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DentaQuest

DentaQuest LLC

465 Medford Street
Boston, Massachusetts
United States - 02129-1454

Customer Service

+1 888 278 7310(General Member Services) 1 2
+1 800 466 7566(Hearing Impaired Line) 2 0
+1 800 341 8478(Provider Relations) 2 0
+1 800 936 0913(WellCare National Medicare Providers) 2 0
+1 800 294 9650(Utilization Management) 2 0
+1 800 237 9139(Report Fraud) 3 0
+1 800 417 7140(Main Corporate Phone) 4 0
+1 262 834 3735(RFP Related Inquires) 2 0

Complaints & Reviews

dental insurance through marketplace.gov

[protected] Group number: [protected] DentaQuest
I signed up for this insurance through the marketplace.gov for pediatric high option which was to cost 49.98 according to the marketplace. Received no info in the mail but called to receive billing info to pay premium which I was then tol would be 66.64. I chose a dentist from the dentaquest website based on my plan and verified with them prior to the visit (Jan 3 evening) that my insurance information was correct and verified. (Children's Dental health of Downingtown, 19335)Time of visit (Jan 6, 2pm) (with a very nervous 7 y.o. taken out of school for the dental work) I was told insurance wasn't in and I would have to pay $220 for the visit or they wouldn't be able to work on my son. I did so, assuming it would be worked out with the insurance. Now I am told by the dental office that they terminated their contract with that insurance in 2018. DentaQuest representatives have taken my information and told me they would call me back multiple times without ever providing an answer as to whether they have a contract with said dental practice or not. Practice says they can't bill due to no contract. Insurance premium paid. Dental bill Paid - more bills coming. No dentist for ongoing needed work for my kids. attached is the dentaquest website dentist search tool and results which I used to chose the Children's Dental Health, 19335 for my children's care.

https://govservices.dentaquest.com

Please contact me at [protected] to help me navigate this time consuming issue. thank you,
Laurie Taylor

dental insurance through marketplace.gov
dental insurance through marketplace.gov

dentaquest could not provide an oral surgeon within 100 miles of me.

For anyone even thinking of Emblem consider this. They have denied a doctors request for an MRA for my 43% blockage and will only approve it when it gets to 70% blockage.
Then I needed a dentist so they "researched the Latest listings" and came up with 3 dentists who nearly dropped the phone when I said I had Emblem . Then I complained about them giving me such a lousy choice and they actually got a conference call going and a Supervisor for their partner in crime Denta Quest said she would get to the bottom of this and did more research and came up with, get this, sending me to the kids practicing on humans at Stonybrook and yet Another dentist who won't take Emblem or Denta Quest . They searched over 100 miles on long island and came up with nothing but lots and lots of emails, phone calls, and not a single oral surgeon in all of Suffolk County. I am not saying the other companies are any better but this is my experience with Emblem.

denied wisdom teeth removal

My daughter was given a referral from her dentist to have her wisdom teeth out. The surgeon sent her xrays and a report to DQ stating she was having headaches, intensive pain, not eating well, under pain medication for over a month and she took antibiotics for the infection, and all 4 teeth were impacted. DQ denied the upper teeth and only approved the lowers. My daughter is being in pain for over a month now. I have appealed the decision and filed a grievance but the receptionist said they do this to Kids all the time. And every time I call DQ say since there's no infection is not medically necessary. They failed to see that she already took antibiotics to prevent the infection to spread. My daughter will get the lowers taken out next week and probably not be able to do the uppers until much later because we don't have the money to prevent her going through this procedure twice. DQ claim that the board reviewing the claims are all dentists but I wonder if that is true because On their website it says that "insurance consultants" make the determination based on submittal of the dental climate form and they can't really say if is medically necessary or not because they do what's on the script for them. Now I have to either come up with over a thousand dollars or wait until my daughter's teeth gets infected or inflamed to get them removed. Just not fair.

customer service

As a provider I have been on hold waiting to talk to someone for an hour and a half. We are not even a provider with dentaquest anymore (for this reason exactly). A patient of ours was incorrectly directed towards our office claiming we are a provider with them (even though the automated system even knows we are not). I am just simply trying to help a person with this very very bad insurance find a dentist they can go to... An hour and a half and still not a single human has spoken.

