Business Profile

Dental Plans

Delta Dental Insurance Company - Georgia

This business is NOT BBB Accredited.

Find BBB Accredited Businesses in Dental Plans.

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.

If you've experienced an issue

Submit a Complaint

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:09/01/2022
Type:Customer Service 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 does not adequately provide customer support.their web page intentionally runs you in circles... i guess in hopes that you just give up.what i needed was either a phone number to contact customer service, or an auto-email reply to help me log in...but no... this company is worthless....and dont bother calling their corporate number: ************.... it never gets picked up.
Business Response
Date: 09/06/2022
Good morning,
Your complaint has been sent to the appropriate department for review.

Thank you.
Initial Complaint
Date:08/26/2022
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 received dental services from ****** *******, DDS, MS, on 29 Apr 22 and 20 May 22. Dr. ******* is an out of network dentist and his staff told me his ****** would submit claim paperwork to Delta Dental (DD) and then DD would pay me directly by check the amount(s) they approved. On 24 Jun 22, I contacted Dr. ******** ****** about my claim since I had not received any payment. I was told a staff member would first contact DD to determine if there was a problem. On 28 Jun 22 I received a call back from Dr. ******** ****** with confirmation the claim had indeed been submitted and that three payments had been authorized as follows: $42.50 and $187.00 for the Apr 29 service and #***.50 for the 20 May ******** She stated she was told by DD that checks for these amounts had reportedly been mailed to me at the correct address. On 28 Jun 22 I called DD myself and talked to ********. She confirmed the same authorization information and amounts previously provided me. She stated she would cancel the original checks and resend (in one check for $343.00), but it would take **** days for the check to arrive. On/about 18 Jul 22 I called DD a second time since the check had not arrived and talked to ****. **** reconfirmed the amount ($343.00) and the mailing address and explained it sometimes took up to two weeks for the checks to actually get mailed after authorization. **** stated the check had been processed on July 6th so could be as late as July 20th before it was delivered. He offered to cancel the check again, but that would restart the process clock so I agreed to wait until the end of that week. On 3 Aug 22 I called DD a 3rd time and talked to ***** explaining that I still had not received any payment from DD for the ********* services . I asked the most recent check be cancelled and that I receive the new check overnight, certified. She said she would make that request. As of this complaint, I have still not received payment.
Business Response
Date: 08/29/2022
Good afternoon,
Your complaint has been sent to the appropriate department to review your concerns.

Thank you.
Initial Complaint
Date:08/25/2022
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 obtained a policy for myself in August of 2020 when my wife, who is an educator, was between placements. Shortly after receiving confirmation of the policy my wife obtained a new job in which dental coverage was provided to her and our family. At that time, in October of 2020, we contacted Delta Dental to cancel my policy, which I was told would be done before the end of the month and no further payments would be required.A few months later I noticed that my bank account was still being debited the monthly amount. I called in and spoke to a representative who said that she would open a case and get back to me. No one ever did. I continue to follow up every few months to no avail. Finally, in the beginning of this year I spoke with a representative who confirmed that she did in fact see that I had obtained another Delta Dental policy in October of 2020 (my wifes policy) and obviously I would not have two coverages with Delta Dental so she made a note, cancelled the policy again, and told me I would be receiving a check for $850.65 and it would be mailed to my home address. I never received anything.My most recent attempt was on April 11th when not only was I shuffled from department to department but was then told by a supervisor to hold while they looked into it only to be put back into the wait queue and start over. Once I did finally speak with someone (***** on 5/26/22) she informed me that the only thing being refunded was one month and that she cancelled the policy.How can you consistently bill someone for a policy that has never been used, has never had one single claim filed against it after the first month, and has a 2nd policy that has been in use the entire time.After reading many other complaints I am convinced that this branch of Delta Dental is committing fraud against elderly people and I have contacted a lawyer. There is absolutely no reason why I would have two separate policies for Delta and they insist they have no record of my call
Business Response
Date: 08/29/2022
Good afternoon ,
Please reply with your enrollee id so we can better assist you.

