Business Profile

Dental Plans

Delta Dental Insurance Company - Georgia

This business is NOT BBB Accredited.

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Complaints

This profile includes complaints for Delta Dental Insurance Company - Georgia's headquarters and its corporate-owned locations. To view all corporate locations, see

Customer Complaints Summary

175 total complaints in the last 3 years.
31 complaints closed in the last 12 months.

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The complaint text that is displayed might not represent all complaints filed with BBB. 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.

Initial Complaint
Date:10/28/2022
Type:Service or Repair Issues
Status:
ResolvedMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
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.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
I am a dentist in network with delta dental and I have a small practice in DFW. In 1/2019 I performed routine dental procedures including a surgical extraction of a tooth. They paid us a few weeks later like they usually do. A few weeks ago I received notice that delta dental was going to reduce that surgical extraction to a simple extraction because their consultant said so. They will take back $65. That effectively would have reduced it to about 1/3rd of what we routinely charge for a surgical extraction. I wrote back to them and included an panoramic xray explaining that the procedure needed to extract that tooth was surgical because the crown was non-existent and a deep pivot point would need to be made to extract the tooth. Today they took back the $65 by reducing the amount from another patient. I think this is crooked business practice taking money back almost 3 years after a procedure was done. These consultants are not qualified.
Business Response
Date: 11/03/2022
Good evening,
This Better Business Bureau assists with Delta Dental of California. We are unable to assist with this complaint with Delta Dental of ********.

Thank you.
Customer Answer
Date: 11/04/2022

Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********, and find that this complaint was misdirected
Sincerely,

****** ****
Initial Complaint
Date:10/19/2022
Type:Order Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
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.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
Delta Dental provides intentionally confusing and convoluted information and tier statuses among their insurance plans. Their representatives provide inconsistent information. What I thought would be a 5-minute informational call turned into multiple calls, over multiple hours, leading me nowhere. When I gave them one last chance to provide clear and concise information in writing, through a pre-treatment estimate, they referred me to a licensed agent--two of whom I already talked to--and provided the wrong phone number.To estimate the actual, out-of-pocket cost for an available plan using my own dentist, I need to know the fee schedule. Delta Dental either does not know their own fee schedule or refuses to provide it WITHOUT stating they are refusing to provide it. It was strongly implied that no one, of the multiple people I spoke to, has any idea what Delta actually pays for any service in my locality and has no possible way of finding out. I felt that they were probably attempting to deceive me, or at best, were being lazy. Not knowing the value of any given plan makes it impossible to determine whether it is worth buying and its stated price and stated percentage payouts (of their unpublished maximum payout) completely arbitrary. For all I know, and at this point one should presume, their maximum payout is $1 for any and all services and their policies may be a sham.
Business Response
Date: 10/21/2022
Good evening,
Please respond with your enrollee identification number so we may further assist you.

Thank you.
Customer Answer
Date: 10/21/2022

Complaint: 18249975

I am rejecting this response because: it's indicative, if not the epitome, of the incompetent and/or deceptive nonsense I have dealt with for hours. As someone looking to determine the price of a policy to buy, it is implicit to any rational human being that I am not an enrollee. Yet they ask for my enrollee number. This is either a dishonest response or Delta has been gracious enough to hire people with special needs.

Sincerely,

*************************
Business Response
Date: 10/24/2022
Good morning,
Unfortunately we are unable to assist you, in order to resolve your issue we need an enrollee identification number. Otherwise if you are not a member with Delta Dental there would be no way for us to provide you with a fee schedule.
Thank you.
Customer Answer
Date: 10/30/2022

Complaint: 18249975

I am rejecting this response because it is intentionally deceptive. They claim "there is no way to provide a fee schedule" to non-enrollees. This is patently absurd. They are refusing to provide a fee schedule, which is a far cry from being unable to provide one. And there is absolutely no guarantee whatsoever that an enrollee wouldn't run into the same exact problem--a deceptive refusal to provide information.
Further, a refusal to provide information is tantamount to a dental insurance company claiming they have no way of knowing how much dental procedures cost and the percentage of each they cover. Absurd on its face. How would enrolling suddenly enlighten them as to their primary job function?
They have my address. They indeed do have a fee schedule for non-participating dentists--including their Premier tier--for the local area. Otherwise, they'd be unable to reimburse any patients or dentists in the local area. Claiming there is "no way to provide a fee schedule" is a lie.
I'm not sure sure how refusing to provide transparent pricing information to consumers, and lying about it when asked, is even legal. Or maybe it's not.

