Sure the desired resolution is to cancel my insurance and obtain a full refund for all payments made this year Because of gross incompetence in the processing of my insurance I do not believe that [redacted] has received any benefits for services rendered
Dear Mr [redacted] ,The Revdex.com has forwarded a copy of your recent complaint regarding your Delta Dental Clear Plan policy We have looked into the matter and have provided our response to your concerns below.Our records confirm that you initially completed online enrollment in the Delta Dental Clear Plan policy with an effective date of November 1, Enrollment information and plan information can be found on our website, www.DeltaDentalCoversMe.com Page of your contract indicates that when you buy the Delta Dental Clear Plan policy, you agree to keep it in force for at least months You may terminate your policy upon annual renewal as long as Delta Dental receives written notice at least days before the renewal date A copy of the Clear Plan policy is included for your reference Review of your eligibility history shows that your policy was renewed for your benefit period November 1, through October 31, 2016; there is no documentation on file that you had requested to cancel your plan prior to the renewal of your policy The Declaration page which is included with this notice and was sent to your email address, [redacted] , states that you understand this is a minimum one year contract If you wish to end your Clear Plan policy, you must notify Delta Dental at least days prior to the renewal date To discuss your Delta Dental Clear Plan policy, you may contact representatives at www.DeltaDentalCoversMe.com, [email protected], 1-855-335-or Delta Dental, PO Box 103, Stevens Point WI 54481- Sincerely, [redacted] **Program Integrity AnalystEnclosuresDelta Dental Clear Plan policy contractDeclarations page
Complaint ID [redacted] Dear Mr***, The Revdex.com has forwarded a copy of your complaint regarding your dental benefits plan The complaint and all relevant information have been referred to me for research and replyAccording to the information in our claims and eligibility system, coverage for your spouse and dependent was active January through August However accurate eligibility information was not updated in our system correctly until August 11, Your family, nor the treating dentist, could verify coverage until August 11, This delay in processing eligibility is completely unacceptable Due to our lack of responsiveness and less than ideal customer service, we will honor your request to provide a full refund for the entire premium collected January through August A thorough audit of the account will be completed When the total amount you have paid for the coverage for your spouse and dependent is calculated, a refund will be processed and issued Our claims data indicates Delta Dental received and paid $for treatment completed August 10, Typically we would require payment for the month in which benefits were paid, but in this case due to our poor customer service and the many difficulties you had with this plan, we not require premium payment for the month of August and the payment to the dentist will not change Thank you for doing business with Delta Dental of Colorado We appreciate your patience and apologize for all that you went through to get this resolved We hope that sometime in the future you will give us a chance to regain your trustShould you have questions, you may reach me at [redacted] @ddpco.com Sincerely, [redacted] **
Dear Ms [redacted] , Delta Dental of Colorado (DDCO) is in receipt of a copy of your recent complaint submitted to the Revdex.com (Revdex.com) serving Denver/Boulder It has been referred to me for research and reply All of the information you provided has been thoroughly reviewed and compared to our claims and eligibility system Our records indicate that DDCO provided your dental benefits plan from January 1, through April 30, There is no active eligibility in our claims and eligibility system for you There are no claims for you received or processed for treatment completed in There are no documented phone calls in your record received from you in It appears that you may be covered by Delta Dental in a state other than Colorado Delta Dental of Colorado is a member of Delta Dental Plans Association, a network of independent dental companies that conduct business in all states, as well as the District of Columbia Each Delta Dental company has individual claims systems that contain all enrollment and claims data for their own members Member and claims data are not shared among the various Delta Dental companies as we are separate businesses Claims, grievances or appeals for patients must be submitted to the correct Delta Dental for appropriate processing For example, Delta Dental of Colorado cannot process a claim, grievance or appeal for a patient covered by Delta Dental of California (DDCA) Nor does DDCO have access to any of DDCA claims or other patient data You may wish to review your dental insurance card or member benefit book to find the state and address of the Delta Dental that provides your current dental coverageYour complaint can then be forwarded to the appropriate carrier for response [redacted] Program Integrity Analyst Delta Dental of Colorado
Dear Mr [redacted] ,Delta Dental is in receipt of the complaint submitted to the Revdex.com We have looked into the matter and have provided our response to your concerns below.Thank you for the detailed account of your experiences related to your eligibility and billing concerns regarding your dental benefits plan On behalf of Delta Dental, please accept our sincere apology for the time you have invested in trying to resolve the issues detailed in your complaint letter.Our records confirm your statement that your coverage with the Kaiser Federal Buy Up plan was canceled effective September 1, Your spouse received dental services in September and due to the cancelation of your policy, initially those services were not paid Based on several phone calls with you or your spouse, it was our understanding that you requested your coverage to be reinstated.Your policy was reactivated December and we processed premium payments for September 2015, October and November for a total of $($per month for three months) This is the amount referenced in your letter that was processed from your checking account on December 8, 2015.Reactivating your coverage allowed processing and payment of the claim for your spouse for services completed September 15, Delta Dental paid $directly to your dentist for these services Reactivating your coverage also restarted your automatic billing process This resulted in $processed from your checking account on December 18, for January coverage and another premium processed on January 27, for February