DentaQuest
reviews and complaints

My upper left canine (#11) broke and a large piece fell off (exposing the nerve and creating a "pocket"), on October 15, 2023.

On Oct 16, 2023 Dentaquest informed me that my preferred dentist is not in their network and they referred me to one off "their people".

Over 3 months have passed since then, I have had 3 appointments with two of their dentists, and I still have this broken tooth!

I cannot eat or drink without extreme pain, and have spent many many hours on the phone with them. Yesterday they told me that the authorization request was not received until Jan 23, with a 48 hour decision time-table.

This was said on Jan 29. I believe that 38 hours would have ended before the 26th. On Jan 30, there is no change. How many months does it take for "emergency care"?

They either need to fix their system, or get some professional dentists in their network!

is with Denta Quest. I have been trying to find her a dentist for over six months. They keep giving me the run around, saying that someone will call me to find her a dentist and make her an appointment. I am continually calling with no results. I ask to talk to supervisors who tell me they are putting it in as high priority, but still, nothing happens. I then ask for a manager, and they always come up with reasons a manager can't talk to me. I have filed a complaint; still, nothing happens. I called again today, and they said they would put it as an emergency. I said no, that's been going on for six months. Nothing happens; can I speak to a manager? Today I get, "Sorry, they are in a meeting." My daughter now has a hole in her tooth and wakes up crying. A 14-year-old shouldn't have to go through this because of incompetence. She now will probably have to have it pulled. Hopefully, this complaint will help

The Optima Medicare Advantage plan contracts with Denta Quest for the dental insurance offered with the plan. When it was time for a cleaning I contacted Denta Quest who told me that Aspen Dental in Harrisonburg VA was in their network and they made an appointment. When I arrived for my appointment I completed the paperwork and turned that in along with my insurance card only to be told that Aspen does not accept DentaQuest and is not part of the DentaQuest network.

I would like to know why Denta Quest lied to me. I live in the country and it was a long drive into the City for what turned out to be a waste of time and money.

I don't understand the 180 and 365 day waiting period for actual dental work to be done beyond cleaning. I recently retired and had to open enroll in dental coverage. I choose one of the more expensive plans and wrongly assumed it would be comparable to "regular" insurance companies.

The insurance should list the actual coverage dates to begin 365 days from your first payment. You don't have any significant insurance until then. You are charged a full year of premiums before you can actually use most of the coverage.

I guess the good news is open enrollment begins soon so I can switch to another company.

This company has a contract with CoreSource - Medicaid Ohio

They state they have a network of more than 100,000 access points nationwide. I have been trying for months to find a dentist to no avail. I was told they find me a dentist 50-miles 1 way from where I live. That is a 100 mile in one trip. That is not acceptable. I was then told I don't know what to tell you. They have no dentist to offer here in the Cincinnati area. They have called themselves and find out that. They have numerous complaints with the BBB for the same thing. The there is an Alert on the BBB page.

CURRENT ALERTS FOR THIS BUSINESS

Pattern of Complaint:

According to BBB files this business has a pattern of complaints concerning consumers who experience difficulty using the business’ website to find a provider. Consumers state that the information on the website is out of date or incorrect, and that the business does not resolve issue(s) when contacted by phone, as they often experience long wait times when calling. Consumers indicate that they want easier access and to current and correct provider information online and via phone, as well as better customer service. BBB sent a written notice to DentaQuest Group, Inc. identifying the potential pattern of complaint with a request for a business response. As of 4/5/2019 he business did not respond to BBB's request.

DentaQuest page even states

Reliable Member Access to Quality Dental Care

Time-tested recruitment strategies and network support from local teams ensures your members have access to the right providers when and where they need care, from routine prevention to restorative treatments.

A network of more than 100,000 access points nationwide wrapped with tele dentistry services for 24/7 coverage.

Digital Performance Reports track provider performance according to claim volume, diagnostic codes, and other categories

Simple and intuitive onboarding, claims processing and administrative management makes dentists want to treat more of your members.

They are unable to provide what they are stating.