denial for orthodontist service

Wow! I'm a single mother with a special needs teenager and after reading everyone's heartache in dealing with this company is it worth requesting a review? Its FL Medicaid? He has TMJ migraines grinds teeth crowding over/underbite speech issues mouth pain and DQ Ins rejects claim. Saying "Our dentist looked at the information sent" Hmm I question that statement.

braces denial

My son has crowded and impacted teeth and my dentist agreed he needed braces and gave us a referral to an orthodontist. The orthodontist agreed he needed braces and said they highly doubt I would be denied since he has impacted teeth. Well, Dentaquest denied us. We went back to the dentist a few months later and he couldn't believe we were denied and gave us another referral to a second orthodontist. This orthodontist could not believe he was denied and agreed it was medically necessary for braces. He said there was absolutely no way they could get "21 points" when he clearly had "28 points" (26 points are required to be approved). Dentaquest denied us again. This insurance is such a SCAM. Something needs to be done! There is NO reason kids (and adults) should have to suffer because they don't want to pay!

Periodontal

They denied deep tissue cleaning. The dentist told me to resubmit the claim "because Dentaquest often lies." I printed out Dentaquest's guidelines for covering this procedure and brought it back to the dentist this morning. The dentist showed me the claim they submitted and it matched exactly with dentaquest's guidlines yet they still denied it. What they're doing is illegal and immoral but I guess they don't think patients will do the research, because they just made it very easy to take legal action.

service/ providers/customer service

When tell I've never been so pissed off I've emailed Steven Polluck the CEO of this company to think the issue would be resolved about continued car for my son and braces and now he has devolved and infection and has been hospitalized and now being treated for an infection that hopefully doesn't spread through his body. No supervisors call you back and I've been waiting months I'm highly pissed off.

lack of dental benefits

I have been calling for over 6 months I believe to get benefits for my mother, Alberta Siegel. She has a cracked molar that needs to be removed and a front tooth that has fallen out. I have received very few names of dentists in my area. She originally went to one that is now claiming it is no longer 'credentialed' with you. A waste of time. She went to Polo Dental a few months ago and no one has bothered to call me back. They also barely speak English. My mother has been in pain for months and looks like a hillbilly missing her front tooth. Your service is a sham. Very few competent adult dentists in my area and no follow up from the lousy dentist we were forced to go to. I have called your corporate office but can't get through. Obviously you don't want to hear complaints. Now I have no choice but to file a complaint with AHCA and the Governor of Florida. Dentaquest is nothing but a ripoff for taxpayers. Taking their money and providing no services. Shameful!

customer & provider service, the lies

Omg, this consumer DentaQuest has been a complete nightmare I have been calling and recording calls with customer service for over a month and yet nothing has been resolved. They keep you on the phone well on hold over 30 minutes without checking back. Oh my how aggravating when you're at work trying to take care of business for you kids. I've made two complaints were I received an confirmation [protected]-01&[protected] and each time I was advised I would get a call back and i have yet to receive a callback and I'm sick of it nobody wants to help. Even the corporate level nothing is done. Pissed parent!!!

  • Th
    ThanhH Oct 07, 2019

    This DentaQuest is a very very very bad dental insurance in the USA. They never solve any problems when you called. They deny the coverage on check up and cleaning twice a year and didn't approve for wisdom teeth removal, they always had mistaken when my dental office summit the claims so they don't have to pay for the services, I feel like Who ever has a bad luck to get their dental insurance. what a nightmare when you deal with them.

    -1 Votes

needs for my daughter, but they won't pay..

My daughter went to the dentist and the dentist said she needed braces but dental quest won't approve them for her. Stating it's not medically necessary for her. How can they make a determination like the Dr. doesn't no what he's doing..they not the doctor and they haven't seen my daughter to make a decision like that..the reviews that I seen about them making me wanna change plan.. they don't care about my child well being, they care about saving them money to not pay.. can't wait to find better that will put my daughter needs first..

customer service

Nobody answers the phone. I've been trying to call to see if my child's regular appointment will be covered, since a dentist came to my kids school, because she will be due in a few weeks, but when I call, all I get is an automated system asking for a number I don't even know what it is & it goes on to playing music. I've tried calling 2x just today, which I'm actually on the phone right now, and I've been on hold for 35 minutes already & nobody has ever picked up the phone. How am I supposed to find out this information if nobody will pick up the phone, because I also have to make an appointment by a certain date but I can't even see if I'm allowed to because they won't pick up the phone.