coverage The premium processed on January 27, was not completed and was not deducted from your checking account.Our records confirm that you called our representatives again on February 4, to resolve your concerns related to processing your premium for your dental plan During this call you made it very clear that you did not want to be enrolled in the plan and you expected a refund for all recently processed premiums.The following day, February 5, 2016, our billing agents initiated a refund for $ This includes premium previously processed for coverage provided September 2015, October 2015, November and December At the time we initiated the refund, we had not processed the failure notice for the premium issued January In total, the refund initiated on February 5, included five months of coverage at $per month This refund should already be credited to your account If you have not received the refund, please contact me at [redacted] Per your request, DDCO has refunded your checking account and your coverage is canceled It is our goal here at Delta Dental of Colorado to provide the highest level of customer service to all of our members In your case we fell far short of that goal and for that we offer our genuine apology.Sincerely, [redacted] **Program Integrity Analyst
Dear [redacted] ***,Upon receipt of your phone call on May 18, 2017, Delta Dental representatives began researching your concerns and working with you to issue rightful benefits due to you We found that your home address provided to Delta Dental by your employer was not your current address That is why previous reimbursement checks were not received by you On May 19, 2017, Delta Dental's claims department issued two reimbursement checks to you for the outstanding amounts issued on previous checks Our records indicate that on May 25, 2017, Delta Dental representative [redacted] *called you to verify that you had received the reimbursement checks She reports that you had received and cashed both checks Further, our eligibility team contacted your employer to let them know that the address they provided for you is incorrect The eligibility team for your employer updated your address on the eligibility file on May 23, and your current address is now uploaded into our claims processing system Please accept our sincere apology for the miscommunication of data that resulted in you not receiving reimbursement checks due to you for completed dental services We are certain the incorrect information is updated and the issue is resolved Should you have any questions or require additional assistance, you may reach me at [email protected], [redacted]
Dear Mr [redacted] , The Revdex.com has forwarded your additional concerns regarding the renewal of your dental policy, the Delta Dental Clear Plan We have carefully reviewed the terms of your policy Please see below for our responseYou are correct in that you have fulfilled the 12-month contract for your initial enrollment with coverage effective November 1, through October 31, Pursuant to the terms of the Clear Plan, after your plan has been active for months, for your convenience, the policy will automatically renew There is no need to re-enroll or resubmit payment information This prevents accidental lapses in coverage However, as described on page of your contract/benefit book, if you do not want to renew the policy you only need to provide written notice (electronically or through the mail) before your renewal date There is no indication that you provided notice of non-renewal prior to the automatic renewal on October 30, Your policy was therefore renewed for an additional month contract The Declarations page, which was provided with our initial response, indicates the renewal was processed on October 30, and a copy of this document was forwarded to you at [redacted] In order to cancel your policy, you only need to provide written notice (electronically or through the mail) to Delta Dental at least days before your next renewal date which is November 1, This process is outlined on page of the Clear Plan contract/benefit bookWe hope this response provides satisfactory explanation regarding the renewal and cancelation process for the Clear Plan policyShould you have additional questions regarding your policy, you may contact Delta Dental at www.DeltaDentalCoversMe.com, [email protected], 1-855-335-or Delta Dental, PO Box 103, Stevens Point WI 54481-Sincerely, [redacted] Program Integrity Analyst
Final Consumer Response /* (2000, 7, 2016/01/07) */
Can the complaint please be closed as resolve? After numerous attempts I finally received a call and was provided a copy from their customer relations department
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is satisfactory to me
Sincerely,
*** ***
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID 11120124, and find that this resolution is satisfactory to me
Sincerely,
*** ***
Dear Mr. [redacted],The Revdex.com has forwarded a copy of your recent complaint regarding your Delta Dental Clear Plan policy. We have looked into the matter and have provided our response to your concerns below.Our records confirm that you initially completed online enrollment in...
the Delta Dental Clear Plan policy with an effective date of November 1, 2014. Enrollment information and plan information can be found on our website, www.DeltaDentalCoversMe.com. Page 11 of your contract indicates that when you buy the Delta Dental Clear Plan policy, you agree to keep it in force for at least 12 months. You may terminate your policy upon annual renewal as long as Delta Dental receives written notice at least 60 days before the renewal date. A copy of the Clear Plan policy is included for your reference. Review of your eligibility history shows that your policy was renewed for your benefit period November 1, 2015 through October 31, 2016; there is no documentation on file that you had requested to cancel your plan prior to the renewal of your policy. The Declaration page which is included with this notice and was sent to your email address, [redacted], states that you understand this is a minimum one year contract. If you wish to end your Clear Plan policy, you must notify Delta Dental at least 60 days prior to the renewal date. To discuss your Delta Dental Clear Plan policy, you may contact representatives at www.DeltaDentalCoversMe.com, [email protected], 1-855-335-8275 or Delta Dental, PO Box 103, Stevens Point WI 54481-0103. Sincerely,[redacted]Program Integrity AnalystEnclosuresDelta Dental Clear Plan policy contractDeclarations page
Dear [redacted],Upon receipt of your phone call on May 18, 2017, Delta Dental representatives began researching your concerns and working with you to issue rightful benefits due to you. We found that your home address provided to Delta Dental by your employer was not your current address. ...
