Business Profile

Dental Plans

Delta Dental Insurance Company - Georgia

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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:12/14/2023
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.
The insurance wont pay claims to my dentist office. We have talked to delta dental about the denied claim for a service provided to my daughter on 3/3/2023. They have all the information needed. I spoke to a claim specialist INQ235500.
Business Response
Date: 12/15/2023
Good afternoon,

This has been received and submitted to the appropriate department for review. Please allow up to 30 days for a response.

Thank you
Initial Complaint
Date:12/12/2023
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 ordered a new policy from delta dental on 11/30/23. My old policy was supposed to be cancelled on 11/30/23. I PAID UPFRONT for the new policy as I was told I had to by representative! My card was charged. NOW I have a bill for ****** cents starting Dec 1st. This is a mistake. I have now spoken to 2 representatives that do not know what they are doing and can't resolve this and keep putting me on hold to speak to their supervisor. This is outrageous. I need this taken off my bill. I will be canceling all dental insurance with them if this doesn't get resolved ASAP. The incompetence is insane!
Business Response
Date: 12/15/2023
Good afternoon,

Please respond with your enrollee id so we can further assist.

Thank you
Initial Complaint
Date:12/05/2023
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.
this is the worst company on earth. their grievance and appeals process is simply for them to take the time to justify any incompetence or mistakes theyve made. if you have to file a grievance, consider it denied. they play keep away with the grievance caseworkers so you cant speak to them and everybody else that answers the phone is rude and uninformed. theyve given me misleading information on numerous occasions and have yet to take responsibility for either. i even caught a rep in a lie since she was coincidentally one that i spoke to previously and instead of apologizing or clearing it up, she chose to transfer me mid call to a different insurance company that had to transfer me back to DD. what a complete joke. i have a clear cut issue that DD has not lifted a finger to assist with, let alone go above and beyond. everything DD does is to leverage their company, to save DD time or a dollar, its never about the policy holder. i doubt there are any real disciplinary measures or oversight in these departments. on top of that, the departments dont work in unison, nobody knows what anyone else is doing or why they do it, nobody has any accurate definitive information to share and everyone makes it seems like theyre helping you until you get contradicting information on a later phone call. you guys should spend more time on the aspects of your business that help customers feel like theyre appreciated as customers and not just another policy on your computer screen. like you actually want to accommodate them and not just cut corners because its in the best interest of delta dental. unfortunately my issue is still ongoing after 2 months and over 10 phone calls. DD is as far away from a customer first motto as you can get.
Business Response
Date: 12/07/2023
Good morning,

I sincerely apoligize for your experience. Can you please advise the issue you have that needs resolved.

Thank you
Initial Complaint
Date:11/28/2023
Type:Product 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 called on 11/21/23 speaking with **** to cancel coverage effective 11/30/23. Of course, one week later your online portal is still showing coverage active with no cancellation showing. Why?
Business Response
Date: 11/29/2023
Good morning,

Please reply with your enrollee id so we can further assist.

Thank you
Customer Answer
Date: 11/29/2023

Complaint: 20930444

I am rejecting this response because:
The business has requested the following. The enrollee ID is: ************

Sincerely,

*********************
Business Response
Date: 11/30/2023
Good morning,
Your complaint has been submitted to our grievance and appeals team for review. Once this has been resolved you will receive a letter for the termination.

Thank you
Customer Answer
Date: 12/01/2023

Complaint: 20930444

I am rejecting this response because:
Per my phone call to the business on November 21st, 2023, I spoke with **** who assured me that the policy would be cancelled in a few days effective November 30, 2023, I was given call reference number SF20231121463408862.

Sincerely,

*********************
Initial Complaint
Date:11/28/2023
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.
Have been calling since MAY ****************************************************************** mailed. To me instead of provider. I filed the is claim myself there is no coordination of benefits. Not they are still processing claims to the providers office 6 months after my TREATMENT has ended despite my continued calls and submissions
Business Response
Date: 11/29/2023
Good morning,
Please see a copy of a resolution sent from your previous grievance regarding this complaint.