Thank you.
Customer Answer
Date: 08/30/2022
My AARP Member ID is ************.
Business Response
Date: 08/31/2022
Good evening,

Please see the response.

Thank you
Initial Complaint
Date:08/17/2022
Type:Product 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.
Delta dental charged my account without my authorization. I decided to not renew my plan because I recently became full time at the FIre Department and didnt need the insurance any longer. In February I received an email that said my plan was going to be canceled and that they were sorry to see me go. Then in June I received another email that said would you like to enroll in autopay which I did not respond to or anything. Then yesterday 8/16/2022 they took out $107 to renew my membership that I did not consent to. Im pretty sure that it is illegal to take out money with a customers account that they didnt authorize. I called them and requested my money back and they only thing they did was cancel my membership and told me that I may receive a check after the end of the month for the months not used??? How is this okay when I didnt even authorize the payment that was taken?? Obviously I didnt expect this payment to take out and its caused me a big financial hardship because I live basically paycheck to paycheck with cost of living and having a family of 5. This isnt right.
Business Response
Date: 08/18/2022
Good afternoon,
We have received your complaint and sent it to the appropriate department for review. All correspondence pertaining to your complaint will be sent to you directly from Delta Dental due to no HIPAA authorization filled out by you.

Thank you.
Customer Answer
Date: 08/18/2022

Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is ok

Sincerely,

*********************************
Initial Complaint
Date:08/16/2022
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.
On Sept 13, 2021 I had dental work performed by my Dentist, The Dental Group/Riverdale **. My primary insurance company i.e. United Concordia denied payment for the bill; and my Dentist then submitted the claim to Delta Dental my secondary provider for payment. After months of not being paid, my Dentist contact Delta and was told they needed an explanation of benefits from my provider confirming non-payment by United Concordia. That document was sent. A couple more months went by without payment, my dentist and I contacted Delta and was told they didn't have the **** but after checking further they found it. They said payment would be processed. Still almost a year later Delta has not processed the claim and now they are saying my provider needs to submit a claim dispute. Why?? Not only that both my provider and I called Delta again and we are getting the run around i.e. put in the hold que several times, waiting more than an hour or more to get a rep, get a rep who then puts us back in que, got another phone rep named **** who did the same thing, put me back in the hold que for another hour. Remedy: I want by dental bill paid by Delta without any further delays. I also want a detailed explanation why this bill was not paid. Why are we being asked to submit a dispute claim almost a year after the bill should have been paid. Please help!!!
Business Response
Date: 08/17/2022
Good afternoon,
Please reply with your enrollee id so we may better assist you.

Thank you.
Initial Complaint
Date:08/02/2022
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 purchased an individual plan with Delta Dental MO on August 16th, 2021. My son was getting braces ,and my ex-wife told me that her co-pay at the dentist would be much lower if he was double covered with Delta Dental. My wife has Delta Dental through her employer, and I called Delta Dental and purchased a plan for $145.50 a month and explained to the representative why I was purchasing the plan. My sons co-pay did not decrease any, and the dentist office told us sometimes it takes a little bit for it to take affect and a check might even be sent to myself or my ex-wife. I reached out to Delta Dental in June 2022 to explain to them that his co-pay was still the same price. Delta Dental then told me over the phone and after 11 months of paying $145.50 per month ($1,600.50 in total) that an individual plan (which I purchased) did not cover braces. I asked the representative if there was any way that Delta Dental could apply the $1600.50 to my sons co-pay or if I could be refunded. She informed me this could not be done, and that I would have to pay in August 2022 because it was a 12 year plan and then the phone call got disconnected. I have tried to contact them many times, with the same answer that I would "Have to pay the last month of August!" I told them I would not be doing that and asked to speak to a manager of some sort, and again the call was disconnected.I ended up changing my debit card at my bank so the last payment would not be processed. I have tried filing a complaint with them on their website, and I don't even get a response back. When I do call their phone number I get the same answer, and my call gets disconnected. I feel as if I got scammed, and they don't seem to care. This has been one of the worst experiences and I want to warn others.
Business Response
Date: 08/05/2022
Good morning,
Please see our response.

