Delta Dental of Wisconsin

See attachedMr [redacted] may end his policy coverage effective 12/31/or upon the one-year renewal on 3/31/Delta Dental will assume the 3/31/date unless Mr [redacted] contacts us to provide other direction

The details of this issue were forwarded to Delta Dental of Washington for responseDDWI will follow up to ensure it has been received

Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and have determined that this does not resolve my complaint For your reference, details of the offer I reviewed appear below To whom it may concern,On December 30, my wife called the customer service number asking for explanation about the deposited checks and if they can just cancel our application and get our refund back,the customer representative said that there is no way they can return the money they deposited not unless we can arrange it with the bank to stop payment.I went to a Chase Bank close to me at around12:00(Franklin Lakes Rd.Franklin Lakes NJ Tel.####-###-####) and spoke to a [redacted] Officer/Relationship banker about the incident and tried to fill up a certain form to halt all deposits,Mr [redacted] called the same number listed to speak to a representative and confirm what happened to process my claim.Waited an hour an nobody was able to pick up the phone which was prompted to be answeredin minutes.The banker informed me that they cannot process the claim not unless he speaks to a representative from DELTA dental.I called my wife and ask her to call DELTA again and see if she can ask them to cancel it again but they said that they could not cancel it since we applied in the Healthcare.gov website to cancel our application.DELTA was quick to get our money but was slow to answer our queries when needed.Their instructions on their billing needs to be investigated as there is not enough details to guide the consumer.I would pursue this claim and call FOX News or any other TV stations if this would not be resolvedin weeks,you have swept my checking account penalizing me to pay fees that should not be charged to me.The checks I issued all have post-dated checks and should have been respected by DELTA that it be remitted as indicated,I have all duplicates to prove my claim including the transaction in the bank as stated Regards, [redacted] ***

Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and have determined that this does not resolve my complaint For your reference, details of the offer I reviewed appear below.I received a letter as previously indicated, stating my husbands policy will renew as of 01/01/Thus however contradicts the statement that the policy would renew as of 4/1/I do not feel it is fair as I have been advised by telephone by a representative of Delta Dental in September 2015, that in order to cancel the policy a statement in writing must be made to cancel said policy I have followed their procedure as previously advised to meThere are two dates of renewal given as well as two contradictions in terms of policy on cancellationPlease advise as this appears to be another attempt to collect on a consumer that is disabled and will incur more financial burden that had been thrice attempted with mitigation [To assist us in bringing this matter to a close, we would like to know your view on the matter.] Regards,

Delta Dental of Wisconsin is a claims administrator for the individual policieswritten by Delta Dental of ColoradoDelta Dental has record of several callsfrom [redacted] requesting cancellation of her policyMs***’s policyhas been terminated July 31, 2015.Tell us why here

Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and have determined that this does not resolve my complaint For your reference, details of the offer I reviewed appear below The response I received from the Revdex.com if Wisconsin simply says: "The details of this issue were forwarded to Delta Dental of Washington for response DDWI will follow up to ensure it has been received."I have been given days to state whether or not I am satisfied with this response I am not satisfied with being on a day clock when I have not received any true response from (1) Delta Dental of Washington, or (2) Revdex.com of Wisconsin.Please start the day clock only after the Revdex.com of Wisconsin forwards to me an actual response from Delta Dental of WashingtonI have attached a copy of my original complaint Regards, Albert [redacted]

[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]
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.
Regards,
*** ***

Delta Dental will wait to hear what action will be taken by *** ***'s bank.Thank you

The letter of complaint for the above referenced has been
received at our office and forwarded to me for response.The purpose of the self-service options are to help
providers find needed information quickly and efficiently through use of the
website or a faxback if they do not have internet
access so that they can best
serve their customersDelta Dental of Wisconsin offers these self-service
options so that dentists can access information when it is convenient for them
and their patientsDentists are able to access this information 24/from the
website as well as making a request for a fax.Once a dental office has obtained benefits through one of
the self-service options, they are provided a Benefit Verification Number
(BVN)The dentist will be asked to provide this number when contacting the
Delta Dental of Wisconsin Benefit CenterUpon the dental office providing the
Benefit Verification Number, Benefit Advisors are happy to assist with any
additional questions.Delta Dental of Wisconsin's
records indicate that Katharina (referred to as Katie) from Dr*** ***'s
dental office contacted Delta Dental of Wisconsin twice on September 7, to
obtain benefit information for the memberDelta Dental of Wisconsin's records
indicate that Kerry spoke with Katie at the 10:a.mand the fax was
delivered at 10:a.mThis document provided the information that she was
requestingIn both points of contact, Benefit Advisors offered to send a
request for a Supervisor callback.The Supervisor returned Katie's phone call on September 8,
at 7:a.m., about business hours after the request was madeThe
Supervisor explained the benefits of accessing the selfservice option with
Katie and indicated the information requested was on the fax that was sent to
herKatie indicated that their office policy is not to keep printed documents
The Supervisor also reviewed the website option which is available hours a
day with immediate access.Delta Dental of Wisconsin
considers this issue to be closed