That is why previous reimbursement checks were not received by you. On May 19, 2017, Delta Dental's claims department issued two reimbursement checks to you for the outstanding amounts issued on previous checks. Our records indicate that on May 25, 2017, Delta Dental representative [redacted]. called you to verify that you had received the reimbursement checks. She reports that you had received and cashed both checks. Further, our eligibility team contacted your employer to let them know that the address they provided for you is incorrect. The eligibility team for your employer updated your address on the eligibility file on May 23, 2017 and your current address is now uploaded into our claims processing system. Please accept our sincere apology for the miscommunication of data that resulted in you not receiving reimbursement checks due to you for completed dental services. We are certain the incorrect information is updated and the issue is resolved. Should you have any questions or require additional assistance, you may reach me at [email protected]. Sincerely,[redacted]
[redacted]
Dear Ms. [redacted], Delta Dental of Colorado (DDCO) is in receipt of a copy of your recent complaint submitted to the Revdex.com (Revdex.com) serving Denver/Boulder. It has been referred to me for research and reply. All of the information you provided has been thoroughly...
reviewed and compared to our claims and eligibility system. Our records indicate that DDCO provided your dental benefits plan from January 1, 2013 through April 30, 2014. There is no active eligibility in our claims and eligibility system for you. There are no claims for you received or processed for treatment completed in 2016. There are no documented phone calls in your record received from you in 2016. It appears that you may be covered by Delta Dental in a state other than Colorado. Delta Dental of Colorado is a member of Delta Dental Plans Association, a network of 39 independent dental companies that conduct business in all 50 states, as well as the District of Columbia. Each Delta Dental company has individual claims systems that contain all enrollment and claims data for their own members. Member and claims data are not shared among the various Delta Dental companies as we are separate businesses. Claims, grievances or appeals for patients must be submitted to the correct Delta Dental for appropriate processing. For example, Delta Dental of Colorado cannot process a claim, grievance or appeal for a patient covered by Delta Dental of California (DDCA). Nor does DDCO have access to any of DDCA claims or other patient data. You may wish to review your dental insurance card or member benefit book to find the state and address of the Delta Dental that provides your current dental coverage. Your complaint can then be forwarded to the appropriate carrier for response. [redacted] Program Integrity Analyst Delta Dental of Colorado
Dear Mr. [redacted], The Revdex.com has forwarded your additional concerns regarding the renewal of your dental policy, the Delta Dental Clear Plan. We have carefully reviewed the terms of your policy. Please see below for our response. You are correct in that you have fulfilled the 12-month contract for your initial enrollment with coverage effective November 1, 2014 through October 31, 2015. Pursuant to the terms of the Clear Plan, after your plan has been active for 12 months, for your convenience, the policy will automatically renew. There is no need to re-enroll or resubmit payment information. This prevents accidental lapses in coverage. However, as described on page 11 of your contract/benefit book, if you do not want to renew the policy you only need to provide written notice (electronically or through the mail) before your renewal date. There is no indication that you provided notice of non-renewal prior to the automatic renewal on October 30, 2015. Your policy was therefore renewed for an additional 12 month contract. The Declarations page, which was provided with our initial response, indicates the renewal was processed on October 30, 2015 and a copy of this document was forwarded to you at [redacted]. In order to cancel your policy, you only need to provide written notice (electronically or through the mail) to Delta Dental at least 60 days before your next renewal date which is November 1, 2016. This process is outlined on page 12 of the Clear Plan contract/benefit book. We hope this response provides satisfactory explanation regarding the renewal and cancelation process for the Clear Plan policy. Should you have additional questions regarding your policy, you may contact Delta Dental at www.DeltaDentalCoversMe.com, [email protected], 1-855-335-8275 or Delta Dental, PO Box 103, Stevens Point WI 54481-0103. Sincerely, [redacted] Program Integrity Analyst
Sure the desired resolution is to cancel my insurance and obtain a full refund for all payments made this year. Because of gross incompetence in the processing of my insurance I do not believe that [redacted] has received any benefits for services rendered.
Initial Business Response /* (1000, 6, 2015/07/27) */
Dear Delta Dental Member,
Or records indicate that on June 18, 2015 you called Delta Dental of Colorado (DDCO) to verify your COBRA eligibility through Teletech Services Corporation. At that time, our agent advised you were not covered and...
referred you to your COBRA administrator.