This company is literally the worst. They pay for basically nothing. They ONLY pay for routine cleanings every 6 months. That's it. Nothing else. Don't have a cavity. Don't need an extraction. Hopefully you're blessed with perfectly straight teeth (no child ever). I've been dealing with this company for 6 years and NOT ONCE have they surprised me and paid for a service outside of a routine cleaning. I have 3 children with a variety of dental needs. Sad and disgusting.

Nevermind how UNEDUCATED their staff is - save yourself and just pick ANY other dental insurance. Don't bother with their appeals process either - that's a complete façade.

Tooth #21, fractured off dl, ml, and full occl of tooth. 1/2 tooth missing. Dentaquest denial reason,

the tooth does not appear to have significant breakdown. Who does this company hire to review there claims?

Resubmitted with photo, denial additional information within 60 days of denied claim? WHAT?

THEN SAYS DECISION IS BEING HANDLED AS AN APPEAL.

Automation said approved btw.

Get letter asking why Office has not sent in an appeal. THIS IS JUST WRONG!

All should send complaint to state insurance commissioner, or if Medicare the Medicare board of insurance.

It's been 5yrs since I received my first dentures, regular wear and tear has them completely useless. I never hardly use my medicid, when I called and tried to get a new set,they told me 1 set every 8 yrs,which is absolutely ridiculous, because anyone knows acrylic dentures do Not last that long,another crooked company, please let me know about any lawsuits being filed

Approximately 5/3/2022, I went to a Dentist. Your Bronx Dentist located at 3310 Bainbridge Avenue, Bronx, New York, I wanted to get full mouth dental implants. I had with me $6,000. my life savings. When I saw the Dentist he advised me that it would cost me over $50,000. The Dentist was not in network with Healthfirst. When the the dentist told me that, he also said since I told him I could not afford that, that he could do for me a lower dentures since I already had my upper dentures. I was so disappointed that I could not have full mouth implants that

I completely forgot that Healthfirst would cover the dentures that I wound up paying all my $6,000. to the office manager. When I realized that I made that mistake I went back and spoke to the office manager that I wanted to be reimbursed my $6,000. she informed me that I could not get all my money back because they had already started working in my mouth. Teeth were extracted, bone graft was done, stitches and impressions were done. She said that she would have to contact Healthfirst to see if they would pay for the dentures then they could reimburse me for that amount. However, every time I had an appointment the office manager told me that she could not get through to Healthfirst, that they were giving her the run around. So I took it upon myself to contact Healthfirst member services myself. I explained everything and was told to submit a complaint to Dentalquest, which I have done. I mailed my complaint on 7/28/2022 with all the documents requested I have not heard anything since. Please

I need to know the status of my complaint and I really need my money ASAP. Thank you.

They have denied for the 5th time crowns on my son's 4 front teeth. After approving him to have 4 root canals done on these teeth ( root canals were done several months ago) the reason for denial (1) must be needed to protect life, prevent significant illness or disability or alleviate severe pain (we have been back to the dentist several times to replace temporary fillings that usually fall out before we make it home but mire importantly is the numerous times antibiotics have been prescribed which take days to work so my son goes days in crying pain) apparently the people at the desk denying these claims have never had a toothache or a child in pain. (2) must be individualized specific consistent with symptoms or diagnosis of illness or injury and not be in excess of the patients needs. ( why would root canals be approved and done and not the remaining crowns to.complete the procedure that was approved) my son's dentist has sent over 5 requests stating my son needs these crowns done. Why isn't the dentists recommendation being approved. I'd really like to see the medical/dental credentials for the people that are denying these claims. I will be contacting my state officials for help with this matter as I am a tax paying citizen

I was given an external referral because all 4 of my wisdom teeth are impacted, bone on bone and need removal from my dentaquest dentist. I was referred because of the need for surgical removal, as none of the 4 teeth are ever going to erupt Theyre coming in sideways. I've had awful headaches, toothaches, sinus issues, its impacted my eating and daily life on almost daily occasion, and I think even my teeth are shifting because there is not enough room.

Talked to Caresource/medicaid with my symptoms and the oral surgeon said the top 2 need to come out and are surgically able. Dentaquest on their site lists that impacted teeth are reason for removal.