Sincerely,

*************************
Initial Complaint
Date:10/10/2022
Type:Order Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
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.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
Delta Dental covers 50% of the cost of an orthodontic treatment. My dentist's business/insurance manager told me Delta Dental would reimburse 50% at the beginning of the treatment and 50% at the end of it. I completed my treatment on May 12, 2022. I still have not received the rest of what they owe me. When I called, they said the second half would be reimbursed in April, so a whole year after the beginning of the treatment. I paid my share, I completed the treatment, I should be reimbursed now, not in a year (and I would have to still be insured by Delta Dental). This is an abusive practice that should be illegal.Could I please be reimbursed now? Delta Dental owes me $450.Thank you.
Business Response
Date: 10/12/2022
Good afternoon,
Please see our response.

Thank you
Customer Answer
Date: 10/12/2022

Complaint: 18194444

I am rejecting this response because: I am enrolled with Delta Dental, how else would have been able to get covered for my orthodontic care?

Sincerely,

***********************
Business Response
Date: 10/17/2022
Good afternoon,
The letter is not stating you are not with Delta Dental it is explaining you are not enrolled with this enterprise of Delta Dental that you are filing the complaint with. Please check your records to locate which Delta Dental enterprise you are enrolled with.

Thank you.
Initial Complaint
Date:10/07/2022
Type:Service or Repair Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
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.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
I have called several times to Delta Dental and spoken to 5 different reps regarding a claim that they didn't pay. It was for claim # *************** of a custom abutment that is going together with an Abutment supported porcelain crown. Delta approved and paid for the crown, but refused to pay for the abutment. I asked the representatives to explain but was given the run around, and then my calls got transferred to another department with no one picking up the line. None of the representatives know or understand my concern and were unable to help resolve the claim in question. Delta Dental is doing a very poor job taking care of their customers who pay them a premium to insure. This is unacceptable, I am hoping BBB can help solve this case.
Business Response
Date: 10/12/2022
Good afternoon,
Please see our response.

Thank you
Initial Complaint
Date:10/04/2022
Type:Service or Repair Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
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.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
Had a dental claim which is covered under my certificate claim denied called custom service rep was inept asked to speak to supervisor they refused filed appeal no response back want claim paid to dentist
Business Response
Date: 10/06/2022
Good afternoon,
Please reply with your enrollee identification number so we can further assist.

Thank you.
Customer Answer
Date: 10/06/2022
ID # **********
Business Response
Date: 10/06/2022
Good evening,
Please confirm if you have a policy with Delta Dental of California enterprise ?

Thank you .
Initial Complaint
Date:10/03/2022
Type:Service or Repair Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
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.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
This office is not equipped to work with the general public. I called the **************************************** office in mid September and spoke with ******. I asked if I can schedule a dentist to see me and treat me for a filling the same day. She said it could be done on a Tuesday or Thursday. I could not schedule on those days. I called today October 3rd and attempted to make an appointment on a Tuesday. She then said that she suggest I call my provider to switch to another office. I asked her if I can speak with an office supervisor as she was not giving consistent information. She said the supervisor is out. I then asked to speak to whomever is covering for the supervisor. She said she is the cover person. It's very concerning that a receptionist is left supervisional duties that is evident she has no experience in navigating and being solution driven. A dental provider office should have someone with experience in dealing with client service issues at any given time when the doors for service are open. I will be sure to escalate this issue to ensure employers are aware of the carriers they select to offer their employees. ****** is not properly trained, has no compassion and presents absolutely no skills in being solution driven.
Business Response
Date: 10/05/2022
Good afternoon,
To clarify is your complaint about a dental office or Delta Dental insurance ?