DDCO received four additional calls from you during June 2015 trying to verify your coverage. During this time, we began working with your COBRA administrator to update your eligibility record. On June 24,2015 DDCO received an update via e-mail correspondence re-instating your coverage from March 1, 2014 through current. Our representatives entered the information into our eligibility and claims system on July 10, 2015 and your coverage remains active as of this writing.
Your claims history shows that DDCO has received, processed and issued benefits for two claims for treatment completed June 17, 2015 and June 24, 2015. If there are any claims that have been denied as a result of this issue, please forward copies of the Explanation of Benefits statements to the Compliance department at [redacted]@ddpco.com. DDCO will reprocess the claims so that you receive appropriate benefits as indicated per the terms of your dental benefits plan.
We hope this outcome provides satisfactory explanation and resolution regarding your concerns expressed to both DDCO and the Revdex.com. Should you have further questions, you may contact me at [redacted]@ddpco.com.
Sincerely,
[redacted]
Program Integrity Analyst
Dear Mr. [redacted],Delta Dental is in receipt of the complaint submitted to the Revdex.com. We have looked into the matter and have provided our response to your concerns below.Thank you for the detailed account of your experiences related to your eligibility and billing concerns...
regarding your dental benefits plan. On behalf of Delta Dental, please accept our sincere apology for the time you have invested in trying to resolve the issues detailed in your complaint letter.Our records confirm your statement that your coverage with the Kaiser Federal Buy Up plan was canceled effective September 1, 2015. Your spouse received dental services in September 2015 and due to the cancelation of your policy, initially those services were not paid. Based on several phone calls with you or your spouse, it was our understanding that you requested your coverage to be reinstated.Your policy was reactivated December 2015 and we processed premium payments for September 2015, October 2015 and November 2015 for a total of $119.22 ($39.74 per month for three months). This is the amount referenced in your letter that was processed from your checking account on December 8, 2015.Reactivating your coverage allowed processing and payment of the claim for your spouse for services completed September 15, 2015. Delta Dental paid $845.60 directly to your dentist for these services. Reactivating your coverage also restarted your automatic billing process. This resulted in $39.74 processed from your checking account on December 18, 2015 for January 2016 coverage and another premium processed on January 27, 2016 for February 2016 coverage. The premium processed on January 27, 2016 was not completed and was not deducted from your checking account.Our records confirm that you called our representatives again on February 4, 2016 to resolve your concerns related to processing your premium for your dental plan. During this call you made it very clear that you did not want to be enrolled in the plan and you expected a refund for all recently processed premiums.The following day, February 5, 2016, our billing agents initiated a refund for $198.70. This includes premium previously processed for coverage provided September 2015, October 2015, November 2015 and December 2015. At the time we initiated the refund, we had not processed the failure notice for the premium issued January 2016. In total, the refund initiated on February 5, 2016 included five months of coverage at $39.74 per month. This refund should already be credited to your account. If you have not received the refund, please contact me at [redacted] Per your request, DDCO has refunded your checking account and your coverage is canceled. It is our goal here at Delta Dental of Colorado to provide the highest level of customer service to all of our members. In your case we fell far short of that goal and for that we offer our genuine apology.Sincerely,[redacted]Program Integrity Analyst
I would like to see where I accepted a new annual renewal on November 1st. I performed the contract of 1 year as I agreed to. I never agreed to another year contract. I saw no forms, signed nothing. Why can't I speak to a person when I call and why can you not call me when I leave messages? That is a terrible way to do business.