With all the correspondence I've had between Dentaquest, I've repeatedly been told "there is no medical reason to remove them". No matter of incorrect or correct paper submission will help, support service is poor and no use at all. This last claim I was also never contacted of this denial via mail or oral surgeon office after waiting 2 months.

With three separate professional opinions and correspondence with Medicaid, I cannot see why this is not medically necessary. I have had 3 Caresource caseworkers work with issue that is impacting my health but nothing has been accomplished. I dont believe their in house dentists accurately look over claims and often deny very quickly in response. The x-rays submitted show the problem clearly on there but apparently not to Dentaquest.

I currently have Optima Health who partners with DentaQuest. DentaQuest is the worst company I’ve ever tried to deal with. They set me up with an appointment with Aspen Dental. Then they denied my insurance claim saying that Aspen is not in network. I filed a complaint with Optima Health and with the State of Virginia. I spent over a month fighting this battle. The whole Medicare advantage type plan is a scam to take your Medicare payments and replace Medicare with unscrupulous insurance operators. Combine that with advantage plan partnerships with totally unethical companies like DentaQuest puts a thief in your pocket with little to no recourse. Insurance companies are thieves and DentaQuest is the worst of these thieves.

Good Morning ,

My name is Tyshondra Barnes I being under DentaQuest plan for about two years and it under Humana. I being having issues this plan in regards to helping me find a dentist in addition, That covers this plan . None of the dentist offices they sent to has not work and I raised my concerns in any event , I dealt with rude customer service over the telephone. I addressed my concerns several times about me not being happy about getting the right service in any event, No to this day did nothing .

An absolute rip off.

I need an oral surgeon. I paid for their higher cost option to make sure it would be covered.

Come to find out, nobody takes this insurance. There are zero oral surgeons that take it.

The dentists that take it, aren't board certified, which a dentist told me is mandatory to even be one.

I'm still gonna be out of pocket for all these costs that I got this insurance for in the first place.

I have be paying premiums to Dentaquest insurance since January of 2020/ two years. I used the insurance for a new crown in August of 2021. I called them in July of 2021 to verify that I was covered. I was told yes. After the $1300 crown was in place, I paid my portion 50%.
Dentaquest have refused to pay there portion. I called them with the dental office on the line. They instructed to dentist to resubmit the invoice. Nothing was done. Called the again, now its January 2022. They said its a mix-up with HIX. They gave me a phone to HIX (1-877-623-6765. Called HIX and they told me they have never head of Dentaquest, they are not one of there vendors.
Called back Dentaquest, they gave me and email address (entollment@dentalcareplus.com) said enrollment would fix, Its been two plus weeks and no response to the email. Call them back on 1/20/2022 regarding the payment on the claim, agent told me I don't have a policy with them., its has been cancelled. Now my premiums are paid up until March 2022. So no notification that I am being cancelled, just my policy has been cancelled and premiums for the next two months will be returned.
They cancel you policy at the end of each calendar year, then reinstated if you press so that you do not qualify for major dental work. They did it twice to me.

I Insurance commissioner or someone in big government should look into how this crooked company is scamming hard working people out of their money.

My daughter has to have her wisdom teeth out, due to her mouth being small and the teeth are buckling and crowding her other teeth, which is starting to cause damage. In addition, the crowding due to these teeth are causing debilitating migraines, which caused her to miss a lot of school. The dentist said they need to be removed, and gave a referral to an oral surgeon. The oral surgeon saw her and took exrays, then submitted for the surgery to DentaQuest. DentaQuest denied it saying it is not medically necessary. Are you kidding me? This is causing massive migraines and is causing buckling of her other teeth... how is this not medically necessary? What, she is supposed to just suffer her teeth being pushed to the point that it causes worse migraines almost daily or damage to her teeth that will cost the insurance even more to fix? What do we pay this company for? Called the insurance company and they said it is not medically necessary, and they cannot change that. Seriously?

Refusal to cover wisdom teeth extraction causing extreme pain and suffering for a minor.
My contact is [protected]@karas1.com [protected]
DentaQuest Claim/Pre-Auth attached with minor's personal information redacted for privacy purposes.

According to the American Dental Association, wisdom teeth removal may be necessary if you experience changes in the area of those teeth, such as:

Pain