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:09/25/2023
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.
H3239363538313731**H H33**3332353236373636H does not process my two claims:I am a member of H3239363538313731**H H33**3332353236373636H, my Enrollee ID ************, ******************** PPO *********** ***** # *****-00005, address H3239363538313731**H **** Co., P. O. Box ****, **********, ** *****, Phone ************. I have two claims, H3239363538313731**H does not process these two claims: Claim # 2023234*****69 *************** Aug. 1, 2023 I paid $1500.00 to Dr. ******** An, DDS for my Tooth #** CROWN, (D6065) Implant supported Porcelain/Ceramic CROWN., and Claim # ************** *************** July 12, 2023 I paid my dentist Dr. ** $700.00 for Tooth #** ABUTMENT (D6057) Custom Fabricated ABUTMENT. Regarding these two claims, my dentist office submitted claims with attached **Rays that they asked many times to H3239363538313731**H, I personally also contacted H3239363538313731**H by phone and by their online contact, you can see in the attachments the Ticket numbers from H3239363538313731**H **************** they email me, but no answer, no calls, no help from them at all, only they provided ticket numbers, and yet they have not process these two claims. Since July 12, 2023 the Abutment procedure, and Aug. 1, 2023 the Crown procedure, it's a long period for these two procedures that have been done and they have all the info, but yet there is no, nothing, I have all the documentation if you need I can send them to you. I don't know why they do not process these two claims, my dentist office even submitted new claims with **Ray and filled out dispute form from H3239363538313731**H regarding the **Ray with **** Tracking # **********************, and they have the proof of delivery to H3239363538313731**H. I just want H3239363538313731**H process these two claim and pay to my dentist office, so they can reimburse me for these two payments.
Business Response
Date: 09/27/2023
Good morning,

Your complaint has been received and routed to the appropriate department for review. We appreciate your concerns, please allow 30 days for review.

Thank you
Initial Complaint
Date:09/25/2023
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.
I was a Delta of PA customer from ~March-October of 2022. My child was in the middle of an Orthodontic Treatment Plan which was mostly covered by another Delta Branch, Delta of VA, prior to and since the time window mentioned above. Due to miscommunication between the practice, me, and insurance providers, claims were not submitted to Delta of PA until months after I stopped being a customer. However, these claims were submitted within the 12 month/1 year window of services rendered. Delta of PA denied the claims and has not responded or followed up with me after multiple inquiries (Aug 24, Sept 8, etc) despite quoting a response in 3-5 business days. Note, the claims they've been asked to cover are only for the time frame when I was paying for their coverage and was a customer, and they were the only claims submitted to them for the entire duration of me being their customer. To clarify, ********************** of PA happily collected insurance costs out of mine and my company at the time's wallets every pay period, but are refusing to provide the coverage/service that was paid for. I have had other insurance issues in the past, but never a company that would ignore inquiries. At the very least they could follow up with me with a justification as to why they're not covering services that fall well within the boundaries of what they cover.I do not recommend Delta of PA, unless you enjoy paying for insurance that does not provide insurance in exchange for payment. I am now stuck paying ~$900 more out of pocket, when my previous payment plans had already been completely done and settled. That being said, I do recommend Delta of PA for Dental Insurance if you enjoy abrupt changes to your finances because they refuse to provide coverage you paid for.
Business Response
Date: 09/25/2023
Good afternoon,

Your complaint has been received and submitted to the grievance and appeals department. Please allow up to 30 days for review.

Thank you
Initial Complaint
Date:09/17/2023
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.
My son ************************* had braces done and completed by ************************************ The orthodontics office filed a claim with Delta Dental, my dental insurance company, but they never responded. So on my son's last visit, Dr. ******************* collected the service amount covered by the insurance from me and told me that she will send the claim again to delta dental so I can get reimbursed. I contacted delta dental and they said, they only accept mail filing no electronic or fax filing, imagine with all this technology we have nowadays, but I realized why, just to not reimburse their insurers. Anyways,. ************ office filed and mailed them the claim so I can get reimbursed. I contacted them several times and they said they did not receive it, but confirmed from ************ Office that she sent it twice, finally after 2 months they gave me what more information needed. I sent that to ************ and she resent the claim twice again. But no response, it has been 5 months now that I need to get reimbursed from Delta Dental they keep delaying and ignoring. I need assistance please.
Business Response
Date: 09/18/2023
Good morning,
Your complaint has been routed to the appropriate department. Please allow up to 30 days for review.