Complaint: 11107388
I am rejecting this response because:
Sincerely,
[redacted]
[redacted] Dear Mr. [redacted], The Revdex.com has forwarded a copy of your complaint regarding your dental benefits plan. The complaint and all relevant information have been referred to me for research and reply. According to the information in our claims and eligibility system, coverage for your spouse and dependent was active January 2016 through August 2016. However accurate eligibility information was not updated in our system correctly until August 11, 2016. Your family, nor the treating dentist, could verify coverage until August 11, 2016. This delay in processing eligibility is completely unacceptable. Due to our lack of responsiveness and less than ideal customer service, we will honor your request to provide a full refund for the entire premium collected January 2016 through August 2016. A thorough audit of the account will be completed. When the total amount you have paid for the coverage for your spouse and dependent is calculated, a refund will be processed and issued. Our claims data indicates Delta Dental received and paid $48.00 for treatment completed August 10, 2016. Typically we would require payment for the month in which benefits were paid, but in this case due to our poor customer service and the many difficulties you had with this plan, we not require premium payment for the month of August and the payment to the dentist will not change. Thank you for doing business with Delta Dental of Colorado. We appreciate your patience and apologize for all that you went through to get this resolved. We hope that sometime in the future you will give us a chance to regain your trust. Should you have questions, you may reach me at [redacted]@ddpco.com Sincerely, [redacted]
Sure the desired resolution is to cancel my insurance and obtain a full refund for all payments made this year Because of gross incompetence in the processing of my insurance I do not believe that [redacted] has received any benefits for services rendered
Dear Mr [redacted] ,The Revdex.com has forwarded a copy of your recent complaint regarding your Delta Dental Clear Plan policy We have looked into the matter and have provided our response to your concerns below.Our records confirm that you initially completed online enrollment in the Delta Dental Clear Plan policy with an effective date of November 1, Enrollment information and plan information can be found on our website, www.DeltaDentalCoversMe.com Page of your contract indicates that when you buy the Delta Dental Clear Plan policy, you agree to keep it in force for at least months You may terminate your policy upon annual renewal as long as Delta Dental receives written notice at least days before the renewal date A copy of the Clear Plan policy is included for your reference Review of your eligibility history shows that your policy was renewed for your benefit period November 1, through October 31, 2016; there is no documentation on file that you had requested to cancel your plan prior to the renewal of your policy The Declaration page which is included with this notice and was sent to your email address, [redacted] , states that you understand this is a minimum one year contract If you wish to end your Clear Plan policy, you must notify Delta Dental at least days prior to the renewal date To discuss your Delta Dental Clear Plan policy, you may contact representatives at www.DeltaDentalCoversMe.com, [email protected], 1-855-335-or Delta Dental, PO Box 103, Stevens Point WI 54481- Sincerely, [redacted] **Program Integrity AnalystEnclosuresDelta Dental Clear Plan policy contractDeclarations page
Complaint ID [redacted] Dear Mr***, The Revdex.com has forwarded a copy of your complaint regarding your dental benefits plan The complaint and all relevant information have been referred to me for research and replyAccording to the information in our claims and eligibility system, coverage for your spouse and dependent was active January through August However accurate eligibility information was not updated in our system correctly until August 11, Your family, nor the treating dentist, could verify coverage until August 11, This delay in processing eligibility is completely unacceptable Due to our lack of responsiveness and less than ideal customer service, we will honor your request to provide a full refund for the entire premium collected January through August A thorough audit of the account will be completed When the total amount you have paid for the coverage for your spouse and dependent is calculated, a refund will be processed and issued Our claims data indicates Delta Dental received and paid $for treatment completed August 10, Typically we would require payment for the month in which benefits were paid, but in this case due to our poor customer service and the many difficulties you had with this plan, we not require premium payment for the month of August and the payment to the dentist will not change Thank you for doing business with Delta Dental of Colorado We appreciate your patience and apologize for all that you went through to get this resolved We hope that sometime in the future you will give us a chance to regain your trustShould you have questions, you may reach me at [redacted] @ddpco.com Sincerely, [redacted] **
Dear Ms [redacted] , Delta Dental of Colorado (DDCO) is in receipt of a copy of your recent complaint submitted to the Revdex.com (Revdex.com) serving Denver/Boulder It has been referred to me for research and reply All of the information you provided has been thoroughly reviewed and compared to our claims and eligibility system Our records indicate that DDCO provided your dental benefits plan from January 1, through April 30, There is no active eligibility in our claims and eligibility system for you There are no claims for you received or processed for treatment completed in There are no documented phone calls in your record received from you in It appears that you may be covered by Delta Dental in a state other than Colorado Delta Dental of Colorado is a member of Delta Dental Plans Association, a network of independent dental companies that conduct business in all states, as well as the District of Columbia Each Delta Dental company has individual claims systems that contain all enrollment and claims data for their own members Member and claims data are not shared among the various Delta Dental companies as we are separate businesses Claims, grievances or appeals for patients must be submitted to the correct Delta Dental for appropriate processing For example, Delta Dental of Colorado cannot process a claim, grievance or appeal for a patient covered by Delta Dental of California (DDCA) Nor does DDCO have access to any of DDCA claims or other patient data You may wish to review your dental insurance card or member benefit book to find the state and address of the Delta Dental that provides your current dental coverageYour complaint can then be forwarded to the appropriate carrier for response [redacted] Program Integrity Analyst Delta Dental of Colorado
