ComplaintsforDelta Dental Insurance Company

Dental Plans

View Business profile

Need to file a complaint?

BBB is here to help. We'll guide you through the process.

File a Complaint

Initial Complaint
06/17/2024
Complaint Type:
Order Issues
Status:
Resolved
The complainant verified the issue was resolved to their satisfaction.
My Complaint: I had to pay out of pocket for a covered wisdom tooth extraction my daughter had on 25 April 2024. The doctor would not bill Delta Dental because Delta Dental denied a previous claim that they said they would cover to the same provider (Three Rivers Oral and Facial Surgery phone ************) on 12 December 2022. What I want: Reimbursement from Delta Dental for Wisdom Tooth extraction on 4/25/2024 I paid out of pocket in the amount of $781.00 What I sent Delta Dental on 5/29/2024: Documentation of the wisdom tooth extraction I paid for on 4/25/2024 in the amount of $781.00 and documentation of the prior wisdom tooth extraction on 12 December 2022 that Delta refused to pay resulting in Oral Surgeon refusing to accept Delta coverage on 4/25/2024.Delta Dental will not respond to my complaint.
Business response
06/20/2024
Good morning,

Please respond with your enrollee id.

Thank you
Customer response
06/20/2024
My Enrollee ID is ************
Business response
06/26/2024
Good afternoon,

Thank you ****. Delta Dental responded on 6/12/24 by sending out an authorization form. This needs to be filled out by your daughter since she is 18+. I have attached another copy that you can reattach and get back to us quicker than mail, as soon as this is received the complaint will be created.

Thank you

Customer response
06/28/2024
I have attached the signed authorization form as requested.
Business response
07/02/2024
Hello,

This was received and submitted to our grievance and appeals team for review. We have also uploaded the authorization form.

Thank you
Customer response
07/02/2024
I am not going to say in advance that I will "accept" Delta's appeals procedure. I have paid into this insurance for thirty or more years and the fact that I had to pay out of my own pocket for a simple wisdom tooth extraction which is a covered procedure is more than a little stunning.
Customer response
07/03/2024
It was not clear what information needed updating. My original complaint said Delta Dental would not respond to me. Delta Dental has responded to you since I filed the complaint so if that is the "updated information" in question respecting the complaint then yes Delta Dental has now responded to you since you are involved. What I want however is the $781 I had to pay out of pocket for a covered procedure (wisdom tooth extraction) for my daughter. Her authorization for Delta has also been uploaded.
Business response
07/08/2024
Hello ****,

Your complaint was submitted to our grievance and appeals team the same day the authorization was uploaded for your daughter. The last message was to advise you of this as well as to let you know the authorization has been received. Please allow around 30 days for the appeals team to review your complaint and for you to receive a resolution.

Thank you

******************
Customer response
07/08/2024
I understand. I will not say in advance I will accept the resolution until I know what the resolution is.
Thank you.
Business response
07/09/2024
Hello,

I understand as well.

Thank you
Customer response
07/10/2024

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
06/16/2024
Complaint Type:
Sales and Advertising Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Our daughter, *************************, aged out of our dental insurance. Delta Dental should have provided us with the paperwork demonstrating she no longer had insurance. They failed to do that and now she does not have any coverage because she is no longer in her special election period. Now we are facing cost exposure because of their negligence. ************************* Member ID ************ Primary member is ***************************************. They need to resolve this by either extending her coverage or contacting the dental company to extend her SEP. This is on them to resolve.
Business response
06/20/2024
Hello,

Due to HIPAA law we are unable to assist until an authorized personal health information form is filled out by the dependent. This was sent through mail as well as we have received a complaint already directly from the subscriber. Please see attached form.

Thank you.
Initial Complaint
06/13/2024
Complaint Type:
Billing Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
********* Dental has been forcing me to pay beyond what I owe according to my Explanation of Benefits (EOB). My dental insurance company has advised me to not pay more than what is mentioned in the **** In addition, the dental office is not sharing the information requested by my dental insurance on my behalf even after several attempts. The dental office sent me a statement for services rendered more than a year ago and I am not required to pay it as per my dental insurance benefits. In some instances, even the date of service is wrong (not a valid date). I've called them several times to discuss this, but they refuse to discuss the situation with me in good faith. They say that someone else in the headquarters is responsible for billing and refuse to discuss it further. When I ask them to put me in touch with the person/office responsible for billing, they refuse to do that
Business response
06/20/2024
Good morning,

This Better Business Bureau only services members of the Delta Dental of California enterprise, I am unable to view your enrollee information to assist you. Please reach out to Delta Dental of Oklahoma.