Thank you.
Initial Complaint
Date:08/01/2022
Type:Sales and Advertising 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.
Delta Dental refuses to send me a refund based on the 40% out-of-network rate. They claim the amount they will cover is based on what they magically call the "Maximum Contract Allowance". This is essentially the amount Delta Dental is willing to cover for different dental procedures which do not equal the amount paid by a patient. THESE AMOUNTS ARE NOT DISCLOSED BEFOREHAND. THEY ARE NOT EXPLICITLY found in writing ANYWHERE on Delta Dental website or their Enrollee handbook. In other words, ONLY after I had dental work done and paid the dentist a large bill, ONLY THEN DID Delta Dental let me know, how much they will cover; this amount was NOT the 40% rate they list in their patient handbook BUT A LOT LESS. If Delta Dental is TRANSPARENT they SHOULD NOT KEEP these "Maximum Contract Allowance" numbers hidden from patients UNTIL AFTER THYE HAVE dental work done. IT IS A STRATEGY TO TRAP A PATIENT!!!After I had dental work completed and paid a large amount of money upfront THINKING DELTA DENTAL WILL COVER 40%, I WAS TRAPPED. ONLY after the work WAS completed DID Delta Dental tell me what they are willing to cover; WHICH WAS A LOT LESS THAN WHAT I PAID!IS THIS A FAIR PRACTICE? DON'T patients DESERVE TO KNOW IN ADVANCE what these "SECRET" "Maximum Contract Allowance" numbers ARE? SO THAT A PATIENT CAN MAKE AN INFORMED DECISION whether to proceed with the treatment or not? WHY ARE THESE NUMBERS NOT DISCLOSED? would Delta Dental DO THE RIGHT THING AFTER I EXPLAINED THIS OVER AND OVER and RECEIVED NOTHING BUT IRRELEVANT AND DECEPTIVE ARGUMENTS?I hope whoever reads this complaint has moral and ethical standards and is willing to step in and do the right thing. Though I imagine I will simply receive another patronizing reply written by someone trained in the art of misleading and ambiguous language willing to craft another "genuine sounding" response meant to confuse the reader while pretending to really care.
Business Response
Date: 08/05/2022
Good morning,
Please our response. The complaint has been sent to the appropriate department, all correspondence will sent directly to you from Delta Dental.

Thank you.
Customer Answer
Date: 08/07/2022

Complaint: 17649953

I am rejecting this response because:
I have not received any communication from Delta Dental addressing the issues I raised in my complaint letter and in particular the refund I requested.

Sincerely,

*****************************
Business Response
Date: 08/11/2022
Good morning,
Please allow time for the correspondence to be received.

Thank you.
Customer Answer
Date: 08/16/2022

Complaint: 17649953

I am rejecting this response because:
Delta Dental continues to refuse to send me a refund

Sincerely,

*****************************
Business Response
Date: 09/08/2022
Good evening,
You have several pending cases on file. Please allow time for the appropriate department to review them.

Thank you
Customer Answer
Date: 09/14/2022

Complaint: 17649953

I am rejecting this response because:

It has been weeks and I continue to be asked to wait and wait and wait.

Sincerely,

*****************************
Initial Complaint
Date:07/29/2022
Type:Customer Service 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.
Enrollee Name:*********************** Date of Birth:4/5/1978 Enrollee *************** ************************************************************** ICUBASTLEO Plan Number:************* Effective Date:4/1/2021 End Date:Eligibility Status:Active Program Type:Delta Dental PPOSM I am looking for an update on the claims sent over for processing on 7/25/22. I have checked the portal and there are no claims found. Per our call to Delta Dental Reference number ***************** Representative name: ******* the claims were sent over with all of the required documentation and should be in the process of review. I need an update for the dental billing office who is also attached to this email. Our son ************************** has an appt in August to have his braces removed these claims NEED to be processed as the removal is already 1 month delayed. ******* and ************************* are still in treatment they also have appts on 8/24/22 if something isnt done their treatment is also in jeopardy of being cancelled. These claims are also WAY past the processing timeline set.
Business Response
Date: 08/05/2022
Good morning,
Please see our response.

