DentaQuest

Good morning,
please provide the necessary member information in order to proceed with your complaint:
Member Name:
Member ID:
DOB:
please note that our complaints department is closed after 5pm eastern and we do not operate on the weekends. with the requested information above we will be able to proceed in identifying the appropriate referral your child needs to see a specialist. please provide the required member information at your earliest convenience.

[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 [redacted], and find that this resolution is satisfactory to me. 
Regards,
Jasmine [redacted]

Review: it is ridiculous how horrible the DentaQuest service is. I have been after a referral for my daughter for over 2 months. They continue to put me on hold or on a three-way call with my daughters dentist and continue to have them fax the referral. it has been faxed to them over 4 times to 3 diferente fax number and each time them claim they never received. I've spoken to a [redacted] and a [redacted] and now a supervisor called [redacted], who put me on hold for over 30 minutes because when the call was transferred no one "[redacted]" never told her what the call was about. They are dealing with kids lives and have no accountability for what they do. They treat humans in an inhumane way forcing children to endure pain and even infection due to their lack of service. They discriminate against gender and ethnicity, belittling and condescending peoples lives and livelihood.Desired Settlement: I NEED THE REFERRAL TO BE HANDLED IMMEDIATELY AND FOR MY DAUGHTERS TMJ AND WISDOM TEETH ISSUE TO BE RESOLVED

Business

Response:

Hello,

Several attempts were made to contact the complainant at the daytime phone number provided however, no contact was made. A voice message was left for a call back in order to acquire additional member information as the subscriber in question was not identified in our system with the information provided.

please have complainant provide the necessary information in order to proceed with case:

Member Name:

Member ID:

DOB:

thank you,

Consumer

Response:

Review: I cancelled DentaQuest Dental policy 3/31/15. I have called at 6 times, each time, they bump up the waiting period 2-4 wks to refund me for April payment $25.49.

Anthem Silver my health ins, a rep from there said they were fraudelent.

I have a confirm # from a May 18th call # 2[redacted]2. when I called Friday June 19 2015, they said the computers were down?? They would call me back first thing Monday, never did. I just want my money back.Desired Settlement: $25.49

Business

Response:

Good Afternoon,

The members check was sent out via overnight mail FedEx tracking number [redacted].

The member should have received a refund in the amount of $25.49. The actual delivery date and time was

6/30/2015, 1:43pm.

Consumer

Response:

[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.]

I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me.

Review: I purchased dental insurance through Dentaquest at the end of last year and established an online account after receiving an invoice....in January. The effective date of coverage was 1-1-15 and was able to successfully pay the premiums for January and February using the online account. The dentist office says coverage was terminated as of 1-1-15. I had no knowledge if this because my premiums were accepted successfully as processed payments for the two months. If this is the case why didn't the online payment process flag the transaction which would notify me there was an issue ? How was I to pay a bill by January 1st if I had no invoice and was still able to create an online account and submit payments if the coverage had been terminated on 1-1-15 ???? This was the effective date of the policy !! Deceitful business practice folks, and you know it. Just another legal "blame the system" programming loop hole you've created to deny coverage and keep your money.

Customer service has requested coverage be re-instated but now owe the dentist office $200 for cleaning. This is the most unscrupulous insurance scam I've ever encountered.Desired Settlement: That the dental insurance coverage be retroactively instated for January, February and March due to lack of premium refund and unethical business practice.

Business

Response:

Dear [redacted]Problem Report ID: [redacted] DentaQuest Case #: [redacted]Member Name and

ID:

[redacted], [redacted]Issue: Member stated she had purchased dental insurance through

DentaQuest at the end of last year and established an online account after

receiving an invoice in January. The member was able to successfully pay the

premiums for January and February using the online account. When the member

went to the dental office she was informed her coverage was terminated as of

1/1/2015. The member proceeded to have a dental cleaning performed at the

dental office. Mrs. [redacted] states

that if her membership or payment had an issue the system should have flagged

or indicated that her membership was terminated when she was making her

payments. The member is disputing an

amount of $38.00 Action/Findings: on March 25, 2015 Mrs.