Thank you.
Initial Complaint
Date:09/21/2022
Type:Order Issues
Status:
UnresolvedMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
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.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
I have dental insurance for my family with Delta Dental and my premium payments are made through my previous employer Cobra benefit manager Payflex (see uploaded documents). My first dental bill was for my wife *******'s 5/22/2022 visit. I spent many frustrating hours talking to Delta Dental and Payflex with each organization blaming the other for not being able to process my claim. Delta Dental would claim that my wife was inactive with them since Payflex did not send the proper payment or information and Payflex reassured me that I was active as of 4/1/2022 and the correct payment and information was sent. With great difficulty I was able to arrange a 3 way call with Delta Dental, Payflex, and myself with the conclusion that Payflex had sent them the correct information and payment. Delta Dental apologized and reassured me I would not have to go through this long painful back and forth communication in the future and they paid that bill. A 2nd bill was submitted for my 9/6/2022 dental visit and the exact same frustrating event occurred. I again with great difficulty was able to make a 3 way call on 9/12/2022 at 2:15 PM and the Delta Dental rep was *****. She apologized, told me she could not make the correction, she would definitely have an upper level Delta Dental person correct their mistake and they would call me back to confirm everything was taken care of. She also said she would make a point to call me back also to confirm I received the call from Delta Dental. It is now 9/21/2022 and my bill is still not paid and no one called me. I can't continue calling them back over and over and not get any results.
Business Response
Date: 09/28/2022
Good Afternoon,
I have submitted your claim to be reprocessed for payment as well as submitted your complaint to the grievance department to review and ensure this issue does not continue.

Thank you,
******************
Customer Answer
Date: 09/29/2022

Complaint: 18059838

I am rejecting this response because:
I checked my Delta Dental account and as of 9/29 the claim still shows I am responsible for 100% of the bill. I have spent many difficult hours trying to correct the mistakes with my last 2 delta dental unpaid claims and also expect an additional $200 for my time and frustration.

Sincerely,

*********************
Business Response
Date: 10/03/2022
Good evening,
As stated in the previous response your complaint has been submitted to the grievance department for review. Please allow time for your concerns to be resolved.

Thank you.
Customer Answer
Date: 10/09/2022

Complaint: 18059838

I am rejecting this response because: I noticed today on Delta Dental sight that my 9/6/2022 visit was finally paid, but it also continues to state that my insurance is inactive despite the fact that I have been paying my monthly premiums regularly and on time. I also did not receive the $200 compensation I requested for the unnecessary and frustrating hours I had to endure to get my last 2 visits covered properly

Sincerely,

*********************
Customer Answer
Date: 10/10/2022
I have been paying my insurance premiums regularly and am up to date with payments, however Delta Dental continues to show me as being inactive in the ******************************************************************* Delta Dental Plan. I want them to show me as being active and take steps to make sure I don't go through the same problem of having future dental visit coverage declined because I am not listed as an active member in the plan.
Business Response
Date: 10/12/2022
*************,
You have an active grievance on file which is currently pending, appeals specialists are working on your complaint at the moment which is why there has been no update other than the claim paying. Please allow time for this to be researched to ensure this does not happen again as well as why this is happening.
Thank you.
Customer Answer
Date: 10/17/2022

Complaint: 18059838

I am rejecting this response because: I can't accept Delta Dental's response until my family and I appear as having insurance and my previous grievances have been addressed. My plan, Adventist Health system-AHMG **************************************** now shows my insurance ended 9/30/2022. I have been paying my premiums regularly.

Sincerely,

*********************
Business Response
Date: 10/19/2022
Good morning,
Unfortunately the grievance process takes about 30 days, when your complaint is resolved you will receive correspondence.
Thank you.
Customer Answer
Date: 10/23/2022

Complaint: 18059838

I am rejecting this response because: I received your letter yesterday, see attachment. See part I labeled A: Previously you showed I was not active in September, then after I filed my BBB complaint my9/6/2022 visit was finally covered and you changed my coverage to ending 9/30/2022. As I have said multiple times I pay my insurance premium monthly through pay flex and I am still active. You have me as not having coverage after 9/30/2022 which means I would have to go through this long ordeal again after my next visit. This reflects incompetency of Delta Dental.
In the section I labeled B you further tell me to contact Payflex. Again I have contacted pay flex many *****, they say they pay my premium regularly and they don't understand why Delta doesn't reflect this. With great difficulty I arranged a 3 way call previously as in my previous notation and the Delta Dental rep told me and Payflex rep she didn't know why my payments were not reflected. Payflex gave Delta Dental rep all the information she requested. If you show me as being not active you need to call Payflex and see what the problem is. That is the major component of my complaint.
Your lengthy letter did nothing to resolve my problem-show me as being currently covered with your plan