I paid you guys thru doxo for a payment of 35.00

445699 Paid Denta Ouest a payment of 35.00 was supposed to be Denta Trust. Someone from Denta Ouest cashed the check knowing that I Barbara Mayes do not have a plan thru Denta Quest. I...

incompetent - idiots should be in jail.

A few days before Christmas, I developed a toothache. I went to our local
provider (Charlotte County Health Department), who informed me that I
needed the tooth removed by an Oral Surgeon, due to an infection. He
could not do it, and gave a me a list of reasons. Reasons such as "we're
closing for the holidays in an hour". Now, I have survived Sepsis back in
2014, and open heart surgery, during which I received an artificial Mitral
Valve. I have tooth infection, plus a a history of Mitral Valve replacement
and Sepsis. Anyone with a medical background knows I am at big risk
with a tooth infection. So the Dentist at Charlotte County Health
Department sends me home with a prescription for a ten day supply of
clindamycin, and refuses pain meds because of an "opioid crisis". He
also informs me that he couldn't work on me anyway, without a prior
approval from my primary physician, and a separate approval from my
insurance, Molina Healthcare.
So I call my primary, which is North Port Health Center. I tell them I
urgently need an approval, due to my pain, and the risk due to my heart
condition. I leave a voice mail, stressing the urgency of my situation.
North Port Health Center never calls me back. I then call Molina
Healthcare. They put me in touch with "Dentaquest", whom they say is
my dental insurance provider. Dentaquest gives me the names of two Oral
Surgeons, that will take my insurance. They are the only two within an
hours drive.
The first one, "Great Expressions", in Ft. Myers, tells me that they have not
actually had an oral surgeon there for some time, so they cannot help me.
The second one, "Coast Dental" in Cape Coral, takes my info, verifies my
insurance by having me give my member ID, etc., and schedules an
appointment for January 3rd, 2019, about a week and a half from the day I
called them. It was the best I could do, so I took the appointment, and
continued taking the antibiotics.
At about One O'Clock in the afternoon of January 3rd, the day of the
appointment, Coast Dental of Cape Coral calls me and says "Sorry, we
don't take Molina Insurance, as of the 1st of January". Yes you read it
right. Two and a half hours before the appointment that I had counted on,
and scheduled mine and my families time around- "sorry, no appointment
for you. Bye".
I then call Molina Healthcare and ask what I was supposed to do. I need
the tooth out, I waited and took the meds, and now there is no oral
surgeon that will see me. Molina refers me back to Dentaquest. The
Dentaquest automated phone system takes my insurance info, then has
me on hold for 2 hours straight, before hanging up on me. I call back,
and eventually get a live person, and I explain the urgency, with my tooth,
my history, my heart, etc. The person refuses to identify themselves,
and they tell me that they need to figure out why I "have two health plans
in the State of Florida", and if I am "supposed to do that". They refuse
to discuss my urgent need, my pain, and the fact that they sent me to
oral surgeons that either don't exist or were about to drop Molina from
their coverage plan.
I tell the person that their paperwork is not my problem, and that I just
need to see someone. They try shouting me down, as I explain about
my heart. Then they hang up on me. (Yes, I recorded the conversation)
I then call Medicaid Administration in Florida, who tells me they can't help
me until my grievance with Molina is resolved (could take 3 days), and then
after that, a Medicaid investigation (could take another week to 10 days).
They say I need to call Molina back, and have them straighten things out.
I call Molina back, and they say they have nothing to do with dental care at
all, but they will call Dentaquest for me anyway, straighten out their
coverage issues, and they will call me back with all the information I need
to be seen. They have not called me back. Why am I "shocked"?
I am nearly out of antibiotics, my tooth hurts, no one will see me, and I am
very concerned about my heart.
It's 10:00 am on the 4th of January. No one has called me.
My conclusions:
North Port Health Center failed to call me back, when faced with an urgent
request. Charlotte County Health Dept., should have treated my tooth. It
was medically necessary. Molina has not followed through with promised
info. Coast Dental failed to inform me of their intention to drop Molina,
thus extending my pain and increasing my risk for Endocarditis.
Dentaquest- where to begin with them? Knowing the risks I face, they
sent me to two providers, one that was not an oral surgeon, and another
that was about to drop the insurance plan. During the first call to
Dentaquest before Christmas, they either knew or should have known that
Coast would not be able to help me after January 1st. On the second call
to Dentaquest on January 3rd, they shouted me down on the phone and
hung up on me, when I insisted we deal with the provider issue, rather
than their perceived "two plans" fantasy.
The state of Dentaquest's knowledge of my case as of the time of this
writing, is that I am in need of an urgent tooth extraction, I am in pain, and
at risk for severe heart complications, and they have hung up on me rather
than provide an accurate list of Oral Surgeons that will take my insurance.
My guess is that they should not be doing business in the State of
Florida.
I have no one left to call, no provider, no nothing. I am nearly out of the
antibiotics that I have been on since before Christmas, and am not feeling
well. My head hurts constantly from the tooth, and I am scared of having
my heart go bad again. I would be doing something to take care of my
tooth if I had any more choices, or anyone else to call, instead of taking
the time to write this out. I really don't know what to do next.