Dear Lartrice ********:
Thank you for your patience during our review of your concerns. This letter is in
response to your inquiry/complaint, received March 09, 2023, regarding the
payment issued for orthodontic treatment that began December 28, 2022. You
stated you paid in-full upfront; therefore, you submitted your own claim with the
intent of receiving reimbursement. You have requested we investigate how and/or
why the payment was sent to the dental office.

The following individual(s) participated in the decision-making:
Appeals Specialist
The Employee Benefit Booklet for ************ ******, "The PPO Provider or Premier
Provider must accept assignment of Benefits, meaning these Providers will be paid
directly by Delta Dental after satisfaction of the Deductible and Enrollee
Coinsurance" (page 9 under Additional Obligations of PPO and Premier Providers).
This information is also stated on page 5 of the Evidence of coverage for Adventist
Health System under 'Additional advantages of using a PPO Dentist or Premier
Dentist'.
A review of the claim for orthodontic treatment that began December 28, 2022,
shows Delta Dental issued a payment of $1,682.00 to ***** Road Dental Care on
February 2, 2023, from your ************ dental plan. On February 15, 2023, Delta
Dental issued a payment of $395.50 to ***** Road Dental Care from your Adventist
Health System dental plan. Your orthodontic benefits provided by Adventist Health
System are paid in monthly installments following the initial down payment;
therefore, on February 22 and March 8, 2023, periodic monthly payments of $105.50
were issued to ***** Road Dental Care. This claim was submitted to Delta Dental
electronically by ***** Road Dental Care.
PO Box 1860
**********, ** 30023-1860
March 27, 2023
Re: Case ID: **********
Member Name: *************************

Because *****************************, DDS, is a Delta Dental Dentist, ***** Road Dental Care is
contractually required to submit claims for all services provided in their office to
Delta Dental members. In return, Delta Dental is contractually required to send all
payments for services provided to Delta Dental members directly to ***** Road
Dental Care.
Upon receipt of your complaint, we contacted ***** Road Dental Care and spoke
with ****** regarding your payment for orthodontic treatment that began
December 28, 2022. ****** advised that you made two payments totaling
$1,549.00. She stated your payments were made based on the insurance
information you provided ***** Road Dental Care. ****** told us they were
unaware you had two coverages; therefore, your copay was not calculated based
on a coordination of your benefits.
We encourage you to speak with ***** Road Dental Care as they are willing to
update your orthodontic contract based on your additional coverage. Once
updated, a refund will be processed based on your preferred method. In the future,
we recommend giving your dental provider all of your insurance information at the
time of service to ensure the maximization of your benefits and minimization of
your out-of-pocket expenses. You can also ask them to submit a predetermination
for treatment expected to exceed $300.00 to avoid overpaying
Initial Complaint
Date:11/24/2023
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 called Delta Dental Insurance on 2 Oct 2023 to let them know that I was awarded 100% VA disability and I would like to cancel my policy (*********) with them because VA covers my dental now. I sent proof by text message and email to ********************** and corresponded with the representative *******************************, program analyst FEDVIP healthcare and insurance at least twenty times or more to get final confirmation of the cancellation. To this date I have not received a letter or notification of cancellation. Finally, on the 23rd of October she had emailed that we have approved the cancellation of your enrollment. Yesterday, Delta dental reps as of today, 24 November doesnt show any cancellation request from benefeds. Please help in getting final closure. I am paying $48.98 a month. Request that I am not charged for Nov and Dec and cancel the insurance sending proof.
Business Response
Date: 11/27/2023
Good morning,

We are unable to locate you at this time in the system. Your name and identification number provided does not show up. Can you please provide any other information to locate you and can you advise what your group name and number ?

