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Complaint Details
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Initial Complaint
04/05/2023
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
I filed a claim for reimbursement , due to going out of the country for treatment. The claim was denied due to the need of xrays. the xrays have been confirmed recieved by Dental dental on several occassions. I cannot get anyone to tell me the time frame , what the hold up is, what they are waiting for etc.. now again as of the 29th they denied claim claim saying they have no xrays even though the xrays are there. I cannot speak to anyone in claims, any manager and cannot get anyone to care enough to do anything to help me on this claim
Business response
04/07/2023
Please read the attached company response requesting additional information. Thank you.Initial Complaint
03/22/2023
- Complaint Type:
- Billing Issues
- Status:
- Answered
I received a bill from my orthodontist. I was calling the orthodontist and Delta Dental back and forth for days until Delta said that a payment would be sent off. The representative from Delta Dental told me 50% of the bill should have been covered and when I told her that the payment sent did not equal 50% she told me I was right. Yet, theres still no other payment sent. My orthodontist have been threatening to put this bill on my credit and Delta is no help. They said they are unable to reach Delta. Another representative from Delta said there needs to be adjusting from my orthodontist and they need to talk to them but yet Delta doesnt respond to my orthodontist after several attempts. 50% has not been covered yet and the representative told me to wait until after the first payment was sent to see if any changes will occur. Nothing else happened and ** really confused at this point. This is horrible.Business response
03/23/2023
Good morning. Additional information is required for the company to respond. Please read the attached. Thank you.Customer response
03/23/2023
Better Business Bureau:
I have reviewed the response made by the business in reference to complaint ID ********, and to provide my information to confirm membership my name is **************** and Im under the insurance of my father *********************. I do not have an insurance card in my possession but I can provide further information to confirm Im a member of Delta Dental.
Sincerely,
********Customer response
03/23/2023
Complaint: 19638732
I am rejecting this response because:Im under my fathers insurance by the name of ********************* as *******************************. I do not have a card with me but I can provide further information to confirm membership. Thank you.
Sincerely,
********Initial Complaint
12/29/2022
- Complaint Type:
- Customer Service Issues
- Status:
- Answered
I initially was transferred twice to speak to someone in a particular department at Delta Dental to review insurance coverage regarding oral surgery. The periodontics office submitted an estimate; however, none of the procedures were covered. The most ignorant, rude, unprofessional customer service representative I have encountered name ****** had the foulest attitude. Each time I attempted to inquire about anything, ****** was extremely condescending. The conversation got to the point where I was annoyed and told her she had a nasty attitude; and the call was disconnected. Delta Dentals customer service is AWFUL. When I called ******************** to speak with someone in management regarding this matter, there isnt a department and/or phone number to contact anyone.Business response
12/30/2022
Good afternoon. Attached is the company response. Thank you.Initial Complaint
12/20/2022
- Complaint Type:
- Service or Repair Issues
- Status:
- Resolved
On November 10th, I purchased a self paying dental policy and I've been trying to cancel it since about the 18th when it was revealed to me that I was able to continue getting ******** assistance from the health insurance marketplace. I filed multiple online requests to cancel with absolutely no reply, I put in a support ticket with no reply, I have called every customer service number I could find on the website/policy contract and keep getting messages like "our office is now closed"(during office hours) or "You've reached a non-working number." The one time I talked to a representative, she transferred me to a non working number! (Named *****) The one form of contact I have received them was an email saying my payment would be coming out on schedule, which sent me into a rage after endlessly trying to contact these people. On the contract it does not state clearly anywhere how one can cancel these plans effectively/easily, which seems to bee part of the runaround. I am a single man with low income and having that payment come out on the 27th will hurt my bottom line. Where are the humans at Delta Dental? My complaint/situation is so easy and could be resolved in moments, and yet it feels like this business is hoping I will resign myself and stay on their contract.Initial Complaint
11/07/2022
- Complaint Type:
- Order Issues
- Status:
- Answered
My small business has had a dental plan with Delta Dental of Illinois since 2018. The premiums have always been paid in advance and in full. (In fact, I pay extra to keep extra payment on the account in case it's ever needed.) They have e-mailed me a monthly bill every month showing charges and the payments. Sometime in May/June, they decided to cancel my policy without notifying me. They continued to e-mail me statements, and cash my monthly checks. I became aware of this when one of our dental providers notified us that the claim was denied. We now have outstanding bills with our dental providers that Delta is not giving us clear answers about. I'm attaching the prior 3 months bills showing active until November when they retroactively refund several months.Business response
11/11/2022