Thank you.
Initial Complaint
06/07/2024
Complaint Type:
Order Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Delta Dental has taken me through much red tape to pay one claim. The policy allows for a maximum of $1,500 to be paid for orthodontic treatment. The treatment was rendered by *********************** at *********** Orthodontics in August of 2023. The provider first submitted the claim for $5,300. They were then told by Delta Dental to check with my secondary insurance company, Guardian. The provider followed their instructions, only to find out the obvious, Guardian does not cover orthodontic treatment for adults. Delta Dental was stalling. After this unnecessary step, the provider submitted the claim a second time and for the same amount, $5,300. Delta rejected the claim again while notating the same procedural alert--check with Guardian. This was more stalling on Delta's part. The provider obliged and then submitted the claim a third time. This time, Delta paid half of the entitlement which was $750. I asked both the provider and the insurance company why only half of the entitlement was paid by Delta. Delta claims that the provider submitted the claim, the third time, for a lesser amount of $1,930. However, the provider's records reflect that they submitted the same amount of $5,300. When Delta opted for the lesser amount of $1,930, it allowed them to pay out only 50% of the allowance. Delta has not shown proof that the claim was submitted by the provider for a lesser amount. Their practices appear to be unethical and an attempt to string me along in order to continue collecting enrollment fees from me. I also get the impression that they hope that I get frustrated enough to cancel the policy so that they will not be obligated to pay the fill entitlement. To be clear, the entitlement states that Delta is to pay for 50% of the complete treatment up to $1,500 and that is within one contract year. They have not held their end of the agreement, and after reading the BBB complaints on this company, it seems to be standard practice. At what point does this become criminal?
Business response
06/11/2024
Hello,

Please respond with your enrollee id .

Thank you
Customer response
06/11/2024
Delta dental requested that I send my enrollee ID which is ************.
Business response
06/12/2024
Hello,

Thank you for your response. Your appeal has been created and routed to our grievance and appeals team for review.

Thank you
Customer response
06/12/2024
I will await.
Business response
06/14/2024
Hello,

Thank you .

******************
Initial Complaint
06/04/2024
Complaint Type:
Service or Repair Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
So we had some work done for son at dentist office while with delta dental. I had changed jobs months after works was done. To find out that they did not pay there portion of the dental work they were suppose to have paid for. This is not ok at all so we had gotten stuck with the bill and what I need to happen is then send me a check for the balance that was owed by them. I paid to have it dental through my employer and there should be zero issue after the fact that your portion that was in the paper work you covered was. It paid in full. We are expected to pays ours in full at time of appointment and so should you all. I dont care if I my job change ended our use of you all at all. But I do care that you did not do what was stated to be done at the time we had his work done. So again we need this portion now sent to us so we can put it towards care credit due to lack of you all doing your job and doing like it should have been handled.
Business response
06/05/2024
Good morning,

Please respond with your enrollee id number.

Thank you
Initial Complaint
05/23/2024
Complaint Type:
Order Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
i pay them 50 dollars per month for the last few years. suddenly after i get work done through the dentist, I was made aware that the coverage was cancelled due to lack of getting funds. I can understand if you're not getting paid then I shouldn't be covered. However I need more than an email to let me know that I'm no longer covered with something as important as dental insurance. Now I just got work done and the dentist is charging me THOUSANDS of dollars for my operation. When I called Delta, they said they have no obligation to help me in any way because the policy is terminated. Thats how you treat a multi year customer? They just take my money and ran essentially . Terrible business and they should be held responsible.
Business response
05/24/2024
Good afternoon ,

Please reply with your enrollee id.

Thank you
Initial Complaint
05/17/2024
Complaint Type:
Product Issues
Status:
Unresolved
The business responded to the dispute but failed to make a good faith effort to resolve it.
Visited on out of network dentist on February 20, 2024. My dental company told me to pay up front, promising to reimburse me for the costs later. The total cost is over $1000. Since then, they have sent me a check, but it was returned because I had an address forwarding via the ***** The received the check back on April 1st. The Voided the check on April 16, and resent the check on May 1st. Then, they sent a letter on May 3rd. I have received the letter a few days ago, but have still not received the check. I decided to drive over to the ********** post office and mail myself a letter to my house to see how long it takes. I have since received that letter also, but not the reissued check that they allegedly sent on May 1st.When I called, they told me it can take up to 15 weeks for the check to arrive. Why would a check from ********** GA to ****** GA take 15 weeks to arrive? Also why would the letter they sent two days after the check already arrive? Why can't they just do a direct deposit, or send a picture of the check so I can do a mobile deposit? I also have ***** Fargo just like they do. This is getting truly ridiculous. They were lying about sending checks and now they are not even answer the phone or emails. Please stop scamming your customers!
Business response
05/21/2024
Good morning,

Your complaint has been received and routed to our grievance and appeals team for review and resolution.

Thank you
Customer response
05/21/2024

Complaint: 21729196

I am rejecting this response because: The visitation happened on February 19th. The first check was returned to them on the 1st of April. Delta Dental did absolutely nothing until the 16th, which is when I contacted them first. After speaking with them, they promised to resend a check promptly. They then waited until May 1st to resend a new check after promising several times to ship it within a couple days.
On May 3rd, they sent a letter to me, explaining the situation. I received that letter on May 10th. However, the check that they sent on May 1st still has not arrived. I suspect that they still have not even shipped out the check. I then traveled to **********, and mailed myself a test letter on May 11, and I have received that letter on May 16th. However, the check that they allegedly sent out on May 1st still is nowhere to be seen.
I have reached out and asked them to simply direct deposit the funds into my account. They refused. I then offered to stop by and pick up the check myself. They also suspiciously refused. I then asked them to provide tracking number for the check. They refused this as well.
I have called and emailed several times but have received NO RESPONSE WHATSOEVER the entire week last week. The supervisor finally sends me a voice message yesterday saying that the team member in charge of my case was "ill". My case has been in review since freaking April 1st. Delta Dental no longer needs any ADDITIONAL time to review. They just need to freaking ACT!! Stop making it difficult to access claims!!! Why are you playing games like this????????????
This business practice must be exposed to everyone who is a potential customer. I will be contacting the HR department of my employer and informing them of everything Delta Dental has been doing up until now. Delta Dental, you do not need additional time to review. That time has been given to you for over a freaking month. Now is your time to act and stop being a lousy company.