Thank you
Initial Complaint
Date:10/25/2023
Type:Billing 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.
My name is *******************************. I was a Delta Dental insured for approximately three years. My account number was **********; Enrollee ID was ************. My quarterly premium was $215.22, which was charged automatically to a credit card. My account was paid up to and including July 31, 2023.I tried to cancel my policy on August 22, 2023 because my dentist no longer accepts Delta Dental insurance. I called and spoke to a representative. She tried to persuade me to change my dentist, but I refused. She then told me that the system was down, and my request to cancel could not be processed. I then followed up with an email that same day. I never received a response.On or about October 10, 2023 I received a notice from Delta Dental dated October 1, 2023 stating that my policy was cancelled for non-payment effective July 31, 2023.Delta Dental continues to invoice me for a policy that we both agree was cancelled. They now claim that I owe $430.44. I am afraid that Delta Dental will report this to credit bureaus as a bad debt. Please help me!! Thank you.
Business Response
Date: 10/26/2023
Good afternoon,

We have received your complaint and have routed it to the appropriate department.

Thank you
Initial Complaint
Date:10/23/2023
Type:Billing 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.
This company has not responded to any of my emails Ive sent through there website regarding my inactive insurance plan that I was told I had till November to pay what was left owed I have made small payments in good faith and they have been ignoring any concerns Ive expressed and never sent me any communication that anything was wrong. I dont appreciate being treated like this especially when I made a payment this month!
Business Response
Date: 10/26/2023
Good afternoon,
Your complaint has been received and routed to our grievance and appeals team. We apologize for your experience and are working to resolve this for you.

Thank you.
Customer Answer
Date: 10/26/2023

Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********, However I would like them to send their resolution through this complaint or email. Thank you

Sincerely,

*******************************
Customer Answer
Date: 11/01/2023
Complaint: 20771576

I am rejecting this response because: Please reopen the complaint they did not respond or resolve my issue.

Sincerely,

************************************;
Business Response
Date: 11/02/2023
Good afternoon,

As stated before please allow 30 days of time for our grievance and appeals team to review. Once this has been completed you will receive a response

Thank you
Customer Answer
Date: 11/02/2023

Complaint: 20771576

I am rejecting this response because I received two letters one stating they got my email about the poor service and the other one was related to payments but they had the wrong balance and they seemed to not acknowledge that I made payments yet they still cut off my benefits

Sincerely,

*******************************
Customer Answer
Date: 01/23/2024

Complaint: 20771576

I am rejecting this response because:
I have sent multiple emails regarding my benefits and following up about my grievance regarding them not communicating anything about billing even though I was paying on my balance and they continue to ignore me and this is very upsetting when I sent my email on January 10 they were supposed to have responded by now it has been well past the 3-5 business days.

Sincerely,

*******************************
Initial Complaint
Date:10/19/2023
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.
04/14/2023-GRV75855,GRV75856,APP-215679,APP214767 The health care provider-Aspen Dental-immediate Denture First, I complain to aspen dental that denture was not fitting, too big and painful to ware. Two times I went to do the adjustment and only thing they did was, applying some solvent and fill the bigger space, solvent is every ware on my denture creating rough surface on supposed to be smooth. The denture creates sore patch when wearing and eat feel like a I am wearing a mouthpiece. It took more than a month and many phone calls to get to this point.I wonder the so call "Decision making panel" never physically inspect my denture. My first appeal was rejected by this "kitchen Cabinet" saying provider followed the correct procedure, that I never complained. My complain is the defective product provide by the provider and reimburse money paid to the provider so, I can get a denture from any other provider.The second time I call and complain though Rep never filled my complaint and I have to call again to get updated status and found out rep never filled my complain and this time filled a claim.The so call decision making "Tabletop" "kitchen cabinet" that included DDS QC coordinator and appeals specialist never understood my complain. If they understood, 1, they should refer me to independent dentist to verify my claim.2, they should know, the product was immediate denture, and I am qualified for replacement denture under my plan. I am not sure the so-called decision-making panel qualifications; credentials need verification by insurance commissioner. My third complain was, provider removed my right end tooth (32) even I raised concern and not necessary for denture replacement. This never addressed.1, Refund money provider charge me and approve for replacement of immediate denture ***********.2, Investigate and report the provider to Insurance commissioner for state investigate.3, Provide me comprehensive report for my future reference.THIS COMPLAIN WAS NOTABOUT THE PROCESS, ITS ALLABOUT THE DEFECTIVE PRODUCT"REPLACE IT AND REFUND.
Business Response
Date: 10/27/2023
Hello,
This complaint has been received.