  • Gi
    GinnieG May 06, 2019

    post this on facebook, maybe someone will pay for your surgery. I am scared for you and for myself too. I don't trust this provider.

    I also think I have an infection. My dentists said I have to see an oral surgeon, did not want me to come in to check if it was an infection. I'm going over there tomorrow anyway, it hurts like hell and I'm not young.

    0 Votes

premium payment

I've been trying to my premium since the 15 the of December when I signed up for them. I called and they told me I wouldn't be able to make the payment until the 1st of January. Well today is the 1st and I try to make a payment online and my account it locked. I tried to call the company back bc when I press the forget my password it still wouldn't reset it back and the office is close. The only way you pay your premium with this company is through mail or online on a company and not a smart device. I always pay my bills online or by phone they don't advise you of this information when your looking for benefits. Now I'm about to have no dental benefits due to the lack of communication and technology with this company. This is the worse experience ever.

  • De
    DentaQuest Customer Service Jan 02, 2019

    Hi Racquell,
    We sincerely apologize for your poor experience with DentaQuest and trying to pay your bill online. Our company was closed in observance of the New Years holiday, but we are regularly open for business Monday - Friday 8:30-8:00 EST. If you would like to provide you provide your phone number, we can reach out to you directly to resolve this issue. Otherwise, please give us a call directly; we can ensure that a payment extension is granted and assist with any website issues.

    0 Votes
  • Br
    Brittany Thorne Jan 04, 2019

    @DentaQuest Customer Service Hello. I am having the same exact issue. I’ve been calling all day today and I’ve been on hold for over 2 hours to speak to someone. Can some one please call me. I am trying to pay my bill online but my account is locked. Brittany 6109992270.

    -1 Votes

crown denial for front tooth after root canal

445699 I had received a root canal on my front tooth #9 and it is so fragile and cracked in center it is in need of a root canal. In my DentaQuest handbook for covered services a crown...

oral surgeon referral

My daughter has been trying to get 4 impacted wisdom teeth taken out since her March 2018 visit with her dentist Mark Johnson in Flagler Beach, FL. We were referred to Dr Jason...

services

Do not purchase from this Company / I bought my plan Va EPO thru the marketplace. I was led to believe this was insurance, It's not. Even though on the web sight, on my plan it states Restorative coverage, I was informed today that cleaning is all they cover no matter what the web sight says. So I give them $227.00 a year and they cover a $80.00 cleaning . What a Scam! Even the dentist said this is worthless. And some how they are being promoted on the Heath Care.gov web sight.

periodontal cleaning

They cover only the basics. But in order to do the maintenance that they do cover I need a deep tissue periodontal cleaning. Or there's no way to do the maintenance that's the...

services

I choose this plan in December and paid the monthly fees. As of today 1/25/2018 I am still not in this system and I am unable to use the health coverage I have paid for. This i...

authorisation approval

The oral surgeon office Is having complications With the approval They claim they put emergency paperwork through got no response within 48 hours I have been in contact with Dent...

dental provider complaint

We are a dental provider who has been working with Dentaquest for several years now. They are the worst insurance company out there. They don't know how to process claim...

customer service/provider availability

First of all they act like your trying to steal someone's identity because you call them and request a list of providers near you. Three phone calls later and getting a half way...

cannot find me an oral surgeon — have been searching for months.