Dear Mr [redacted] ,Delta Dental is in receipt of the complaint submitted to the Revdex.com We have looked into the matter and have provided our response to your concerns below.Thank you for the detailed account of your experiences related to your eligibility and billing concerns regarding your dental benefits plan On behalf of Delta Dental, please accept our sincere apology for the time you have invested in trying to resolve the issues detailed in your complaint letter.Our records confirm your statement that your coverage with the Kaiser Federal Buy Up plan was canceled effective September 1, Your spouse received dental services in September and due to the cancelation of your policy, initially those services were not paid Based on several phone calls with you or your spouse, it was our understanding that you requested your coverage to be reinstated.Your policy was reactivated December and we processed premium payments for September 2015, October and November for a total of $($per month for three months) This is the amount referenced in your letter that was processed from your checking account on December 8, 2015.Reactivating your coverage allowed processing and payment of the claim for your spouse for services completed September 15, Delta Dental paid $directly to your dentist for these services Reactivating your coverage also restarted your automatic billing process This resulted in $processed from your checking account on December 18, for January coverage and another premium processed on January 27, for February coverage The premium processed on January 27, was not completed and was not deducted from your checking account.Our records confirm that you called our representatives again on February 4, to resolve your concerns related to processing your premium for your dental plan During this call you made it very clear that you did not want to be enrolled in the plan and you expected a refund for all recently processed premiums.The following day, February 5, 2016, our billing agents initiated a refund for $ This includes premium previously processed for coverage provided September 2015, October 2015, November and December At the time we initiated the refund, we had not processed the failure notice for the premium issued January In total, the refund initiated on February 5, included five months of coverage at $per month This refund should already be credited to your account If you have not received the refund, please contact me at [redacted] Per your request, DDCO has refunded your checking account and your coverage is canceled It is our goal here at Delta Dental of Colorado to provide the highest level of customer service to all of our members In your case we fell far short of that goal and for that we offer our genuine apology.Sincerely, [redacted] **Program Integrity Analyst
Dear [redacted] ***,Upon receipt of your phone call on May 18, 2017, Delta Dental representatives began researching your concerns and working with you to issue rightful benefits due to you We found that your home address provided to Delta Dental by your employer was not your current address That is why previous reimbursement checks were not received by you On May 19, 2017, Delta Dental's claims department issued two reimbursement checks to you for the outstanding amounts issued on previous checks Our records indicate that on May 25, 2017, Delta Dental representative [redacted] *called you to verify that you had received the reimbursement checks She reports that you had received and cashed both checks Further, our eligibility team contacted your employer to let them know that the address they provided for you is incorrect The eligibility team for your employer updated your address on the eligibility file on May 23, and your current address is now uploaded into our claims processing system Please accept our sincere apology for the miscommunication of data that resulted in you not receiving reimbursement checks due to you for completed dental services We are certain the incorrect information is updated and the issue is resolved Should you have any questions or require additional assistance, you may reach me at [email protected], [redacted]
Dear Mr [redacted] , The Revdex.com has forwarded your additional concerns regarding the renewal of your dental policy, the Delta Dental Clear Plan We have carefully reviewed the terms of your policy Please see below for our responseYou are correct in that you have fulfilled the 12-month contract for your initial enrollment with coverage effective November 1, through October 31, Pursuant to the terms of the Clear Plan, after your plan has been active for months, for your convenience, the policy will automatically renew There is no need to re-enroll or resubmit payment information This prevents accidental lapses in coverage However, as described on page of your contract/benefit book, if you do not want to renew the policy you only need to provide written notice (electronically or through the mail) before your renewal date There is no indication that you provided notice of non-renewal prior to the automatic renewal on October 30, Your policy was therefore renewed for an additional month contract The Declarations page, which was provided with our initial response, indicates the renewal was processed on October 30, and a copy of this document was forwarded to you at [redacted] In order to cancel your policy, you only need to provide written notice (electronically or through the mail) to Delta Dental at least days before your next renewal date which is November 1, This process is outlined on page of the Clear Plan contract/benefit bookWe hope this response provides satisfactory explanation regarding the renewal and cancelation process for the Clear Plan policyShould you have additional questions regarding your policy, you may contact Delta Dental at www.DeltaDentalCoversMe.com, [email protected], 1-855-335-or Delta Dental, PO Box 103, Stevens Point WI 54481-Sincerely, [redacted] Program Integrity Analyst
Final Consumer Response /* (2000, 7, 2016/01/07) */
Can the complaint please be closed as resolve? After numerous attempts I finally received a call and was provided a copy from their customer relations department
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is satisfactory to me
Sincerely,
*** ***
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID 11120124, and find that this resolution is satisfactory to me
Sincerely,
*** ***
Dear Mr. [redacted],The Revdex.com has forwarded a copy of your recent complaint regarding your Delta Dental Clear Plan policy. We have looked into the matter and have provided our response to your concerns below.Our records confirm that you initially completed online enrollment in...
the Delta Dental Clear Plan policy with an effective date of November 1, 2014. Enrollment information and plan information can be found on our website, www.DeltaDentalCoversMe.com. Page 11 of your contract indicates that when you buy the Delta Dental Clear Plan policy, you agree to keep it in force for at least 12 months. You may terminate your policy upon annual renewal as long as Delta Dental receives written notice at least 60 days before the renewal date. A copy of the Clear Plan policy is included for your reference. Review of your eligibility history shows that your policy was renewed for your benefit period November 1, 2015 through October 31, 2016; there is no documentation on file that you had requested to cancel your plan prior to the renewal of your policy. The Declaration page which is included with this notice and was sent to your email address, [redacted], states that you understand this is a minimum one year contract. If you wish to end your Clear Plan policy, you must notify Delta Dental at least 60 days prior to the renewal date. To discuss your Delta Dental Clear Plan policy, you may contact representatives at www.DeltaDentalCoversMe.com, [email protected], 1-855-335-8275 or Delta Dental, PO Box 103, Stevens Point WI 54481-0103. Sincerely,[redacted]Program Integrity AnalystEnclosuresDelta Dental Clear Plan policy contractDeclarations page
Dear [redacted],Upon receipt of your phone call on May 18, 2017, Delta Dental representatives began researching your concerns and working with you to issue rightful benefits due to you. We found that your home address provided to Delta Dental by your employer was not your current address. ...