Thank you
Initial Complaint
Date:09/14/2023
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.
On 6/9/23, I had three wisdom teeth extractions. My primary dentist referred me to the oral surgeon that performed the extraction, and I was assured that I had coverage for this procedure. Both my provider and I have been going back and forth with Delta Dental to get payment on the claim, as they paid significantly less than what should have been paid, based on my coverage. I spoke to three representatives who claimed to submit my claim for reprocessing, and it was never reprocessed. Same script was given to my provider and nothing was ever updated. This is my only choice of dental coverage through my employer, and it is ridiculous how little was paid on this claim. Someone needs to actually reprocess the claim instead of lying that it will be done in 30 days. I have coverage for the procedure, but it seems like Delta Dental is refusing to pay because of the codes used, per one rep. ******** my provider explained those are the correct codes for each removal.
Business Response
Date: 09/15/2023
Hello, Good morning,

Your complaint was routed to the appropriate department for review.

Due to no authorization being filed all correspondence will be sent to you directly from Delta Dental.
Customer Answer
Date: 09/15/2023

Complaint: 20600855

I am rejecting this response because Delta Dental has promised both my provider and myself that they would reprocess my claim and have an update within 30 days. My provider has been contacting them since June 2023, and it is always the same story. My claim was never reprocessed as promised, and I feel as if I cannot take their word.
I need to visually see my claim be reprocessed for me to believe any action is being taken. This has been going on for far too long.

Sincerely,

*******************
Business Response
Date: 09/15/2023
Hello.
Please allow 30 days to receive a Resolution Letter from our Grievance and Appeals Department.
Have a nice day.
Customer Answer
Date: 09/15/2023

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:09/11/2023
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.
I changed my address back in January. I notified everyone: banks, credit card companies, insurers, etc, including Delta Dental. Everyone has updated my address EXCEPT Delta Dental. I have notified them several times and STILL they are sending SENSITIVE mail to the person that is now at my OLD address! I spoke with several people there who said they would escalate, but nothing was actually done. Then I was told I needed to change it at Healthcare.gov. Well that was done back in January so Delta Dental has NO EXCUSE! The other problem is I really shouldn't be getting mail from them anyway because I have set my preferences to PAPERLESS too many times to count. They are completely incompetent. Now I have to resort to filing an actual complaint to get this simple task rectified.
Business Response
Date: 09/12/2023
Hello,

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

Thank you
Customer Answer
Date: 09/12/2023
Enrollee ID ************
Business Response
Date: 09/21/2023
Hello,

This has been received and your complaint has been submitted to our grievance team. Please allow timing for review.

Thank you
Customer Answer
Date: 09/21/2023

Complaint: 20585353

I am rejecting this response to allow time for the business to review and get back to me

Sincerely,

*********************************
Business Response
Date: 09/25/2023
Good afternoon,

The grievance team has an alotted time of 30 days to review complaints. They will reach out once they are finished with the review.

Thank you
Initial Complaint
Date:09/07/2023
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.
Delta dental of ******* will not follow the details of my policy. Specifically charging an annual deductible for my recent preventative care visit. A grievance was filed by me (case id **********, ***********. Claim **************. Please contact *************************** or ********************************* at ************.
Business Response
Date: 09/11/2023
Hello,

Your complaint has been received and routed to the appropriate party.

Thank you
Customer Answer
Date: 09/12/2023

Complaint: 20569891

I am rejecting this response because:

it only states they received the complaint. The issue has not been resolved.

Sincerely,

***************************
Business Response
Date: 09/12/2023
Hello,

This issue has not been resolved however it has been routed to the correct department to do so. Please allow time for Delta Dental to review.

Thank you
Initial Complaint
Date:09/06/2023
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.
I went through Clear choice Dental in order to have Dental Implants set in place. Clear choice does not bill insurance directly. I had to pay Clear Choice out of pocket first. I was given all the paper work to file the claim myself with our insurance provider, which was Delta Dental at the time of this service. I mailed the claim to Delta Dental, waiting for the claim to be reimbursed. I call to follow up, they tell me they are processing the claim. The next time I call they inform me they are missing information. I have been through this cycle of mailing and waiting several times now. This is why it has taken me this long to file with the BBB. I just called again, after sending in all the paper work, to inquire the status of the claim. They informed that they are missing a detailed invoice. The pictures I am attaching shows all the information I most recently sent them in order for them process and pay on this claim. The ****** is what we paid to Clear Choice. Delta was supposed to reimburse me eighty percent for this claim. I am now asking for the entire amount due the hassle they have put me through this last year and a half.
Business Response
Date: 09/07/2023
Hello,

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

Thank you
Initial Complaint
Date:08/30/2023
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.
I have been going back and forth with this company over a month regarding coverage that I currently have. A claim was submitted in the middle of August. Initially it was rejected stating that additional information was needed to process the claim. However after further speaking with the representative (*******) from Delta dental, it was confirmed that all information was provided and they could not understand why the claim was rejected in the first place. At that time I was told that it will be resubmitted to be reprocessed and paid. The time frame they initially gave me was it could be up to 30 days. Here we are 30 days later, And now my health provider is demanding that I pay out of pocket, only to find that the claim was never resubmitted for processing. I was again given the 30-day time. However this is unacceptable.I'm attaching the original version of the claim which a representative from Delta dental already confirmed has sufficient info to process, however they have yet to keep up their end of the deal when it comes to my dental insurance.
Business Response
Date: 08/31/2023
Hello,
This has been received and submitted to our grievance and appeals team for review.

