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Delta Dental of North Carolina

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Reviews Delta Dental of North Carolina

Delta Dental of North Carolina Reviews (3)

Misrepresented insurance coverage and unable to contact customer service. I ordered dental insurance at delta's website, they requested my previous dental policy number. After giving my information for a quote. It went to payment information screen and I was issued insurance. Since I was giving previous insurance info I assumed I would not have a waiting period. Once I get my information by email I find there is a wait period.Nowhere on the website is information on cancellation or contract details.Do I have a contract? (Am I obligated to making monthly payments for 12 months?)Can I cancel at any time?Why is there a waiting period when I had continued coverage?When I call the number I am told they are unable to handle my call and eventually the phone hangs up. Why can't they handle my call? Are they going to be able to handle my payment when it is due on the 5th?Will they handle my claims?Desired SettlementI just want to be out of this contract (if there is a contract)I don't want any money taken out of my account.Business Response Dear Mr. [redacted],Delta Dental of North Carolina (DDNC) is in receipt of your complaint filed with the Revdex.com. DDNC considers this complaint to be important and utilizes every opportunity to identify consumer concerns. With respect to your inquiry regarding continuous coverage, the portion of the enrollment website that requests prior policy information is for internal reporting purposes only. Nowhere on the website does it state that existence of prior dental coverage would waive any waiting periods.Per our records, your official enrollment date is Friday, January 31, 2014, which coincides with the filing date of this Revdex.com complaint. The welcome package, which includes the Policy and identification card is normally mailed within five days of official enrollment. Therefore the welcome package was in the queue for mailing on the date this complaint was filed. Important policy information, such as cancellations, renewability and coverage period can be found in the Policy, as well as the Delta Dental Individual and Family Plans brochure on Delta Dental's website.Regarding claim handling and payment practices, our industry-leading technology platform has been internationally recognized as providing the best in fast, flexible service including online, real-time claims processing. In 2013, more than 94% of claims were processed within 10 business days, with a 99.9% financial accuracy rate.Lastly, our Customer Service department who typically answers calls within seven seconds on average, with an abandonment rate of 1.43%, is currently experiencing extremely high call volumes and increased wait times due to peak enrollment season and inquiries regarding the Affordable Care Act. We sincerely apologize for any inconvenience caused. To follow up on your inquiry, our customer service attempted to contact you on Friday, February 7, 2014 to address and resolve any further concerns. Should you have any further questions, please contact our Customer Service department at (XXX)XXX-XXXX.

Delta dental unable or unwilling to provide a record of a past claim.I have been a delta dental insured member since 2009. I recently attempted to get a copy of a claim for my dependent wife [redacted] date of service 05/05/2011. I was told that there is nothing that can be done and they can not provide a copy of the claim because it was from a different company.Desired SettlementI want a copy of the insurance claim for 5/05/2011Business Response Dear Mr. [redacted]:Delta Dental of North Carolina is in receipt of your complaint filed with the Revdex.com. DDNC considers this complaint to be important and utilizes every opportunity to identify consumer concerns.The EOB, which details the claim in question was mailed to your home address on October 3, 2014. We apologize for any inconvenience this may have caused. Should you have any further questions, please contact the Customer Service representative that handled this request at [redacted], ext. [redacted].Sincerely,Delta Dental of North Carolina

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Delta Dental misrepresents their coverage on their website.When acquiring a quote through Delta Denta's [redacted].com website they clearly state in a table of coverage that it applies to "[redacted] Dentist,[redacted] Dentist, and Nonparticipating dentist." I signed up for their insurance as a result of this information. Now that I am a member I am being told that the coverage ONLY applies to [redacted] dentists and not my dentist which is[redacted], I was then forced to pay $115 for services I was lead to believe the company covered when I signed up.When I called customer service I was told that the information was clearly available if you call and ask customer service. I was then told that I should have called and asked customer service if I had questions. However, I did not have questions at my time of purchase because it was made very clear on the website that I was purchasing coverage for [redacted] dentists,[redacted] Dentists, and Nonparticipating dentists. Delta Dental is misrepresenting their services and lying to their customers, it is only after the customer signs up that they receive a benefits package that explains the actual coverage they receive. I am now stuck with this insurance. Desired SettlementI want my bill partially refunded. I am more than happy to cover my clearly stated $75 deductible to Delta Dental, however I should not be held responsible for the additional $40 I was lead to believe was covered due to the false information on their website. I would also like to see their website updated to reflect their actual coverage so no one else is tricked into paying for something they will not receive. Business Response Dear Ms. [redacted],Delta Dental of North Carolina is in receipt of your complaint filed with the Revdex.com. Thank you for bringing your concerns to our attention. Delta Dental of North Carolina considers this inquiry to be important and uses every opportunity to identify consumer concerns. Upon receipt, we promptly researched your inquiry.It should be of note that our individual product web portal (www.[redacted].com) is intended to provide a convenient overview of coverage, and not intended to be a complete description or guarantee of payment. Disclaimer language to this effect is clearly displayed on the website. Nonetheless, your inquiry prompted us to revisit the language on our website. To act in the best interest of the consumer, we will update the language to clarify certain benefit and deductible details for each plan offered via www.[redacted].com.A review of your records indicate that you are enrolled in our individual and family plan; Delta Dental [redacted]. Your policy states that covered persons are responsible for any differences between the Delta Dental [redacted] and Delta Dental [redacted] dentist schedule, if a [redacted] dentist is not utilized for dental services. With this plan, it is very important that you utilize the services of a Delta Dental [redacted] network dentist in order to maximize benefits and reduce your out-of-pocket costs.I would like to point out that Delta Dental has the largest network of dentists locally and nationally. Nearly 40% of all licensed dentists in North Carolina are in the Delta Dental [redacted] network. To locate a Delta Dental [redacted] network dentist in your area, please visit our website, or call us at (800)-[redacted].Given the particulars of your inquiry, which resulted in an improvement to the quality of our website, we will make a one-time exception and re-process your claim. This exception is for this case only and does not set a precedent for future situations of this type. Payments for treatments completed by Delta Dental network dentists are paid directly to the dentists. Please contact your treating dentist for your refund. We hope this outcome provides a satisfactory explanation and resolution regarding your concerns expressed both to Delta Dental of North Carolina and the Revdex.com. Should you have an questions, please feel free to contact us at (800)-[redacted].Sincerely,Delta Dental of North CarolinaConsumer Response Thank you so much, I understand my individual policy, it was explained well in the welcome packet I received after purchase. And while I am not happy with my policy, I do not have any arguments against it's language or outline in those documents. My complaint was the misleading language on your site that lead me to purchase a policy that was not what I wanted, leading me to be stuck with inferior coverage for the remainder of the year. I intended to purchase coverage that would allow me to continue seeing my favorite dentist, it saddens me that I will have to look elsewhere for dental care. However, I am very happy to hear that you reviewed the language on your site and are looking into changing it to make it clearer for customers in the future. Thank you for handling this matter quickly and professionally. Final Consumer Response

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Description: Insurance Companies

Address: 300 Phillips Road, Raleigh, North Carolina, United States, 27609-6084

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