Delta Dental of California Enterprises

Complaint: [redacted]I am rejecting this response because:Date Sent: 4/28/2017 12:00:00 AM
Just received letter this morning from Benefeds who administers Delta Dental.  It was dated 4/19/17.  I have attached it.  Received my direct deposit from OPM retirement and another $53.91 was taken from it for May.  So far, they have taken $107.82 without my authorization.  Apparently, they will continue to take $53.91 monthly dental insurance.  In fact the attached correspondence indicates they will take out another $107.81 to catch up for prior 2 months that they could not collect because they did not have my written authorization for monthly allotments.  It wasn't until I signed a written authorization for DeltaCareUSA to take monthly allotments from my pension.  Delta Dental used that written authorization from DeltaCareUSA to enable them to take $53.91 from my monthly pension.  DeltaCareUSA was only $25+ monthly allotment.  Please advise, as it has been 5 days already from April 23, 2017 to make a decision to cancel Delta Dental premiums through unauthorized monthly allotments.Sincerely,[redacted]

Complaint:...

[redacted]
I am rejecting this response because:I want Delta Dental to fax me a copy of my authorization to allowing auto pay using my Safe Checking.  I only signed an authorization for DeltaCare USA for autopay from Safe Checking account.  Bottom line:  I want to canel Delta Dental and keep DeltaCare USA with autopay that I signed and autorized.  Again, please cancel Delta Dental as I autopay with DeltaCareUSA and obviously do not 2 dental insurance.  Please advise ASAP.  Thank you.
Sincerely,
[redacted]

Initial Business Response /* (1000, 10, 2015/08/17) */
Re: Complaint Case #: XXXXXXXX
Consumer: [redacted]

Dear Revdex.com Dispute Resolution Department:
A copy of your email dated August 12, 2015 to Delta Dental Insurance Company re the above matter was recently forwarded to Delta Dental...

of California (DDC), Federal Government Programs.
Mr. [redacted] is enrolled in the TRICARE Military Retiree Dental Program administered by this company out of its Sacramento offices.
This program offers dental benefits to certain retired military personnel and their dependents, as authorized by 10 U.S.C. §1076c. By federal regulation (32 CFR §199.22), the Department of Defense has determined that state and local laws and regulations pertaining to health or dental insurance are preempted under the auspices of 10 U.S.C. §1103. Delta Dental therefore respectfully asserts that the Revdex.com lacks jurisdiction over this aspect of the complaint. However, in the interest of Customer Service, we will be responding directly to the complainant to advise Mr. [redacted] we have honored his request for early disenrollment from the TRDP.
We hope this information is helpful. Please advise if further information is needed.
Sincerely,
DELTA DENTAL of CALIFORNIA
Special Correspondence Unit
Federal Government Programs
Initial Consumer Rebuttal /* (2000, 12, 2015/08/19) */
(The consumer indicated he/she ACCEPTED the response from the business.)

Mr. [redacted],In review of the letter you received from BENEFEDS, it is administered by Long Term Care Partners, not Delta Dental.  We have no record of you being covered under our Delta Dental PPO plan for Federal employees.  We only have record of you being covered under DeltaCare only.  Please contact BENEFEDS at the [redacted] number to address your concerns.  Thank you,Quality Management

April 20, 2017   [redacted]                                              ...⇄    Re: [redacted]         To whom it may concern: Thank you for your inquiry received April 11, 2017. We appreciate the opportunity to respond to your concern. Information cannot be released to another individual unless [redacted] authorizes the release.  As a result, we are unable to respond to your concern at this time, as there is no release on file.  Please note, we have opened a grievance for Ms. [redacted], and will be responding directly to the member no later than May 10, 2017.  This privacy restriction is the result of the U.S. Department of Health and Human Services (HHS) Office for Civil Rights, which announced this rule effective September 23, 2013. This privacy rule was created to strengthen the privacy and security protections for health information established under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). This restriction means that no Personal Health Information (PHI) belonging to another person can be released to another individual unless the owner of the PHI has provided permission to do so.   If you have any questions or concerns regarding this matter, you may contact me directly at [redacted], extension [redacted].  Sincerely,[redacted]Appeals SpecialistSubscriber Services

