Complaints

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:10/31/2023

  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.

  I have Delta Dental of MO for my dental insurance. My dentist is no longer going to be in-network with Delta Dental on January 1, 2024. I reached out to Delta to ask how much they will pay an out of-network dentist in zip code ***** for 3 *** codes. How can I budget for my FSA/HSA card without knowing how much I will be paying out of pocket? Delta sets the maximum plan allowance for these codes, but will not share these fees with covered members. They said have my dentist send in a treatment estimate. I have to get my teeth cleaned every 3 months. Which is January 2024. It takes Delta 4-6 weeks to process an estimate. My dentist can't send the estimate until January 1, 2024. If they send it now Delta will process the claim as my dentist being in-network still.I feel Delta Dental should be transparent with what the maximum allowance fees are for its members.

  

  Business Response

  Date: 11/20/2023

  Delta Dental of Missouri (DDMO) has recently responded to similar inquiries and complaints submitted by ***** and ***************************.  They have made direct inquiries to DDMO, as well as submitting requests through the labor union which provides their dental benefit plan.  The ********** have also filed a complaint with the Missouri ********** of ******** and Insurance. 
  
  DDMO has responded to all of the Felsingers direct inquiries and complaints. We have provided them with a variety of options to obtain cost estimates if they choose to get services from an out of network dental provider.  As a DDMO subscriber, ********************** can register on our website and use the Dental Cost Estimator, or he can access the independent Fair Health website for consumers.  In addition, ********************** could request his provider obtain a pre-determination of benefits prior to receiving treatment.  
  
  The Felsingers will receive optimum benefits under their dental plan if they utilize an in-network provider.  DDMO would be happy to provide them with a directory of the many participating dentists in their area.  

  Customer Answer

  Date: 11/20/2023

  Complaint: 20805112
  
  I am rejecting this response because:  The two options Delta says we can use to determine our out of pocket amounts do not actually provide the required information. See attached.  Having my dentist send a prior authorization takes 4-6 weeks for Delta to respond with what they will pay.  This is unacceptable since my appointment is before Delta will respond.  I don't understand why Delta refuses to provide what they pay on dental procedures.  
  
  
  
  Sincerely,
  
  *****************************

• Initial Complaint

  Date:07/17/2023

  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.

  On 3/6/2023 My dental provider advised me that I needed a deep cleaning on my teeth & that before they could schedule the procedure they needed to send a pre order to Delta Dental, which covers said treatment. I have telephoned Delta Dental 3 times since March and each time they tell me that they are sending over to a supervisor and someone will call me back. In the meantime I am paying for insurance and cannot get the treatment my dentist has recommended and the health of my teeth are declining as it has almost been 6 months with no response from Delta Dental.

  

  Business Response

  Date: 07/18/2023

  Dear Ms. **********,

  Thank you for your inquiry.
  We apologize for the delay in getting your treatment plan
  processed.  Our records show that the pre-treatment estimate was approved
  and returned to your dental office on July 11, 2023.
  If you have not heard from your dental office, please
  contact them to discuss the estimate and set up your appointment.

  Delta Dental of Missouri

   

• Initial Complaint

  Date:01/31/2023

  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.

  On JULY 17 2022 I had a tooth extraction at EMERGENCY DENTAL CARE US ROSEVILLE MN. for $600.62. I gave them my insurance card but they said I would have to pay first and then they will submit my insurance info. to make a long story short, No one has paid my 600.62 back to me, my Insurance (Delta Dental) said they would pay me in full but won't because the Doctor ******* ***** was not crendentialed at the time of service. After calling both the doctors office & Delta Dental Several times over the last 6 months , i still have not been paid back. I was very patient each time I called and was very nice about it, I felt like I was getting the run around. The guy in the dentist office said he doesn't have time to be calling delta dental. and Delta dental kept saying different things to me, I asked so I am just out of Luck? and she said no but because he was credentialed it was like having my neighbor pull my tooth out so they will not pay, But I was thinking its not my fault that the doctor wasn't credential , he is now credentialed, So one time I called she said the check was on the way to the doctors office and I explained to her that they said the check was supposed to go to David, and she said she would change that in her notes, We have called several times Speaking with different people each time, and each time it looks like delta dental will take care of it and still nothing has happened. I called in mid December and the agent said she would expidite the case and take care of it and it would be taken care of by the end of December, but still nothing has happened.... I now i have word from emergency dental saying that Delta Dental should take care of this and pay me back. as this is why we pay for insurance, Please help us get the money back, I am STILL out 600$ and its ***lding interest on the credit card.

  

  Business Response

  Date: 05/22/2023

  We apologize for the delay in responding while we worked with several other entities to resolve Mr. ***’s complaint.

  In July 2022 Mr. *** received services from Emergency Dental Care USA in Minnesota.  When the dental claim was received by Delta Dental of Missouri (DDMO), we were unable to process the claim as benefits could not be determined based on the provider information submitted on the claim.  Unfortunately, the dentist Mr. *** saw, was not on record in the Delta Dental Plans Association database.  Mr. ***’s claim was denied with the following explanation.

  Benefits could not be determined due to the providers tax id, license number, and/or the treatment location submitted is missing or is different from the one on file with Delta Dental.  Once the provider registration with the local Delta Dental Plan is completed a new claim will need to be submitted for benefit consideration.

   

  DDMO worked with Delta Dental of Minnesota to establish a record for Dr. ******* at the office location where services were rendered