Sincerely,

*****************
Business response
05/21/2024
Hello,

I have checked the records and do show a check was issued on May 1, 2024 I also see previoulsy checks have been returned. I apologize you are not receiving the checks and for the frustration in the matter. Our grievance and appeals team will be in contact regarding your complaint.

Thank you
Customer response
05/24/2024

Complaint: 21729196

I am rejecting this response because:
As mentioned SEVERAL times in previous communication, repeating an action that has already proven to be unfruitful is NOT much of a solution. If two attempts have already failed, what would resending the check a 3rd time do? Why can't you make exceptions for exceptional cases?
Answer this Delta Dental. What if 100 attempts all fail, and I never receive the check? Then what becomes of the amount? I have offered MULTIPLE solutions that you have consistently rejected
1. Send certified mail (for tracking purposes)
2. Allow me to collect the check personally.
3. Direct Deposit the check for me.
You have utterly rejected ANY of these 3 alternatives which are actually EASIER FOR YOU than it would be to continue to mail out a check as if this was 1840. If so, why can't insured members also pay by sending a check? Why would their coverage discontinue if the post officed delayed their delivery? Isn't that double standard?
What you are doing is really nothing short of a scam. It is the oldest trick in the book, and this explains your abysmally low rating, as well as multiple BBB complaints. FIGURE OUT A WORKING SOLUTION.
MAKE AN EXCEPTION AND FIX YOUR OLD SYSTEM.

Sincerely,

*****************
Initial Complaint
05/16/2024
Complaint Type:
Service or Repair Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Delta dental has repeatedly stalled and delayed in paying legitimate claims over several years. Most recently they have stalled over 6 months and now will not reply to email or website inquires. They claim process seems to be made intentionally difficult (only accept US Mail claims from individual) and there is no tracking process. They have now disable my online access and I can no longer view my account online.
Business response
05/20/2024
Good morning,

Please respond with your enrollee id.

Thank you
Initial Complaint
05/16/2024
Complaint Type:
Order Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Ive been trying to contact Delta Dental for well over a month with 5 emails and calls to customer service that they do not answer. Ive gotten no response from Delta Dental about how to send my Payment and as a result my service was terminated. Absolutely non existent customer service. I want my services restored for the negligence of the company.
Business response
05/20/2024
Good morning,

Please respond with your enrollee id.

Thank you
Initial Complaint
05/14/2024
Complaint Type:
Service or Repair Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
I have cobra health insurance through a previous employer. It is good for 18 months. It will end August 1. From the beginning February 2023, I have been making payments every month for this plan. ********** Blue Shield of Georgia, has canceled my plan four times causing me Serious problems with my finances and medical bills. They will never call me back. They say they have to refer to a supervisor and 24 to 48 hours. I will get a call. I have done this four times. I have never gotten a call back.
Business response
05/15/2024
Hello,
Please respond with your enrollee id so that we are able to assist you.

Thank you
Customer response
05/21/2024
Here is my enrollee id number
********************* Delta dental Georgi
***********
Business response
05/22/2024
Good afternoon ****,

I have received your information and created a complaint with our grievance and appeals team for review. Please allow up to 30 days for this to be resolved.

Thank you

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. ↩

BBB Business Profiles may not be reproduced for sales or promotional purposes.

BBB Business Profiles are provided solely to assist you in exercising your own best judgment. BBB asks third parties who publish complaints, reviews and/or responses on this website to affirm that the information provided is accurate. However, BBB does not verify the accuracy of information provided by third parties, and does not guarantee the accuracy of any information in Business Profiles.

When considering complaint information, please take into account the company's size and volume of transactions, and understand that the nature of complaints and a firm's responses to them are often more important than the number of complaints.

BBB Business Profiles generally cover a three-year reporting period. BBB Business Profiles are subject to change at any time. If you choose to do business with this business, please let the business know that you contacted BBB for a BBB Business Profile.

As a matter of policy, BBB does not endorse any product, service or business.

Cookies on BBB.org

Need to file a complaint?

Complaint Details

Showing all complaints

Business response

Customer response

Business response

Customer response

Business response

Customer response

Customer response

Business response

Customer response

Business response

Customer response

Business response

Business response

Business response

Customer response

Business response

Customer response

Business response

Business response

Business response

Business response

Customer response

Business response

Customer response

Business response

Business response

Business response

Customer response

Business response

BBB Rating & Accreditation

Contact Information

Customer Complaints Summary