May 2, 2017       [redacted]                                              ...⇄    Re:    [redacted]                                            ...⇄                    Case ID#:  [redacted]                   To whom it may concern:   Thank you for your follow-up inquiry received April 26, 2017. We appreciate the opportunity to respond to your concern.   Information cannot be released to another individual unless [redacted] authorizes the release.  As a result, we are unable to respond to your concern at this time, as there is no release on file.  Please note, we have opened a grievance for Ms. [redacted], and have responded directly to the member on May 2, 2017.   This privacy restriction is the result of the U.S. Department of Health and Human Services (HHS) Office for Civil Rights, which announced this rule effective September 23, 2013. This privacy rule was created to strengthen the privacy and security protections for health information established under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). This restriction means that no Personal Health Information (PHI) belonging to another person can be released to another individual unless the owner of the PHI has provided permission to do so.    If you have any questions or concerns regarding this matter, you may contact me directly at [redacted], extension [redacted].   Sincerely, [redacted] Appeals Specialist Subscriber Services

Complaint: [redacted]I am rejecting this response because:there is no one form on their website to fill out to log my complaint for the refund I have been waiting for since 4/25/17 after 3 phone calls. I will call them once again but every phone call response from delta dental is "check is processed and it will take 14 to 21 days to receive" Sincerely,[redacted]

June 26, 2017
 
 
 
[redacted]...

[redacted]
 
 
 
 
 
RE:   Complaint#:                                      [redacted]
            Complainant:                                [redacted]
 
 
                                        ...⇄                                         ...⇄
 
Dear Mr. [redacted]:
 
Delta Dental Insurance Company is in receipt of your correspondence regarding the above-referenced complainant.  It appears that this inquiry was sent to us in error.
 
Based on the information included with the correspondence, it appears the complainant is covered under a dental program administered by Delta Dental of Wisconsin. Please forward the attached correspondence to the appropriate plan for resolution.
 
[redacted]
 
 
We appreciate your cooperation in this matter.
 
 
Sincerely,
 
[redacted]

Complaint: [redacted]
I am rejecting this response because:Because of the fact that this is ridiculous. It was never communicated to me by the this company that I needed to sign any release and as far as I am concerned this is a shady tactic to delay a resolution and too put me out of pocket for a dentist benefit that was misquoted to me by a benefits agent. This is an under handed tactic and as far as my concern this company is only trying to take my money without my permission and they are running a dental insurance scam. But I know my rights as a consumer and I work in the world of medical insurance. I will press forward with this until this company does the right thing and compensate me for the fact that they messed up. If they think that I am going to go away or get bored with this, they are sadly mistaken, because should they not correct this mistake that they made at my expense, I will be seeking legal help. 
Sincerely,
[redacted]

Complaint: [redacted]
I am rejecting this response because: I have Delta Dental monthly premium taken from my monthly Retirement Pension.  I understand that it was administered through Benefeds a PPO insurance.  However, Benefeds issued a Delta Dental group card that Delta Dental that should indicate my belonging to Delta Dental, which would seem that Delta Dental Insurance should have some say in its administration through Benefeds. The main dispute I have is that Benefeds refuse to cancel it on my request and stated further that I would have to wait until Dec 2017 for Open Season to cancel it.  And I am upset that Benefeds used  my authorization for direct pay from my DeltaCare USA.  Delta Dental is unauthorizely withholdiing monthly from may pension. Please advise, as this would tarnish Delta Dental for allowing this unfair. deceptive false advertisement business practice to happen.  Please help me to cancel Delta Dental, as I am unable to pay two monthly dental insurances, as I am on a fixed income and it would be a hardship financilly.
Sincerely,
[redacted]

August 4, 2017
 
 
 
Revdex.com, Inc.
[redacted]
 
    ...

                                        ...⇄ Re:       [redacted]         
                                        ...⇄                 Case ID:      [redacted]               
 
 
To whom it may concern:
 
Thank you for your inquiry received August 1, 2017. We appreciate the opportunity to respond to your concern.
 
Information cannot be released to another individual unless [redacted] authorizes the release.  As a result, we are unable to respond to your concern at this time, as there is no release on file.  Please note, we have an open a grievance for Ms. [redacted], and will be responding directly to the member no later than August 8, 2017.
 
