta Dental processed this incorrectly. I would like a resolution to this complaint. In addition their appeal process is outdated really sending a letter that one has no knowledge in how this is being received. Not to mention that this business was supposed to update their system years ago to make it more patient friendly and this is not the case. Given that this is medical issue I am not going to upload any documents. Please note that I am also going straight to the Business as well to have this resolved as well to voice my complaint.

  Business response

  01/30/2024

  January 30, 2024
  
  
  
  *************************
  *************************************************************-5612
  E-mail: *****************
  
  Case:                    21177799
  Subject:                 Pre-determination (PTE) #************, tooth **
  Issue:                    1087927
  
  Dear ********************,
  
  This notice is in response to the complaint you submitted to the Better Business Bureau, which was received on January 22,2024. Our understanding of your complaint is regarding the following:
  You were unable to obtain the processed predetermination online.
  The predetermination of benefits denied coverage for a crown on tooth **.
  Your plan benefit year is July 1 to June 30.
  Delta Dentals appeal process is outdated and not patient friendly.
  Your request and all relevant information have been referred to me for research and reply. 
  
  All of the available information related to your request has been thoroughly considered.  Based on review of that information and the terms of the plan contract, it has been determined that the initial processing must be upheld. Information relevant to that decision is set out below.
  
  First, you are correct. The processed predetermination of benefits voucher is not available online via your portal with Delta Dental. This document is sent via US mail directly to your address on file. The reason you gave for asking us to overturn the processing of crown denial is Under my current plan I have never had a crown on this tooth. It should also be noted that the plan also runs from July 1 to June 31 despite what is listed with Delta Dental.
  
  While we acknowledge that the plan year for State of Colorado members is July 1 June 30, there are procedures covered by the plan that have frequency limitations that are not a per contract year policy.  For example, per the terms of the administrative services contract with State of Colorado, benefits can be provided for a crown on the same tooth only one time in any 60-month period.
  
  Please see attachment for an excerpt from the appropriate section of the benefit booklet for your reference:
  
  In review of the predetermined benefit voucher, there are three items submitted by the dentist for review by Delta Dental.  The first line is for a buildup (procedure code D2950) on tooth #**.  This procedure was approved because there are no other buildups on file for this tooth in the prior 60-month period.
  
  The second line is for a porcelain/ceramic crown (procedure code D2740) on tooth #**.  This procedure was approved because there are no other crowns on file for this tooth in the prior 60-month period.
  
  The third line is for a gold crown (procedure code D2790) on the same tooth #**.  As the same predetermined benefit voucher has already approved a porcelain crown on this tooth, the second crown on the same voucher was denied as coverage for a crown on the same tooth is not available for 60 months.
  
  It should be noted that if the decision was made between you and your provider to skip the porcelain crown and instead proceed with a gold crown, the gold crown would be covered as there would be no other approved crown procedures on this tooth in the prior 60-month period. 
  
  The denial of line three on this voucher was not a Delta Dental error.  We cannot authorize benefits for two crowns on the same tooth within any 60-month period per the terms of the administrative services contract with State of Colorado.
  
  In addition, your grievance indicates the following: their appeal process is outdated really sending a letter that one has no knowledge in how this is being received. Delta Dental will accept your appeal via US mail or via email to ********************** received, an acknowledgement letter is issued to you indicating receipt of the request and a time frame for estimated completion.
  
  I hope this notice brings satisfactory explanation and resolution to the concerns you have raised with the Better Business Bureau and Delta Dental.  However, should you have questions or if you want to discuss further, you may reach me at ********************.
  
  Sincerely,
  
  *****************************
  Compliance and Program Integrity Analyst

  Customer response

  02/06/2024

   
  Complaint: 21177799
  
  Thank you for the reply. I was not aware that my dental provider sent in two different requests for a crown.  Can you please send me a copy

  of what Delta Dental received from my Dental provider and the cost that would be covered for Gold and the Cost that would be covered for 

  non gold.- porcelain.  I see that the State of Colorado is having webinar regarding Dental Dental for State Employees on March 7th.  It would 

  be very helpful if this point about the State contract is discussed in this upcoming webinar. 
  
  Sincerely,
  
  ***************************

  Business response

  02/22/2024

  
  Please see the attachments for the response from Delta Dental and all supporting documentation.

   

  Sincerely,

  *****************************

  Customer response

  02/22/2024

   
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.

  It would be nice if the business would also send this via regular mail. Thank You. 
  
  Sincerely,
  
  ***************************

• Initial Complaint

  01/11/2024

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  I wish your assistance in getting Delta Dental of Colorado to process a dental claim that has been pending for a year, leaving me with the distinct impression they are deliberately attempting to avoid paying the claim, by simply refusing to communicate simple clerical adjustments. This hoping I will forget the claim is pending and they can avoid paying. I am also concerned that Delta Dental may ethically screen claims hoping minority policyholders will be less adapt at following up on claims.I have now filed 4 independent claims for a dental procedure for my wife 01/12/2023 to remove and replace a broken implant s**** This was done out-of-network with payment coming to me, instead of the provider. The original claim for $435.00 was submitted on 01/24/2023, which received a rejection for incorrect subscription number. This was correct with second filing in March. Receiving no response, I called in August and was informed a couple boxes needed to be blank. Again, corrections were made with the third filing. Again, receiving no response I called in December, learned an adjustment was needed in my wifes name. This was corrected with the fourth filing.My question is: why they did not contact me expediently if corrections were needed, and why all corrections were not included in one message. Since my wifes name is unusual for natural born Americans implying a high probability, she is a minority, the concern for ethnic screen looking for person likely not to follow up on claims.Delta References: Policyholder Subscription: **************, Patient ID: ****** I note that Delta Dental maintains a D- rating with the BBB.

  Business response

  01/22/2024

  January 22, ****
  
  
  
  **** Loan *******
  ***********************************
  ******************** 80525
  
  Case Number:    2132903
  Subject:               Claim Processing
  
  Dear ******************,
  
  This notice is in response to the complaint submitted to the Better Business Bureau, which was received on January 12, ****. We understand the complaint to be that the submitted claim for services completed 1/12/2023 has not been processed and appropriate benefits issued, even though you have provided information several times. Your request and all relevant information have been referred to me for research and reply. 
  
  The claim in question was received at Delta Dental in January 2023. At that time, there was not enough information included on the claim to identify your coverage. The claim was rejected and reference #************ was issued to the address on the claim on January 30, 2023. The rejection notice stated the following:  Subscriber not found. The subscribers identification does not match a valid subscription number.
  
  This rejection was based solely on the identifying information included on the claim form, compared to eligibility information included in our claims and processing system. Delta Dental does not engage in any ethnic screen process.
  
  Upon receipt of your complaint, Delta Dental staff contacted your dental office to obtain patient records in order to process the claim. The information was received, and the services approved for reimbursement based on the terms of your benefit plan. You will receive an explanation of benefits in the coming days outlining the payment and the payment will be issued this week. 
  
  Should you have questions regarding the processing of the claim(s) in question, you may reach me at ********************.  
  
  I hope this notice brings satisfactory explanation and resolution to the concerns you have raised with the Better Business Bureau and Delta Dental.  However, should you have questions or if you want to discuss further, you may reach me at ********************.
  
  Sincerely,
  
  *****************************
  Compliance and Program Integrity Analyst

  Customer response

  01/31/2024

   
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and once I receive the mentioned explanation of benefits and check for the benefits as covered in my police, I will find that this resolution to be satisfactory to me.
  
  Sincerely,
  
  *****************************

*Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business. ↩