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Delta Dental Plans Association
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Delta Dental Plans Association
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www.deltadental.com
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2.7 24 Reviews

Delta Dental Plans Association Complaints Summary

10 Resolved
14 Unresolved
Our verdict: Dealing with Delta Dental Plans Association, which has an average resolution rate, requires some diligence. Research their service in depth and read a variety of customer reviews for a balanced view. Approach any customer service interactions with detailed and well-prepared queries to facilitate a better resolution process.
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Delta Dental Plans Association reviews & complaints 24

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5:09 pm EDT
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Delta Dental Plans Association Coverage refusal

I pay my premiums on time, and I comply with the requirements of my plan. I had dental scaling on both sides of my mouth, which AARP Delta Dental pre-certified as covered. I complied with their plan requirements as stated in my manual. After I had the scaling, AARP Delta Dental reversed itself and is now refusing to cover $100 toward the scaling. On June 1 2009 I filed a complaint with the Pennsylvania Insurance Department against AARP Delta Dental about this refusal. When I spoke to the Insurance Department agent handling the case on July 7, 2009, she said that AARP Delta Dental had requested, and been granted, an "extension" on the deadline for responding, saying they needed the extra time to gather their information to present to the Insurance Department. I am entitled to have this procedure covered. Through my dental provider's office, I have been told that AARP Delta Dental is claiming that I had scaling twice on the left side of my mouth, according to their records, and that's how they're justifying their refusal to pay. My provider, U of Penn Dental Clinic, says that they have provided AARP Delta Dental with accurate information, reporting that I had the scaling on both sides of my mouth, and that AARP Delta Dental pre-certified the treatment.

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6:05 pm EDT
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Delta Dental Plans Association Joseph Faroosh

Second complaint filed against Dr Foroosh and his underling Dr Dexter Dejesus for refusing service to me in 2008.
ALso their neglect and slow treatment nearly resulted in my having Oral Cancer from teeth #s 30 and 32. These Dentists were well aware of the danger these 2 teeth would cause and did little except prescribe
Amoxicillin for 2 weeks (Nov '08)
Now, they are threatening to send my account to a Collections Agency
for non-payment of $54.00. Yet there is no description of what service
this amount is for.
Delta Dental (my insurance provider) is aware of this situation and
recommended that I switch Dentists.
However, I still have no resolution to my dental needs and I am certainly not going to pay Desert Dental

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4:23 pm EDT
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Delta Dental Plans Association changing ada codes to pay minimum benefits

Our office has been billing delta dental for a long time and the past 2 years have been a little trying. When our office bills out for full comprehensive orthodontic treatment on adolescent patients d8080 delta dental will change the ada code to d8070 (phase I ortho code of transitional dentition) in order to pay out a lessor benefit amount. I usually catch it when I am missing payments and it isnt paying out the full estimated benefit based on the patients treatment fee and lifetime maximum. I have fought with them several times on several patients to the point of parents getting the insurance commissioner involved and I have contacted the ada and the aao to verify what I know is right... It is illegal for insurance companies to change ada codes from what you billed them. They are trying to say they are basing it on the childs age! Which is irrelevent to the type of treatment a patient receives, children are not a robots each child is different and are at different stages of dental development which the orthdontist or doctor knows, not an insurance company looking at an age and an ada code to determine this. I want to complain to someone who can hold an insurance companies accountable from a professional/ dental office. Is there such an agency because I believe we are not considered the consumer?

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FAMILY RIGHTS
Birmingham, US
Jun 17, 2009 10:20 pm EDT

Contact the ADA and send a cc of the letter to your state's insurance regulatory agency/commissioner as well as your state's federal representatives (congressmen/senators).

Keep a copy of all your correspondence and document all conversations (dates, times & who you spoke with).

Any correspondence you send, keep a copy of it - and send it all return receipt so you'll have PROOF that it was received. Talk to the orthodontists or practice managers to see if they have an attorney who can take this up if your practice is being defrauded.

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5:55 pm EDT
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Delta Dental Plans Association Excessive Costs

I spoke to an Delta Dental rep about dental coverage for my 81 yrs. old mother. I was told the best price was thru AARP. I enrolled her in the AARP Delta Dental program and as of January 2009 she has coverage. Imagine my surprise when I was on line, looking for dental coverage for another family member, that regular dental coverage thru Delta Dental is $123.00/yr. with better coverage than what I bought for my mother for $588.00/yr. thru AARP Delta Dental. When I called Delta Dental, they said they had nothing to do woth AARP Delta Dental and that we could cancel her AARP Delta Dental coverage but there would be no refund or pro-rating because there was a clause stating no refunds after 30 days.
After her year is up, we will be seeking coverage elsewhere since apparently AARP and Delta Dental have rep's working for them that are liars, don't know their job, and sell their higher priced services by telling us that's t he best and onlky coverage one can get.

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myrna-ann
East Brunswick, US
Jun 18, 2010 2:06 pm EDT
Verified customer This comment was posted by a verified customer. Learn more

Wait until a claim is made and processed. This company has assigned unrealistic amounts that they will pay for various procedures. And they make it difficut for you to get this information even after you have signed up. You find out after you have submitted your claim.

I had a filling done, for which the the dentist billed $173. AARP Delta Dental approved the full amount but that's not what they used to determine what they would pay. Their contracted amount for the procedure was just $75- the price of a filling maybe in 1960. They paid 50% of $75 less the deductible which came to a grand total of $12. The next filling (with deductilke met) would be $62 from them with $103 my responsibility. Not ot mention the $100 monthly premium. It's as if the customer pays the premiums plus the main cost of the dental work; this insurance covers what would normally be a co-pay.

To get a better idea of how the plan works, I phoned to request the contract amount they will pay for a routine cleaning. The customer service rep did not give it to me, although surely they know. I will have to call back with a diagnostic code number. They advertise that now they allow 3 cleanings a year; not much of a benefit if they will only pay 50% of 1/3 of the bill.
.
The company is very clear that the amount they approve for each procedure is not the amount the contract will cover and depending on the bill you may have to pay more than the 50% they advertise . But in all their examples of how it works, they show a bill of $90 with $80 the contract amount; or a bill of $100 with $80 the contract amount. What actually happens is that the contract amount is less than half of the bill, closer to 1/3. And it is that number they use when calculating the 50% they will reimburse.

I am surprised that AARP has put their name on this insurance policy. I think seniors would be better off using the money spent on the yearly premium to pay their own dental bills.

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Phone number

+1 (630) 574-6001

Website

www.deltadental.com

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