That is why previous reimbursement checks were not received by you. On May 19, 2017, Delta Dental's claims department issued two reimbursement checks to you for the outstanding amounts issued on previous checks. Our records indicate that on May 25, 2017, Delta Dental representative [redacted]. called you to verify that you had received the reimbursement checks. She reports that you had received and cashed both checks. Further, our eligibility team contacted your employer to let them know that the address they provided for you is incorrect. The eligibility team for your employer updated your address on the eligibility file on May 23, 2017 and your current address is now uploaded into our claims processing system. Please accept our sincere apology for the miscommunication of data that resulted in you not receiving reimbursement checks due to you for completed dental services. We are certain the incorrect information is updated and the issue is resolved. Should you have any questions or require additional assistance, you may reach me at [email protected]. Sincerely,[redacted]
[redacted]
Dear Ms. [redacted], Delta Dental of Colorado (DDCO) is in receipt of a copy of your recent complaint submitted to the Revdex.com (Revdex.com) serving Denver/Boulder. It has been referred to me for research and reply. All of the information you provided has been thoroughly...
reviewed and compared to our claims and eligibility system. Our records indicate that DDCO provided your dental benefits plan from January 1, 2013 through April 30, 2014. There is no active eligibility in our claims and eligibility system for you. There are no claims for you received or processed for treatment completed in 2016. There are no documented phone calls in your record received from you in 2016. It appears that you may be covered by Delta Dental in a state other than Colorado. Delta Dental of Colorado is a member of Delta Dental Plans Association, a network of 39 independent dental companies that conduct business in all 50 states, as well as the District of Columbia. Each Delta Dental company has individual claims systems that contain all enrollment and claims data for their own members. Member and claims data are not shared among the various Delta Dental companies as we are separate businesses. Claims, grievances or appeals for patients must be submitted to the correct Delta Dental for appropriate processing. For example, Delta Dental of Colorado cannot process a claim, grievance or appeal for a patient covered by Delta Dental of California (DDCA). Nor does DDCO have access to any of DDCA claims or other patient data. You may wish to review your dental insurance card or member benefit book to find the state and address of the Delta Dental that provides your current dental coverage. Your complaint can then be forwarded to the appropriate carrier for response. [redacted] Program Integrity Analyst Delta Dental of Colorado
Dear Mr. [redacted], The Revdex.com has forwarded your additional concerns regarding the renewal of your dental policy, the Delta Dental Clear Plan. We have carefully reviewed the terms of your policy. Please see below for our response. You are correct in that you have fulfilled the 12-month contract for your initial enrollment with coverage effective November 1, 2014 through October 31, 2015. Pursuant to the terms of the Clear Plan, after your plan has been active for 12 months, for your convenience, the policy will automatically renew. There is no need to re-enroll or resubmit payment information. This prevents accidental lapses in coverage. However, as described on page 11 of your contract/benefit book, if you do not want to renew the policy you only need to provide written notice (electronically or through the mail) before your renewal date. There is no indication that you provided notice of non-renewal prior to the automatic renewal on October 30, 2015. Your policy was therefore renewed for an additional 12 month contract. The Declarations page, which was provided with our initial response, indicates the renewal was processed on October 30, 2015 and a copy of this document was forwarded to you at [redacted]. In order to cancel your policy, you only need to provide written notice (electronically or through the mail) to Delta Dental at least 60 days before your next renewal date which is November 1, 2016. This process is outlined on page 12 of the Clear Plan contract/benefit book. We hope this response provides satisfactory explanation regarding the renewal and cancelation process for the Clear Plan policy. Should you have additional questions regarding your policy, you may contact Delta Dental at www.DeltaDentalCoversMe.com, [email protected], 1-855-335-8275 or Delta Dental, PO Box 103, Stevens Point WI 54481-0103. Sincerely, [redacted] Program Integrity Analyst
Sure the desired resolution is to cancel my insurance and obtain a full refund for all payments made this year. Because of gross incompetence in the processing of my insurance I do not believe that [redacted] has received any benefits for services rendered.
Initial Business Response /* (1000, 6, 2015/07/27) */
Dear Delta Dental Member,
Or records indicate that on June 18, 2015 you called Delta Dental of Colorado (DDCO) to verify your COBRA eligibility through Teletech Services Corporation. At that time, our agent advised you were not covered and...
referred you to your COBRA administrator.