Thank you.
Customer Answer
Date: 08/05/2022

Complaint: 17642832

I am rejecting this response because: I provided the details for the plan in question the plan details are a follows:
Enrollee Name: ***********************
Date of Birth: 4/5/1978
Enrollee ID: ************
Plan Name: ******************** & Universities **************** ICUBASTLEO
Plan Number: *************
Effective Date: 4/1/2021
Eligibility Status: Active
Program Type: Delta Dental PPOSM
I am the mother of *************, ******* and *************************. *********************** and I are divorced however we share joint custody and I am the primary insurance carrier. This is their secondary plan.
If you have questions or need to validate who I am you can reach ************************** at ************, ********************** or ************************************************
Sincerely,

***********************
Business Response
Date: 08/05/2022
Good evening,
The orthodontic claim for ********************* is currently showing that is in a processing state. Were you only checking the status of this or did you want to file a grievance in regards to this as well.

Thank you.
Customer Answer
Date: 08/08/2022

Complaint: 17642832

I am rejecting this response because: claim # 20213493000502 has been denied for Benefits could not be determined because of missing/conflicting orthodontic information. Please submit a new claim or pre-treatment estimate with the date appliances were placed, total case fee, initial banding fee, monthly treatment fees, and estimated number of months of treatment, upon receipt we will process the submitted service(s) in accordance with our processing guidelines. To prevent delays in processing, please do not attach a copy of this EOB to the new claim. (EX577)- all of this has been proved multiple times and the claims for his brothers were able to be paid without any additional information being needed. *****'s appt for removal is on 8/23/22 and I need this claim paid prior to the appt or the office will delay his removal again.
There are no other claims found processed for ************************** (3/15/06) related to braces.
Claim # 20213493007838 for *************************** paid only $1,264.00 when the plan allows up to $1,500
Claim # 20221573017369 for ************************;paid only $1,000.00 when the plan allows up to $1,500
Can someone please explain why the full benefit allowance wasn't paid for these claims?
Sincerely,

***********************
Business Response
Date: 08/30/2022
Once again the information provided below is completely inaccurate. There has been NO claim processed for braces for ************************** (3/15/06). The claim process on 8/10/22 was for general dentistry treatment.

Claim number: ************** paid $78 for D0120, D1110 and D0210- THESE ARE GENERAL DENTISRTY SERVICES

Claim number: ************** is still denied for D0808- THIS IS FOR ORTHODONTIC SERVICES

Jerrys appt is schd for 8/23/22 at 10am there has been no updates or EOPs found for his claim. His claim was submitted on the same day as his brothers claims which have been processed for partial payment and pending an additional payment. Why has ****** claim not been processed. I have called several times this week to talk out the issues but since I have filed a complaint no phone agents will assist me nor will they transfer me to a mgr.

Complaints have been file with The BBB (********), ******************** and ********** of Insurance Regulation (1-1095615001). We request immediate payment of the above referenced claim. According to our records, this claim was filed on [date of filing], however, payment has not yet been received.