Sincerely,

*********************
Initial Complaint
Date:09/21/2022
Type:Product Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
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.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
I used my long time out of network dentist when being covered for Delta Dental by the ********* of **. I understood the consequences of that, and on August 4th filed the necessary paperwork to get reimbursed for 2 dental cleanings each for my wife and myself, and for a bridge to be repaired. They do not let you upload the forms, so I mailed it the first time and then mailed it with tracking the second time (********************). Still haven't received it, no notice of the filings, I would like to make sure I get the reimbursement I am entitled too and not use them again.
Business Response
Date: 09/27/2022
Good morning,
Your complaint has been sent to the appropriate department for review. Due to no HIPAA authorization being filled out all correspondence will be sent to you directly from Delta Dental.
Thank you.
Initial Complaint
Date:09/07/2022
Type:Sales and Advertising Issues
Status:
ResolvedMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
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.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
On 4/13/2022 my daughter, *************************, had a routine dental visit. We have two dental insurances for coverage. My primary dental insurance covered their portion per contract. However my secondary insurance has been nothing but difficult to deal with. Firstly the dental office would not file the secondary insurance but provided me with all forms and instructions.I mailed the claim in June or July along with my other daughters claim work. The insurance processed my other daughters claim without issue.I inquired as to why they did not process ******** and Delta Dental Ins states they never received it. I mailed it again, a couple of weeks later, same response. I have since emailed the claim paperwork 4 additional times per their instructions. On 9/7/22 i received an email response from the rep that the claim was denied because there was no coverage for ****** from 10/1/2021 - 1/1/2022. HOWEVER the date of service was 4/13/2022 which is clearly outside of this date range and they had no issue processing my other daughter's claim which occurred on the same date and for the same procedures. For resolution I would like the claim processed immediately per my coverage policies.
Business Response
Date: 09/13/2022
Good afternoon,
A message has been sent to you directly from Delta Dental regarding your complaint.

Thank you
Customer Answer
Date: 09/15/2022
Business has reached out to me, however I am not willing to accept the response and close the complaint until the claim has been completely processed since they've told me multiple times they are processing it but have not.
As of 9/15/22 9:07 am central time the claim has not shown up in my online account.
Business Response
Date: 09/15/2022
Good afternoon,
As of 9/14/22 the claim was printed and showing in progress at this moment. This may show up on your portal now, please allow **** business days for processing and payment.

Thank you,
******************
Customer Answer
Date: 09/15/2022

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,

*************************
Initial Complaint
Date:09/03/2022
Type:Service or Repair Issues
Status:
ResolvedMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
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.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
I submitted a dental claim via email on or around 07/18/22. Said claim was fully filled out by the provider for DOS 04/08/22 and a listing record of service that was provided. I reached out to Delta Dental (6/22, 7/22, 8/22) using the "contact us" on the website and speaking to 2 different representatives over the phone. To date, I have not received any correspondence from anyone at Delta Dental except for an email dated 5/2/22 (stating my statement was ready but no statement was attached) as well as 3 email messages from "no-***************************************** that had NO information about my claim. This is a concern as it has been 4 months since I had dental work done that I paid out of pocket ($450). To date, it is past time for the next stage of work that I need for completion of the dental work I need to have done. I need feedback and/or reimbursement from Delta Dental before moving forward in the next/completion phase.
Business Response
Date: 09/06/2022
Good morning,
After reviewing your account I found the claim was received but it was never sent back for processing. I routed it over to the claims department for processing and do apologize for the delay. I will make sure to keep track of this for you and if you want to file a complaint as well I can submit that for you.

Thank you,
*********************************
Customer Answer
Date: 09/13/2022

Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********; however I would like to keep this complaint open until I receive a follow up from this business (as promised) or until reimbursement is made.

Sincerely,

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

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Delta Dental Insurance Company - Georgia is NOT a BBB Accredited Business.