[redacted] contacted our Customer Services Department and was

informed by one of our representatives that her dental plan was termed for late

payment. The member was told to send in her payments by mail for March and

April premiums to have it re-instated. AS

of today we have no dental claims on file for this member to indicate the

Provider office was seen at. We have attempted to contact the member with no

response on four different occasions to request a copy of the treatment plan

that was presented to her as this will serve as confirmation of the provider’s

information and DOS the member was treated on. We have also left Voice messages indicating

our contact information so that she may return our calls. Currently, the member

is retroactively showing active as of 1/1/2015. We did not receive a call back

from the member. Final

Resolution: Our systems show that the member has been re-instated with a retroactive

date of January 1, 2015. We will need to obtain the members treatment plan or

claim form from the office to process her charges accordingly to her plan.

Given that the member did not state what office or dentist treated her and with

no successful contact with the member to obtain required information, we will

need to close this case at this time. Should the member contact our Customer

Services Department once again, they may provide her with her current membership

status. Should you have further questions concerning this complaint, you

may contact me directly at ###-###-#### Ext. [redacted]. Sincerely,[redacted]

Review: Sent dental bill to DentaQuest on date of service - 8-7-2014. After 2 mos. I called to find out where my portion of the bill was. Was told they did not receive it until 9-18-2014. Said I found this hard to believe and was told not Post Office's fault, but theirs. After a few more weeks, called again and was told the bill had been processed on 9-28-2014 and check was sent on 10-3-2014. It is now 10-31-2014, and I have still not received my payment. Asked to talk to supervisor, [redacted], and was not able to do that. Was told she was checking into problem and would call me back. That never happened. Called again today and asked to talk to her. Was told she was away from desk. I asked the rep to please tell her to call and leave a message on my answering machine as to where my check might be because it was not in today's mail either. I think waiting 3 mos. for reimbursement on a dental claim is a little extreme. Was also told that I would have to wait until 11-6-2014, call back and put a trace on it. Asked why they could not do it now and they said that is not they way they work. I just feel like this company who is supposed to serve the public is lacking in customer service and follow through. All I am asking is for my check.Desired Settlement: I would like a replacement check be sent ASAP. I have b eenwaiting over and above the desired waiting period. Don't know how they do business with this kind of service.

Business

Response:

To whom it may concern,

A request for reimbursement was submitted by the member to DentaQuest on September 18, 2014, for services by Dr. [redacted] on August 7, 2014. DentaQuest processed the request for payment and check #[redacted] was issued on October 3, 2014 in the amount of $124.00. The check was mailed to the member’s current address.

You think that there would be compassion help and fairness not this company showed none!

Review: I was told by Dentaquest that they had covered my teen-aged daughter's dental fees.

I ended paying 699 dollars out of pocket while being covered by Dentaquest.

I also want to see where the money were gone.

I had never seen a prove whether the money went to the doctor, who treated my daughter at the tme. According to Dentaquest, they had payed every fee the doctor billed.Desired Settlement: In the future, I would like to see more clarity about where the money were payed by Dentaquest. Although we are not using their service any longer, I can't forget the traumatic time when I was dealing with Dentaquest.

if it would be in my power, I would like the Dentaquest be exposed for all the suffering they had brought on all the parents. it has to be known by public.

Business

Response:

Good afternoon,

In regards to complaint [redacted]; DentaQuest is in the process of attempting to obtain additional information from the member in order to be able to respond accurately and completely. We are in need of the provider information and for what dental services the member was charged the $699.00 dollars. I have placed an additional call and sent an email to the member to request the additional details.