Please read the attached company response which includes a copy of the termination notice previously sent to the complainant. Thank you.Initial Complaint
10/26/2022
- Complaint Type:
- Customer Service Issues
- Status:
- Answered
I have outstanding claims from 9/23/22, 10/12/22 and 10/25/22 that are still not in Delta Dental's system. I have tried to call the customer service line multiple times, but get no where. I have emailed about the outstanding claims starting on 10/19/22 asking for a supervisor to contact me so I can figure out why the claims are not in the system. I have also spoken multiple times with the dental office and all the claims they sent in for the 9/23/22 date are uploaded except mine. I even sent the Delta Dental ******** and ******* account messages asking for someone to contact me since I have not gotten a response yet. This is now the second time I have had to fight with Delta Dental to get my claims uploaded. I pay for the insurance, so I should not have to waste my time in order to get my claims in the system. I also feel like the first time someone asks for customer service assistance they should get it. I shouldn't have to try and contact Delta Dental in multiple ways for someone to take care of my problem.Business response
11/04/2022
November 4, 2022
******** Relations Advocate
********************** of ******* &Northern Illinois, Inc.
330 *******************************************************************************************************************************************************************************************************************************************************************************************************************************************************************************************************************************************;
*******, Illinois 60611
Re: BBB File Number 18315354
Dear Sir or Madam,
On behalf of Delta Dental of Illinois,this letter serves as the response to the complaint submitted by a Delta Dental of Illinois member on October 26, 2022, regarding the processing of their insurance claims.
We first want to state that the members service experience does not meet our standards. We confirmed that multiple calls were made on the same claim, which is not acceptable. We are reviewing our internal processes to identify enhancements to prevent claim processing delays such as this in the future.
On October 27, a ******** Service supervisor contacted the ********************** office and we have now received the claims from the office and are expediting claims processing. The supervisor also contacted the complainant to update them on claims receipt and processing, as well as provide a direct email for claims to avoid delays in claims receipt and processing in the future.
We thank the complainant for their patience. Should they have any questions once the claim is processed, they can contact ******************************.
We believe the above information responds to this review. Should your agency need additional information, please contact *************************************.Customer response
11/07/2022
Complaint: 18315354
I am rejecting this response because:I did receive a phone call from a supervisor that provided me his information if I had any future issues. I emailed him last week saying I still couldn't see the October payments online and that the 9/23/22 claim still said pending. I have not received back an email as of today. I then had to call Delta Dental today because over the weekend I received an explanation of benefits for the 10/25/22 claim and Delta Dental sent the check to the dental office instead of to me. The confirmed that it was a Dental Dental error, but now I have to wait at least **** business for that error to be fixed. So I am still waiting on payment for the 9/23/22 claim and now the 10/25/22 claim. I have also again had to email and call Delta Dental over issues. I think the customer service is the worst I have ever had to deal with. I don't appreciate that I have to fight them in order to receive money I am owed. I literally pay then to do this job.
Sincerely,
*************************************Business response
11/11/2022
Attached is the company response. Thank you.Initial Complaint
09/22/2022
- Complaint Type:
- Sales and Advertising Issues
- Status:
- Resolved
They were supposed to send an reimbursement check but we didn't receive any check twice in a row. We had to call again and this time the customer service representative is horrendous and simply not willing to help us with the issue. She reluctantly found our case and said the check is being sent again. But when we asked to verify the address, she just won't read out the full address. We had to keep pressing her to read out the full address including the zip code. In the end the representative just hung up on us before we had chance to complain about the poor experience. The whole experience is just a s*** show.Business response
10/03/2022
October 3, 2022
Customer Relations Advocate
********************** of ******* &Northern Illinois, Inc.
121 **************, Ste 2000
*******, Illinois 60601
Re: BBB File Number 18062182
Dear Sir or Madam,
On behalf of Delta Dental of Illinois,this letter serves as a response to the complaint submitted by the complainant regarding not receiving their reimbursement check for service. A check was mailed to complainants address on file in April 2022. The complainant called our customer service in May 2022, noting they never received the check. After the complainant called, a request was submitted to stop payment and resend the check, but because of an inadvertently missed step in our internal process to reissue payments, the check was not sent. We are reviewing our internal processes and procedures around this missed step to determine how we can improve in the future. The member called on September 19, 2022, and the check reissue process was completed. A check in the amount of $81 was sent to the member at their verified address on September 28, 2022, by U.S. mail.