We believe that failure to release payment may be a violation of ******* Code. ******* statute ********, otherwise known as the Prompt payment of claims, requires insurance companies to make decisions and pay out on claims quickly.
All claims for payment, whether electronic or nonelectronic, must be mailed or electronically transferred to the secondary organization within 90 days after final determination by the primary organization. A providers claim is considered submitted on the date it is electronically transferred or mailed.
(c) Must not duplicate a claim previously submitted unless it is determined that the original claim was not received or is otherwise lost.
(3) For all electronically submitted claims, a health maintenance organization shall:
(a) Within 24 hours after the beginning of the next business day after receipt of the claim, provide electronic acknowledgment of the receipt of the claim to the electronic source submitting the claim.
(b) Within 20 days after receipt of the claim, pay the claim or notify a provider or designee if a claim is denied or contested. Notice of the organizations action on the claim and payment of the claim is considered to be made on the date the notice or payment was mailed or electronically transferred.
(c)1. Notification of the health maintenance organizations determination of a contested claim must be accompanied by an itemized list of additional information or documents the insurer can reasonably determine are necessary to process the claim.
2. A provider must submit the additional information or documentation, as specified on the itemized list, within 35 days after receipt of the notification. Additional information is considered submitted on the date it is electronically transferred or mailed. The health maintenance organization may not request duplicate documents.
(d) For purposes of this subsection, electronic means of transmission of claims, notices, documents, forms, and payment shall be used to the greatest extent possible by the health maintenance organization and the provider.
(e) A claim must be paid or denied within 90 days after receipt of the claim. Failure to pay or deny a claim within 120 days after receipt of the claim creates an uncontestable obligation to pay the claim.
(4) For all nonelectronically submitted claims, a health maintenance organization shall:
(a) Effective November 1, ****, provide acknowledgment of receipt of the claim within 15 days after receipt of the claim to the provider or designee or provide a provider or designee within 15 days after receipt with electronic access to the status of a submitted claim.
(b) Within 40 days after receipt of the claim, pay the claim or notify a provider or designee if a claim is denied or contested. Notice of the health maintenance organizations action on the claim and payment of the claim is considered to be made on the date the notice or payment was mailed or electronically transferred.
(c)1. Notification of the health maintenance organizations determination of a contested claim must be accompanied by an itemized list of additional information or documents the organization can reasonably determine are necessary to process the claim.
2. A provider must submit the additional information or documentation, as specified on the itemized list, within 35 days after receipt of the notification. Additional information is considered submitted on the date it is electronically transferred or mailed. The health maintenance organization may not request duplicate documents.
(d) For purposes of this subsection, electronic means of transmission of claims, notices, documents, forms, and payments shall be used to the greatest extent possible by the health maintenance organization and the provider.
(e) A claim must be paid or denied within 120 days after receipt of the claim. Failure to pay or deny a claim within 140 days after receipt of the claim creates an uncontestable obligation to pay the claim.

Based on the above listed statue the claim was submitted to your organization several times since 4/2021 and a certified mailed copy was sent and received on 6/3/22. Due to the failure to process claims in the time frame allowed this is now an uncontestable claim and Delta Dental has an obligation to pay the claim.

Please respond within 24 hours providing proof that the claims for ***************************, *************************** and ************************* are processed for payment. Proof of processing should be provided with a copy of each EOP.

From: csddic <*********************************>
Sent: Wednesday, August 17, 2022 7:19 AM
To: *********************** <************************************>
Subject: RE: **************** Inquiry Form - Self Insured

Caution:
External Email Do not click on links or open any attachments unless you recognize
the sender and know the contents are safe. Think before you click!

________________________________________
Thank you for contacting Delta Dental Insurance Company,

******* had used $736.00 from the previous carrier(s) and there was only $1,264.00 remaining for Dominics ortho treatment. Jerrys claim has been paid 08/10/2022 and the check is showing outstanding. The provider did not cash the check yet.

Sincerely,

******************
Delta Dental Insurance Company
Initial Complaint
Date:07/25/2022
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.
Purchased Delta Dental threw ****** last year 8/01/21 used the plan for braces. Was sent a letter in the mail threw ****** stating they will no longer be offering Delta Dental insurance that I needed to pick a new plan or cancel services by 8/01/22. On 7/18/22 I noticed my credit card was charged to renew the plan without my permission. Was told I signed up for autopay which I did not. I also could not access my online profile because it said my member ID no longer existed. Called the company and told them what happened and that I no longer needed the plan that I would be canceling. They told me they were refuding my $116 back to my card. Called a week later (today) was told that they canceled my refund and would not tell me why. The rep put in a grievance for me but I have no faith in that since reading other complaints on BBB website. If I would have know this I'd never purchase from them the services. Now I need to cancel my credit card just to avoid further charges. Shame on them. Also they said they don't refund back to cards only by check, so apparently the reps just tell you false information.
Business Response
Date: 08/01/2022
Hello,