Have filed a complaint and grievance back in the month of April 2017; received a letter from an April Brown whom was handling my complaint and grievance - even re faxed her the...

DentaQuest, LLC — dental ins. premium not accepted by phone or internet.

New customer since Jan 2017, wrote checks or money order for first 2 months premiums. Tried to pay online or over the phone and they will not accept it. Requested refund of...

refusal to cover sedation

I've been trying to have a tooth extracted due to infection & dead nerve since late Feb. I was denied 3x. I was sent to an Oral surgeon for sedation due to the active infection not allowing the numbing medication to work TWICE. DQ has denied me 5x total after 5 appeals. Ive been living with constant infections for months. They are inhumane and cheap. They DO NOT CARE ABOUT DENTAL HEALTH JUST THEIR POCKETS!!! Who in their right mind makes a single mother of two small children suffer with oral infections due to a bad tooth BEG for simple care? I find it ironic how they hide behind their desks and you cannot call them directly. I never had this much resistance with any other insurance company. I hope they get theirs!!

payment is inefficient

I like to pay my bill through a check in the mail, and they always send me a late bill, usually less than a week before it is due, which means it is almost late every time. This time, it is less than 1 week, and I still haven't even gotten my bill so I can pay for my insurance! So, I am trying to login online complete the payment for this month. I can't remember my user name or password, and made mistakes, and now it is saying I need to contact the administrator and can't try at all! It is so frustrating, and they don't even give me a contact for that. I hate having to call because the people are rude on the phone and put you on hold for a long time. And there are no emails in sight to contact about an issue like this. Why can't they just send things on-time to ensure I can have the coverage I need? I would love to pay on-time.

poor service quality

I joined a new plan January and in March had a toothache and contacted DentaQuest to choose a dentist. I was told that new dentist (provider) would show on their website 1-April but they had an emergency authorization procedure. Apparently new provider has had problems with this before so they refused.

I wait until 1-Apr and call both DentaQuest and new dentist to verify that everyone sees new provider in the system.

I show up at my dentist and they now see I was switched back to my old (inept) dentist so I cannot use my insurance for my toothache (that will probably require a root canal).

I call DentaQuest and they say it will take a few days before new provider shows up again on their portal. I ask to talk to a supervisor. I'm put on hold, then transfered to a voice mailbox. I leave a message. No return call. I call again and ask for a supervisor; yet another voice mailbox. Again, no return call in several days.

Denta Quest — provider coverage for disabled child

My son has been waiting months to find a dentist that can sedate my 17 year old disabled son for his extensive dental work. We have been given the run around and after more that...

denial of wisdom teeth removal

445699 I cannot believe this! Dentaquest approve only one wisdom tooth removal and denied the main ones that I believe are worse... Their reason?... Because the other 3 are incomplete...

lack of service, denial of coverage, inept

I am a 65 year old man, on Medicare and with Dentaquest (through the Affordable Care Act). I would like to say that Dentaquest is running a fraud on the people of Florida. I have...

orthodontics

My son had insurance through one provider and had braces put on, mid way through treatment his dental insurance changed and I was required to find another orthodontist. It ha...

Dentaquest, Florida — failure of insurance

To: Dentaquest, via fax [protected] From: DL Date: December 4, 2012 Re: Appeal for denial of coverage To Whom It May Concern: When we enrolled in Dentaquest this year, we...

[Resolved] denial of services

DentaQuest is the carrier selected by Fla Healthy Kids which covers children up to age 19 in our state. My daughter was given a referral from her dentist to have her wisdom teeth...