Thank you
Customer Answer
Date: 10/27/2023

Complaint: 20754635

I am rejecting this response because: The message only the confirmation of complain was received after 9 days. Need a expedite solution.

Sincerely,

*********************************
Business Response
Date: 10/30/2023
Good morning,

Grievance and appeals process is usually a 30 day review of your concerns. Please allow this department time to review.

Thank you
Customer Answer
Date: 10/30/2023

Complaint: 20754635

I am rejecting this response because: **************** trying to distance from the service provider and self-ignores their responsibility. Their only theory is "The process is correct" disregarding the defective product supply to it member. It clearly shows how arrogant are these individuals. Next steps are complained to Insuranc commissioner and shareholders.

Sincerely,

*********************************
Initial Complaint
Date:10/14/2023
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 had dental procedures performed by ****************** (PRV538344241) on 6/27/2023. The Delta claim number is ************** and my enrollee ID is ************. My delta plan should pay the provider $651.20, which is the remaining balance of my yearly maximum, and is less than 60% of the plan allowed amount of $1,094.00 on procedure code D4261. Delta keeps rejecting the bill with PEC code BD7, saying radiographs were not submitted. Per the dental billing office, radiographs were submitted with each billing and this has been rebilled multiple times with the radiographs attached, and each time the same denial. **** at the dental office called and talked to a Delta rep who confirmed that the latest "adjustment" was received and that radiographs were attached. They wanted 30 days for processing, which will have elapsed on 10/15/2023 with no response/payment. The charges are 90 days old and now the dental clinic is coming after me for money that Delta owes. Delta: Please pay this claim in accordance with my policy. Please expedite this request and don't give the standard "we get 30 more days" response as you were given the 30 days you requested every time you got a complete and correct billing, the most recent of which was 29 days ago. Time's up, meet your obligations. Expected resolution: Delta pays the dental provider on the aforementioned claim. ASAP.
Business Response
Date: 10/16/2023
Good morning,
Your complaint has been received and routed to the grievance and appeals team for review. Please allow around 30 days for your resolution.

Thank you
Customer Answer
Date: 10/16/2023

Complaint: 20735417

I am rejecting this response because: Delta does not seem to be handling this issue with any sense of urgency. In my original complaint, I pointed out how every time they process the bill/claim incorrectly, they claim they get another 30 days. Response from Delta was literally that: give us 30 more days. This should have been processed and paid within 30 days of the original receipt of the complete bill with supporting documentation. Someone who works in adjustments needs to take a few minutes out of their day and review the most recent claim with the radiographs attached and process for payment according to the policy. They keep denying payment for ***************, despite those records being attached, which is the very definition of bad faith practices. Delta, please provide more detail on what steps are being taken and what the timeframe is. I shouldn't have my credit ruined or need to pay a bill I don't owe over processing errors by your claims and adjustments department(s).

Sincerely,

***********************
Business Response
Date: 10/18/2023
Good afternoon,
Upon review of your claims the previous submissions did not include x-rays which is why the claim denied. The system is showing another submission recently which is currently in progress with the requesed information. We apologize for the delay but if the the required information is not received at the time of receipt that holds up the processing time. Our grievance and appeals team will be in contact once this has been reviewed or the new claim has finished processing.

Thank you
Customer Answer
Date: 10/23/2023

Complaint: 20735417

I am rejecting this response because: While I certainly am pleased with the information provided in the last message which provided more detail on the claim in process by Delta, I can't ***************** complaint as satisfied until the payment is made to the dental provider per the terms of the policy. However, it looks like things are moving toward that result, at which time I will be grateful for the help and response from Delta. I am only submitting this rejection today as the BBB suggests that if I waited more than 7 days to respond that the complaint would automatically be considered resolved. Otherwise I would have waited until the payment was made and then came back and marked this as an accepted resolution. Since there is still a chance that payment won't be made, however remote, I can't claim resolution today.
Sincerely,

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

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