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I had a root canal performed on November 23, 2011. I paid $231 out of pocket at the time that the service was rendered. Delta was supposed to cover the remaining balance of $720.

,102 claim denied

Approximately one month later, the dental office contacted me to indicate that the claim was denied by Delta on the grounds that they were not my primary insurer. I contacted Delta to find out why they have another insurer listed when indeed they are my sole provider, and after spending nearly a half hour on the phone, was told that it was an internal error and would be corrected.

I was contacted by the dental office again in January 2012 indicating that they had still not been paid. I again contacted Delta, and was told the exact same thing as my original call in December, and it would be taken care of. Following up in February, I was told that the status of my account has still not changed, and the bill has not been paid.

I am going to have to pay the balance out of pocket or go to collections. In my opinion, this is criminal. The insurance account has been paid promptly by my employer for the past 8 years, yet Delta refuses to rectify their error and honor the terms of the policy.

The end result for me will be no different than if they were to pickpocket my wallet and remove $720. Meanwhile, the temporary filling in the tooth is deteriorating, and I will be forced to pay for a crown out of pocked or lose the tooth.

If given a choice between Delta and any other carrier, chose the latter. It may actually be wiser to save the money that you would spend on Delta insurance premiums and pay cash out of pocket.

Review about: Delta Dental Dental Crown Service.

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Anonymous
Port Huron, Michigan, United States #592040

Delta Dental is a joke.My husband needed an implant.

The dental office did everything they were supposed to do. Delta Dental told them they do cover implants. The procedure was done and when the claim was submitted Delta Dental denied the claim. After several months of fighting with Delta Dental they finally agreed to have a so call consultant call the dentist office and discusss the procedure.

Problem with that is Delta Dental doesn't call when they say they will. Procedure was done in 8/11 and it is 1/10/13 and we are still trying to get this resolved.

We had to pay $2000.00 so it didn't get turned in to collections.We will not be signing up for Delta Dental in July when my husbands insurance renews with his employeer.

Anonymous
#496469

I pay for Delta Dental through my employer.I needed a root canal and a crown.

My out of pocket cost was $985 for the root canal and and $775 for the crown. I'm told by the provider that Delta just contracts "us" a lower rate. I find it unbelievable that I pay for "insurance" and my out of pocket is still nearly $1700 for one tooth. If I had said I was a cash pay patient, I believe I would have gotten a better rate.

Delta's contracted rates are out of touch with usual and customary in my area. How can anyone be OK with paying $1700.00 for one tooth when they are insured?

Thanks for nothing Delta.You wont be getting my renewal next year.

Anonymous
#465115

I have Delta insurance provided through my employer.It appears that Delta is paying less on all of my claims than is stated in my plan information.

Where they should be paying out a minimum of 50% (x-rays, cleanings, crowns) up to 80% (root canals) they are paying anywhere from 34% to 53%.

For example a claim for $190 that should have been covered at 60% resulted in a payment to my dentist of $71.20...how is that possible?Has anyone else encountered this problem?

Anonymous
to Craig Williams #687433

Because they aren't considering the full amount of $190.Their approved amount for your $190 claim is probably far less and it's that amount that they pay 60% of.

And their "approved" amounts are ridiculously low and don't keep up with dental costs.

If you complain, they just tell you to visit one of their "in network" dentists.There were very few of them near where I live and doing some research some didn't even attend dental schools in this country.

Anonymous
to Craig Williams La Vista, Nebraska, United States #697642

Pulling tooth costs $75.00, $90.00 & another place $129.00 in NE so they say they pay 80%.The 80% is on $40.00.

They pay only $32.00 and you get stuck with the rest of the bill. Anyone have a Dentist that pulls a tooth for $40.00?

Don't get this insurance it is a waste of money!:cry

Anonymous
#425083

I sympathize with you. Delta clients should be informed that dentists universally hate Delta Dental for their unethical business model. It's discounted dentistry with no quality control and no accountability to either the dentist or the patient.

For example, In Austin Texas, Castle Dental franchises are listed as 4 of Delta's top 10 DHMO providers. Castle Dental has an F rating with the Austin Better Business Bureau.

If you are paying for Delta benefits as an individual, even if you have bad teeth, you will in the long run save money paying out of pocket rather than having Castle dental’s work re-done.

If on the other hand, you receive Delta as an employee benefit, please tell your boss that Delta is a huge, sleazy company. You'd be better off pocketing the money paid to Delta.

Thanks for your time.

D. Kellus Pruitt DDS

Anonymous
#424875

My husband and I are long time Delta Dental of California members and I don't have Twitter. Please contact me lorraine.reiner@sbcglobal.net

Anonymous
#424835

I had a tooth extraction 11/14/11.I have been tangling with Delta Dental since they denied the claim [wrong code].The claim has been sitting in "reprocessing" since then, and my husband spoke to many people, includind a supervisor {Kathy} who said she'd call back with a correction but didn't.

In January, they told my husband that they had no record of his many calls!Now we're filing a grievance if they send the forms to do so {7th day tomorrow waiting for those].Then I'm calling the State!

Anonymous
#424749

If you are a Delta Dental of California enrollee, we want to help you get this resolved! Please email feedback@delta.org, Attn: Beth, and we can converse via email or phone. If you're not a CA enrollee, we can help you find the right contact for the Delta Dental with which you have coverage.

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