Thank you
Initial Complaint
Date:08/15/2023
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.
Delta Dental has refused to pay for **rays that I had on 12/9/22 (claim number **************). My Delta Dental policy covers this however Delta Dental has refused to pay it because they are saying that they are the secondary payor instead of the primary payor which is not the case. I have spent numerous hours on the phone with both Dental Dental and United Concordia at the same time to coordinate benefits. During these calls it was determined that Dental Dental was primary and United Concordia was secondary. United Concordia also sent a letter to Delta Dental per their request confirming this. Delta dental was determine to be the primary because it is part of a **** plan whereas United Concordia is a FEDVIP plan. The **** plan is always primary to the FEDVIP. Despite Dental Dental knowing this they continue to say they are the secondary based on the effective date of the insurance which still does not make sense since my effective date for Delta Dental is 2012 and United Concordia is 2015. As a result of this I am receiving past due notices from the dentist for the **ray and I cant go back to the dentist until the balance is paid. Below is a link from my employer website that supports Dental Dental would be primary.**************************************************************************************************************************************************************************************************************************
Business Response
Date: 08/21/2023
Good morning,
Your complaint has been received and is under review.

Thank you
Initial Complaint
Date:08/14/2023
Type:Sales and Advertising 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.
Subscriber to AARP Dental Insurance since April 2021. 11/17,12/1,&12/13 had dental procedures done (fillings) After the fact the dentist office said I had to file claim and I had to pay the $600 charge. Contacted Delta several times before I could get forms. Finally forms completed and sent but getting the run around and no reimbursement..Each time I call I get a different response and always will get back to me. I even filed a grievance and the person with whom I spoke told me there was missing information on forms so I went to dental office and had the missing information faxed to them and as of yet no response. I cant believe AARP would be part of this organization. Its disgraceful that at 81 I am subjected to this when they have been deducting monthly payments from my account. They need to be held accountable. I would appreciate help or advice so I can have closure and then cancel the policy. Thanks
Business Response
Date: 08/21/2023
Good morning,
Your complaint has been routed to the grievance and appeals team for review. I have found your submitted claim and receipts and attached them to the case since the previous case was upheld that this information was not on file. We sincerely apologize for any incovience this has caused you.

Thank you
Customer Answer
Date: 08/21/2023
This is another example of Deltas evasive tactics. Claim submitted in March & when no one contacted me on May 11 I called, spoke to ****** who said he didnt see a claim. However he was able to describe my personal stationery that was attached. How was that possible so I asked to file a complaint. I then was told I had to submit complaint in writing which I did. Received letter dated June 8 CaseID GRV65322 they were reviewing my case. Then June 19 anther letter Case ID APP ****** stating no claim on file. On June 23 called spoke to *********************** & told she would get back to me. June 29 called again & spoke with ********************* who told me problem was 3 missing items on claim form & once received they could move forward. Wow! A claim form emerged! Went to dentist office to retrieve information but instead of giving me their policy was for Delta to call them. On July 21 called & spoke to ******* to pass on the information & she transferred call to **************** & I gave information to ****** She pulled up claim and the status was Pending. She wasnt sure how she could add missing information if she called dentist. I mentioned the names of ********************* & *********************** who she said were supervisors. So on July 24 I went to dentist office and requested they fax missing information to attention of both supervisors & I stood there & observed while it was done. Now I dont know what else can be done unless I start from scratch with filing the claim or I get a lawyer. I was trying to protect my social security income but maybe thats an option to get a lawyer. I will await your feedback with them. Thanks. ***************************
Business Response
Date: 08/22/2023
Hello,
Thank you for your response please allow time for our grievance department to look through all the details of the complaint.

Thank you
Customer Answer
Date: 08/22/2023
Actually theyve had more than enough time to review details.If no response by August 29 2023 I will seek legal help and report them to which agency monitor their business. I am more than gracious and reasonable. Thanks for your effort. I appreciate you.
Business Response
Date: 08/24/2023
Hello,

Thank you for your response, We apologize for your dissatisfaction and ensure we are working on this issue for you.

Thank you
Customer Answer
Date: 08/24/2023
I indicated in my last response that I would like a resolution by 8/30 so I would like to wait until that time giving them every opportunity to make this right and based on that response I will release you from this case. Thanks
Business Response
Date: 08/25/2023
Hello,
Thank you for your response. We appreciate the opportunity to assit you.

Thank you

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