This privacy restriction is the result of the U.S. Department of Health and Human Services (HHS) Office for Civil Rights, which announced this rule effective September 23, 2013. This privacy rule was created to strengthen the privacy and security protections for health information established under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). This restriction means that no Personal Health Information (PHI) belonging to another person can be released to another individual unless the owner of the PHI has provided permission to do so. 
 
If you have any questions or concerns regarding this matter, you may contact me directly at ([redacted], extension [redacted].
 
Sincerely,
[redacted]
Appeals Specialist
Subscriber Services

The member has filed a grievance with Delta Dental which will be responded to within 30 days from the date received.  We do not have authorization to release Protected Health Information (PHI) to your office.

July 14, 2017
 
 
 
Revdex.com of San Francisco Bay Area and
N[redacted]
                                        ...⇄                         RE:      Patient:            [redacted]   
                                        ...⇄                         Case ID#:        [redacted]
BB Case          [redacted]
 
Dear Revdex.com:
 
This letter is in response to your correspondence concerning the above referenced complainant. As this issue pertains to Private Health Information (PHI) we are unable to respond directly to the Revdex.com.  We will accept this as a formal complaint and respond directly to the member. 
 
This privacy restriction is in compliance with the U.S. Department of Health and Human Services (HHS) Office for Civil Rights, which announced this rule effective September 23, 2013. This privacy rule was created to strengthen the privacy and security protections for health information established under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). This restriction means that no Private Health Information (PHI) belonging to another person can be released to another individual unless the owner of the PHI has provided specific permission to do so. 
 
Delta Dental takes enrollee concerns seriously and maintains an internal grievance process to review complaints. As always we recommend that our enrollees submit matters for our review by either contacting customer service at [redacted] to submit a grievance over the phone or request a grievance packet to submit it in writing or submit the grievance online on the following page of our website: [redacted]
Sincerely,
[redacted]
Appeals Specialist
Subscriber Services

Complaint: [redacted]
I am rejecting this response because:Of the fact that they claimed that I needed to sign a release form that was never mentioned to me to sign. This really unacceptable as I know this isn't coming from an actual person and they are using this tactic to delay a resolution further. Why am I being held responsible for the fact that this company made an error at my expense? who do these people think they are? This company is dishonest and not upfront with people in regards to there policies and will do anything to line there own pockets with there claimants money at the claimants expense. Today as a result of this I spoke to a person named [redacted] who supposedly got my complaint and was very rude in talking over me as all I wanted to know what was going on. I really don't know why this company will not do the right thing and correct the error and properly reimburse my dentist and acknowledge there mistake in misquoting my benefits and coverage. Unfortunately, I am stuck with this dental insurance as I need further dental work and I can't afford to wait another 6 months for some coverage to kick in to deal with some cavities from a different insurance. Should this company attempt to deceive me again, I will be seeking out legal help
Sincerely,
[redacted]

Initial Business Response /* (1000, 5, 2015/07/23) */
The enrollee's issue has been resolved.
Initial Consumer Rebuttal /* (2000, 7, 2015/07/30) */
(The consumer indicated he/she ACCEPTED the response from the business.)

Complaint: [redacted]
I am rejecting this response because:There was nothing in the email I got in the response as to what they are going to do. All I got was a response saying was that the company received my complaint. I want an actual response from the company that is...

selling this scam insurance and they are going to actually do something and that I won't have to seek out a lawyer to collect for damages from them. The response is an insult to my intelligence and I want it from an actual person
Sincerely,
[redacted]

Hello,DeltaCare USA is addressing the enrollee's issues through the grievance process. He will receive a resolution after April 23, 2017.  He may contact the coordinator noted on the acknowledgment letter sent to him on April 6, 2017.Thank you,The Quality Management Department

Complaint: [redacted]At this time, I am providing the documentation requested by the company.Sincerely,[redacted]

To whom it may concern,
In response to your request concerning [redacted], we have opened a grievance in regards to the members service in question. We are in the process of requesting records certified from the provider Dr. [redacted] Once we receive the information requested, we will...

send a response to Ms. [redacted] and the provider with our determination. 
Thank you for your assistance.
Sincerely,
Delta Dental of California
Quality Assessment Department

Complaint: [redacted]I am rejecting this response because:
Good afternoon.  The member identification number is [redacted], date of birth is 01-14-1958. (please see attached)
Sincerely,[redacted]