We believe the above information responds to this complaint. Should your agency need additional information, please contact **************************************Customer response
10/04/2022
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,
Renzhuo ****Initial Complaint
09/18/2022
- Complaint Type:
- Service or Repair Issues
- Status:
- Resolved
On June 3rd, 2022, I filed a grievance with Delta Dental, regarding a provider that I saw on May 31st, 2022. The problem is that, as of today, September 18th, I have not received a response. I have called and emailed so many times, that I am totally disappointed. I have been told that it's pending or that a status update will be submitted and my call will be returned in 2 business days or an email will be sent in 1-2 days, with an update. The provider I filed the grievance about performed a service that I never consented to, nor was I informed of the cost. Due to results of this service, which I knew was a scam, I had to see my regular dentist and have the service again. The results were the total opposite of what I was told by this provider. I sent Delta Dental this additional information via email, which proves my claim against this provider. Since they paid this provider and I had to repeat this service, as a 2nd opinion, they denied the claim, stating service only allowed once every 5 years, and now I have to pay monies that they should be paying. If they would have addressed my grievance in a timely manner, when I received the second opinion on July 20th, 2022, I would have known if I or Delta Dental would be responsible for the service.Business response
09/28/2022
September 28, 2022
Customer Relations Advocate
********************** of ******* &Northern Illinois, Inc.
121 **************, Ste 2000
*******, Illinois 60601
Re: BBB File Number 18043041
Dear Sir or Madam,
On behalf of Delta Dental of Illinois,this letter serves as a response to the complaint regarding a grievance against a Delta Dental of Illinois network dentist. Upon receipt, the complaint was forwarded to a manager for research who provided more detail, and then forwarded the grievance to the ******************** for review.
To allow more time to research all details, Delta Dental of Illinois requests an extension for the companys response to October 7, 2022. Please advise if the extension request is granted.Should the Bureau need additional information, please contact **************************************Customer response
09/29/2022
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,
*********************Business response
10/14/2022
Good morning. Attached is the company's confidential response.Customer response
10/19/2022
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,
*******************;Thank you for your help.Initial Complaint
09/08/2022
- Complaint Type:
- Customer Service Issues
- Status:
- Answered
I have called in multiple times trying to have a claim paid. I get a different excuse every time. This is insurance fraud I have a valid claim that needs to be paid by Delta Dental of IL. The orthodontist office that my son goes to says Delta Dental of IL never pays without multiple calls .. I have called over 8 times. Customers should not have to deal with this type of service. I am not sure if they are just wanting people to give up or why they do not pay valid claims which would be fraud people pay premiums and do not get stated benefits.Business response
09/15/2022
September 15, 2022
Customer Relations Advocate
********************** of ******* &Northern Illinois, Inc.
330 *******************************************************************************************************************************************************************************************************************************************************************************************************************************************************************************************************************************************;
*******, Illinois 60611
Re: BBB File Number 17937142
Dear Sir or Madam,
On behalf of Delta Dental of Illinois,this letter serves as the response to the complaint submitted by a Delta Dental of Illinois member on September 8 regarding the processing of their insurance claim.
We first want to state that the members service experience does not meet our standards. We confirmed that multiple calls were made on the same claim, which is not acceptable. We are reviewing our internal processes to identify enhancements to prevent claim processing delays such as this in the future.
The members claim has been processed and a check will be sent to the member on September 14, 2022. We thank the members for their patience. Should they have any questions once payment is received, they can contact ******************************.