Attached is our response.
Initial Complaint
Date:07/18/2022
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.
Due to an infection I was advised by my dentist to get an extraction, bone graft, implant and crown to my tooth #3, which are done in a sequence over many months. On April 26, 2022, I called Delta Dental to ensure I understood my insurance coverage, and an agent told me a bone graft was covered at 80% but only if it was NOT done the same day as a tooth extraction. When I had the extraction done at my dentist, they planned to do the bone graft the same day but I asked for the graft to be done on a separate day so it would be partially covered. After the fact I learned from a different Delta Dental agent that they do NOT cover a bone graft at all. The first agent gave me wrong information. Had the first agent given me accurate information, I would have gotten a bone graft the same day as the extraction. The only reason I didn't was to get the insurance coverage. I have since learned from two periodontists/oral surgeons that by not getting a bone graft the same day as the extraction my jaw bone will suffer erosion. A periodontist has since told me because of the thinning of my jaw bone I now need to get a sinus augmentation (procedure D7951) done before an implant and crown. The periodontist, ****************, submitted a $2,000 fee for the sinus augmentation in a pre-estimate (ref # **************) and Delta Dental said they will pay $496.80 and I will be responsible for $1503.20. I submitted a grievance to Delta Dental on May 24 outlining how the agent's wrong info is resulting in me having to get a pricey sinus augmentation and their response just said guided tissue regeneration wasn't a covered service and so they stand by the decision to deny coverage of it. My grievance said NOTHING about this procedure. I am asking BBB to help me engage Delta Dental. I will be filing an appeal asking them to agree to pay 50% of my out of pocket cost for the sinus augmentation which is $751.60. My original grievance and appeal are attached.
Business Response
Date: 07/22/2022
Good evening,
Due to no HIPAA authorization filled out by you for the Better Business Bureau all correspondence will be sent directly to you regarding your complaint. Your concerns have been sent to the appropriate department for review.

Thank you.
Customer Answer
Date: 07/25/2022

Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********. Due to HIPPA compliance regulations the business Delta Dental has committed to contacting me directly about this case rather than communicate through BBB. I agree with this and am expecting resolution from Delta Dental promptly. If resolution isn't satisfactory, I will contact BBB again.

Sincerely,

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

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, except for customer reviews. Customer reviews posted prior to July 5, 2024, will no longer be published when they reach three years from their submission date. Customer reviews posted on/after July 5, 2024, will be published indefinitely unless otherwise voluntarily retracted by the user who submitted the content, or BBB no longer believes the review is authentic. BBB Business Profiles are subject to change at any time. If you choose to do business with this company, please let them know that you checked their record with BBB.

As a matter of policy, BBB does not endorse any product, service or business. Businesses are under no obligation to seek BBB accreditation, and some businesses are not accredited because they have not sought BBB accreditation. BBB charges a fee for BBB Accreditation. This fee supports BBB's efforts to fulfill its mission of advancing marketplace trust.

Cookies on BBB.org

Complaints

Customer Complaints Summary

If you've experienced an issue

Filter and sort by

Sort by

Complaint status

Complaint type

Complaint statuses

Business Response

Complaint statuses

Business Response

Complaint statuses

Business Response

Customer Answer

Business Response

Complaint statuses

Business Response

Customer Answer

Complaint statuses

Business Response

Complaint statuses

Business Response

Complaint statuses

Business Response

Customer Answer

Business Response

Customer Answer

Business Response

Customer Answer

Complaint statuses

Business Response

Customer Answer

Business Response

Customer Answer

Business Response

Complaint statuses

Business Response

Complaint statuses

Business Response

Customer Answer

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