DDCO received four additional calls from you during June 2015 trying to verify your coverage. During this time, we began working with your COBRA administrator to update your eligibility record. On June 24,2015 DDCO received an update via e-mail correspondence re-instating your coverage from March 1, 2014 through current. Our representatives entered the information into our eligibility and claims system on July 10, 2015 and your coverage remains active as of this writing.
Your claims history shows that DDCO has received, processed and issued benefits for two claims for treatment completed June 17, 2015 and June 24, 2015. If there are any claims that have been denied as a result of this issue, please forward copies of the Explanation of Benefits statements to the Compliance department at [redacted]@ddpco.com. DDCO will reprocess the claims so that you receive appropriate benefits as indicated per the terms of your dental benefits plan.
We hope this outcome provides satisfactory explanation and resolution regarding your concerns expressed to both DDCO and the Revdex.com. Should you have further questions, you may contact me at [redacted]@ddpco.com.
Sincerely,
[redacted]
Program Integrity Analyst
Dear Mr. [redacted],Delta Dental is in receipt of the complaint submitted to the Revdex.com. We have looked into the matter and have provided our response to your concerns below.Thank you for the detailed account of your experiences related to your eligibility and billing concerns...
regarding your dental benefits plan. On behalf of Delta Dental, please accept our sincere apology for the time you have invested in trying to resolve the issues detailed in your complaint letter.Our records confirm your statement that your coverage with the Kaiser Federal Buy Up plan was canceled effective September 1, 2015. Your spouse received dental services in September 2015 and due to the cancelation of your policy, initially those services were not paid. Based on several phone calls with you or your spouse, it was our understanding that you requested your coverage to be reinstated.Your policy was reactivated December 2015 and we processed premium payments for September 2015, October 2015 and November 2015 for a total of $119.22 ($39.74 per month for three months). This is the amount referenced in your letter that was processed from your checking account on December 8, 2015.Reactivating your coverage allowed processing and payment of the claim for your spouse for services completed September 15, 2015. Delta Dental paid $845.60 directly to your dentist for these services. Reactivating your coverage also restarted your automatic billing process. This resulted in $39.74 processed from your checking account on December 18, 2015 for January 2016 coverage and another premium processed on January 27, 2016 for February 2016 coverage. The premium processed on January 27, 2016 was not completed and was not deducted from your checking account.Our records confirm that you called our representatives again on February 4, 2016 to resolve your concerns related to processing your premium for your dental plan. During this call you made it very clear that you did not want to be enrolled in the plan and you expected a refund for all recently processed premiums.The following day, February 5, 2016, our billing agents initiated a refund for $198.70. This includes premium previously processed for coverage provided September 2015, October 2015, November 2015 and December 2015. At the time we initiated the refund, we had not processed the failure notice for the premium issued January 2016. In total, the refund initiated on February 5, 2016 included five months of coverage at $39.74 per month. This refund should already be credited to your account. If you have not received the refund, please contact me at [redacted] Per your request, DDCO has refunded your checking account and your coverage is canceled. It is our goal here at Delta Dental of Colorado to provide the highest level of customer service to all of our members. In your case we fell far short of that goal and for that we offer our genuine apology.Sincerely,[redacted]Program Integrity Analyst
I would like to see where I accepted a new annual renewal on November 1st. I performed the contract of 1 year as I agreed to. I never agreed to another year contract. I saw no forms, signed nothing. Why can't I speak to a person when I call and why can you not call me when I leave messages? That is a terrible way to do business.
Complaint: 11107388
I am rejecting this response because:
Sincerely,
[redacted]
Complaint ID...
[redacted] Dear Mr. [redacted], The Revdex.com has forwarded a copy of your complaint regarding your dental benefits plan. The complaint and all relevant information have been referred to me for research and reply. According to the information in our claims and eligibility system, coverage for your spouse and dependent was active January 2016 through August 2016. However accurate eligibility information was not updated in our system correctly until August 11, 2016. Your family, nor the treating dentist, could verify coverage until August 11, 2016. This delay in processing eligibility is completely unacceptable. Due to our lack of responsiveness and less than ideal customer service, we will honor your request to provide a full refund for the entire premium collected January 2016 through August 2016. A thorough audit of the account will be completed. When the total amount you have paid for the coverage for your spouse and dependent is calculated, a refund will be processed and issued. Our claims data indicates Delta Dental received and paid $48.00 for treatment completed August 10, 2016. Typically we would require payment for the month in which benefits were paid, but in this case due to our poor customer service and the many difficulties you had with this plan, we not require premium payment for the month of August and the payment to the dentist will not change. Thank you for doing business with Delta Dental of Colorado. We appreciate your patience and apologize for all that you went through to get this resolved. We hope that sometime in the future you will give us a chance to regain your trust. Should you have questions, you may reach me at [redacted]@ddpco.com Sincerely, [redacted]