We believe the above information responds to this complaint. Should your agency need additional information,please contact **************************************Initial Complaint
08/24/2022
- Complaint Type:
- Product Issues
- Status:
- Answered
On 4/18/22, I spoke to customer service **** ******* who told me that I wouldn't have any different cost coverage with a dentist that took over for our previous dentist, even though the new dentist *********************************** was considered Premier, whereas my former dentist *********************** was PPO. Our bills, mine and my wife's came through and that wasn't true. The difference in billed amounts ended up being approximately $500 more, for dates of service of 4/19/22, 6/16/22, and 7/5/22. I got the runaround 3 different people until supervisor ********* admitted that ****** gave me the wrong information. Finally on 8/8, ********* said that we were approved for being compensated for the difference between PPO bills and the higher Premier bills that my new dentist billed us under. Supposedly the check was mailed out to us on 8/8 for approximately $500. No check has arrived to this day, and 5 subsequent calls, all to other customer service reps have all gone without a return call, even though they took down all my information and said someone would call me . 3 requests for supervisor, ********** to call me back have gone unanswered. Today I left a message with another rep and supervisor and still nothing. Absolutely horrible customer service and no professionalism regarding this issue. I will also likely file a complaint with the illinois department of insurance for shoddy insurance practices if this isn't resolved soon with proof of what I was promised and a $500 check, of better yet, a credit on my credit card, which is the same way they have been paid by us monthly for our premiums.Business response
09/02/2022
September 2, 2022
Customer Relations Advocate
********************** of ******* &Northern Illinois, Inc.
330 *************************************************************************************************************************************************************************************************************************************************************************************************************************************************************************************************************************;
*******, Illinois 60611
Re: BBB File Number 17766123
Dear Sir or Madam,
On behalf of Delta Dental of Illinois,this letter serves as the response to the complaint submitted by the complainant regarding their cost of coverage.
As part of our research to respond this BBB complaint, we reviewed all service dates for the complainant and his spouse and confirmed that additional payment of $229 is due to the complainant.
One payment was mailed August 31, 2022,to the address on file for the complainant and two other payments are scheduled to be mailed September 7, 2022. A supervisor from our **************** Team has contacted the complainant and left a voicemail asking the complainant to return their call to explain the breakdown of payments and discuss any possible further concerns.
The complainant also filed a complaint with the Illinois ********** of ********* (DOI) and more detail will be provided in our response to the Illinois DOI. Additionally, we are continuing our investigation into the customer service the member received and these details will also be provided in the response to the Illinois DOI complaint.
We believe the above information responds to this review. Should your agency need additional information, please contact **************************************Customer response
09/07/2022
Complaint: 17766123
I am rejecting this response because: I was told that I would receive compensation for the total difference between the claim coverage of PPO vs. Premier which is at least $320 or more in total, due to their mistake when they told me the coverage is the same between PPO and Premier by ****** in April as ********* admitted. I was originally told I would receive a check for approximately $500. What happened to that promise!!!! That's what **************; ********* Service Supervisor) told me on 8/8 and that the check for $500 would be mailed on 8/10 for that amount. What happened to that check and that promised amount!!!!!
Sincerely,
*****************Business response
09/23/2022
September 23, 2022
Customer Relations Advocate
********************** of ******* &Northern Illinois, Inc.
121 **************, Ste 2000
*******, Illinois 60601
Re: BBB File Number 17766123
Dear Sir or Madam,
On behalf of Delta Dental of Illinois,this letter serves as an additional response to the complaint submitted by the complainant regarding their cost of coverage. Initial benefits in the total amount of $409 were paid to the provider. Additional benefit payments of $229 were paid to the complainant. Total benefit payments are in the amount of $638.
We believe the above information responds to this complaint. Should your agency need additional information,please contact **************************************Customer response
09/25/2022
Complaint: 17766123
I am rejecting this response because:Once again, they refuse to address the problem by deception and nonsensical responses. Yes, they did payout and additional $229 to me, and $409 to the provider, but they failed to address the outstanding unpaid amount of $680. The original submitted claims were for a total of $1691. They haven't paid what the promised or should due to THEIR error, which the keep failing to address, not to mention their lies in the whole process. If this process continues to break down it may have to go to small claims court to address where they can't continue to evade the issue any longer.
Sincerely,
*****************
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Customer Complaints Summary
27 total complaints in the last 3 years.
7 complaints closed in the last 12 months.