Delta Dental of Wisconsin is a claims administrator for the individual policieswritten by Delta Dental of VirginiaDelta Dental has record of several callsfrom *** *** requesting cancellation of his policyHe was unaware ofthe automatic renewalAs a courtesy, the termination date has been
changed toMay 1, and his premium refunded

Mr***'s policy has been cancelled 3/31/

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this does not resolve my complaint. For your reference, details of the offer I reviewed appear below
I am fine with them cancelling my policy and returning the current month's payment for any days I was not covered Unfortunately the are engaged in advertising, as they offer a month policy, but you can only access features advertised in the plan after the month So you either have to renew with Delta after your first policy, or else you don't get to access the services I am paying for They should be ashamed of themselves, especially since I offered to pay all of my premiums for the year upfront, as to not be burdened with silly "restrictions" on services I am paying for
Regards,
*** ***

Delta
Dental had four different dental consultants review the documentation and
x-rays provided by Mr***’s dental officeAll four consultants agree
these teeth do not meet the criteria for crowns.The
dental plan document states that “Crowns, inlays, or onlays are provided when
teeth
are broken down by dental decay or accidental injury and may no longer be
restored adequately with a filling material.” Crowns may be recommended
by a dentist for many reasons, not all of which are covered by the dental
plan. Benefit for crowns is only available when a tooth is broken down by
dental decay or accidental injury to the point where it cannot be restored with
a filling. Some dental offices recommend crowns on teeth with
non-symptomatic fracture lines or to prevent future restorative care; however
benefit is not available for crowns done for those reasons.Treatment
decisions are between a dentist and a patient. The benefits available on
a dental plan should not be the main factor in deciding what treatment is
appropriate. Delta Dental recommends a predetermination for all major
restorative work, because it is upsetting to be caught off guard with a large
out-of-pocket expense.Mr
***’s claim was processed in accordance with the contractual benefits
available under the dental plan.Tell us why here

The Shared Enhanced Plan policy waspurchased by Mr*** via the website on 03/09/with an effective dateof 04/01/The policy is for one year with the first opportunity to cancelon 03/31/One claim for Mr*** has been processed and paid.This plan has a one year waitingperiod
for crowns which is defined in the Summary of Benefits portion of thepolicyBefore completing the purchase of his policy, Mr*** was presentedwith the policy contract and then required to check the box that stated he readand understood the policyThe policy includesa 10-day free look period with a notice stating “If you’re notsatisfied with this policy you can return it anytime within days of the dayyou received itWe’ll void the policy and refund your premiums.” Delta Dental of Wisconsin has canceled Mr***’s policy effective 08/31/2015with no refund in premium payment. Tell us why here

Delta Dental will refund the premium from January - December We also received notification from the Federally Facilitated Marketplace to terminate the policy effective January 1, 2016.Thank you

Dear Mr. Colmerauer:The letter
of complaint for the above referenced has been received at our office and
forwarded to me for response.Mr. [redacted]'s employer, [redacted], offers a voluntary dental plan to its employees. As the
dental insurer, Delta Dental takes direction on...

eligibility maintenance from
the employer.As a courtesy, Delta Dental contacted [redacted] and confirmed Mr. [redacted] discontinued his dental coverage as
of December 31, 2016. Delta Dental processed and paid claims under the dental
plan during the month of January; therefore, a termination date of January 31,
2017 has been entered for Mr. [redacted]. With this termination, Anita [redacted]'s dental
plan through [redacted] is the only plan covering the [redacted] family.

The terms of the policy state it is a 12-month contract that runs through December 31, 2016.

The details of this issue were forwarded to Delta Dental of Washington for response. DDWI will follow up to ensure it has been received.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this does not resolve my complaint.  For your reference, details...

of the offer I reviewed appear below.
To whom it may concern,On December 30, 2015 my wife called the customer service number asking for explanation about the deposited checks and if they can just cancel our application and get our refund back,the customer representative said that there is no way they can return the money they deposited not unless we can arrange it with the bank to stop payment.I went to a Chase Bank close to me at around12:00(845 Franklin Lakes Rd.Franklin Lakes NJ 07417 Tel.####-###-####) and spoke to a [redacted] Officer/Relationship banker about the incident and tried to fill up a certain form to halt all deposits,Mr. [redacted] called the same number listed to speak to a representative and confirm what happened to process my claim.Waited an hour an nobody was able to pick up the phone which was prompted to be answeredin 21 minutes.The banker informed me that they cannot process the claim not unless he speaks to a representative from DELTA dental.I called my wife and ask her to call DELTA again and see if she can ask them to cancel it again but they said that they could not cancel it since we applied in the Healthcare.gov website to cancel our application.DELTA was quick to get our money but was slow to answer our queries when needed.Their instructions on their billing needs to be investigated as there is not enough details to guide the consumer.I would pursue this claim and call FOX 5 News or any other TV stations if this would not be resolvedin 2 weeks,you have swept my checking account penalizing me to pay fees that should not be charged to me.The checks I issued all have post-dated checks and should have been respected by DELTA that it be remitted as indicated,I have all duplicates to prove my claim including the transaction in the bank as stated.
Regards,
[redacted]

Delta Dental regrets that it did not receive timely notification of your husband's decision to terminate his policy and that claims were processed.Delta Dental considers this matter closed.