Review: First off let me start off by saying that DentaQuest is the absolute worst insurance company for dental services to ever deal with. I have insurance with these unprofessional cheapskates and when I went to a dentist that they had under their dental provider services on their website back in the beginning of December I had an exam and xray done on my mouth when I had excruciating pain in one of my teeth due to a cavity for about two months. So on December 16th when I went again to the dentist to talk to the oral surgeon about the next procedure which was to put me under anesthesia to extract three teeth that they would have to cut into my gums because the cavities were so bad and most the tooth was gone on two of my teeth. After having to go to hell with one of the teeth that was supposed to be removed and kept being put on hold from dental services because of Dentaquest that I went to a separate dentist myself to get that one tooth taken out which leaves me with two remaining teeth numbers 29 and 32 that needed to be taken out . So oral surgeon scheduled the date for the extraction zone today January 6th at 1:30 p.m. and its 11:20 a.m. now as I write this complaint. Mind you that on the 15th & 16th of December and the 4th of January my dentist sent Dentaquest a pre authorization to proceed in the two extractions and the esthesia sedation process and Dentaquest failed to send the approval back. So when I called them today they told me that they're denying the anesthesia process which it is impossible for me to not feel pain without anesthesia sedation how deep the cavities are even though I have insurance through these cheap scam artists. Plus when I was speaking to one lady representative she was extremely rude and unprofessional as she basically told me that she would not let me speak and she screamed at me on the phone with unacceptable and inappropriate words, then when I ask for the corporate address to file a complaint and ask to speak to a supervisor she would not transfer me or give me that information. My id# is [redacted].Desired Settlement: Either finish the job with the two extractions of numbers 29 and 30 with the anesthesia included or I will be filing a lawsuit against this company, filing a report on the ripoffreport, and exposing them to my 10000 friends and followers on Facebook, YouTube, Instagram, and Twitter.

Business

Response:

Good afternoon,

Please find the attached resolution letter.

thank you.

Review: I have been trying to get an approvalfrom Denta Quest Dental Insurance for My son [redacted] Member number [redacted] for over 3 months to have his Wisdom Teeth Remove, my son have been suffering with lots of pain since March 8, 2013. After so many phone calls and speaking to several reps in member services dept. I spoke with a Manager "[redacted]" who assisted me and finally on June 24, 2013 she called me to let me know that the surgical procedure for my son was approved. I called the dentist Dr. [redacted] and they scheduled an appointment for July 12,2013 at 10:00 AM . Today I received I voice mail message from the dentist stating they cancelled the appointment due to my son is no longer active with Denta Quest because he turned 19 years old in June 9th, and Denta Quest refuses to Honor the approval . Please let it be clear I spoken with Denta Quest Manager [redacted] and she knew my son is 19 years old since june 9th, and they approved this procedure on June 24, 2013. [redacted] assured me there was no problem and this approval was good for a 180 days from the date it was approved (6/24). My son's condition is worse his face is swollen and suffering terrible pain. I need Revdex.com to please help me resolve this situation I feel I have been abused by DentaQuest How can this be possible after they approved this procedure now they try to find excuses not to pay!!! Please Help ME!!!!Desired Settlement: I need Denta Quest to stop abusing the patients and to stop Playing Games with peoples HEALTH!! and honor the approval, My son is entitled to this coverage.Denta Quest Manager Julie, assured me once the procedure was approved it won't be any problems!!I have been paying the premiums for over 10 years!!year after year!!

Business

Response:

Thank you for allowing DentaQuest the opportunity to address Ms. [redacted]’s concerns.

DentaQuest has reviewed Ms. [redacted]’s concerns and determined that the first authorization request that

was sent to DentaQuest from the office of Dr. [redacted] on September 15, 2010, was partially

approved. DentaQuest determined that it was medically necessary to approve extractions for teeth 16

and 32 with IV sedation. Teeth 1 and 17 were denied because there was no sign of infection or other

medical reason to extract these two teeth.

DentaQuest received a request on June 21, 2013, to release the authorization for Dr. [redacted].

DentaQuest released the partial authorization approval at the request of the member. On June 18, 2013,

DentaQuest received a new prior authorization submission for Mr. [redacted]’s new dentist Dr. [redacted]

[redacted] for extractions of teeth 1, 16, 17, and 32 with general anesthesia. The authorization was

reviewed and determined on June 24, 2013. All of the services was approved based on the information

supplied by the provider.

Action/final resolution: DentaQuest has approved authorization 201316913772400 for Mr. [redacted] on

June 24, 2013. [redacted], Complaint and Grievance Specialist from DentaQuest has contacted

the office of Dr. [redacted] and advised them that the services have been approved. Once the

services have been rendered [redacted] will be working with the office of Dr. [redacted] to assure that

Mr. [redacted]’s claim is paid correctly.

We apologize for an inconvenience to Ms. [redacted] due to the prior authorization requests.

Sincerely,