Customer ReviewsforDelta Dental of Illinois

Terrible coverage. They barely pay a fraction of the costs. Example - I had two fillings replaced. The cost was about $498, which I had to pay upfront, out of pocket. Delta "reimbursed" $190 or so. I have had much better coverage with other companies and I did have to wait for a check in the mail. If you have a choice, go with another insurer.

December 15, 2023 Customer Relations Advocate ********************** of ****************** Illinois, ********************************************************************** Illinois ***** Re:BBB Review ****** To Whom It May Concern:Delta Dental of Illinois is in receipt of your correspondence regarding the above matter. Based on our investigation this review was sent to us in error. The complainant is not in our system as Delta Dental of Illinois subscriber it seems the reviewer might be a member of Delta Dental of ********; they can be reached at ************. While we are all under the Delta umbrella they are a separate entity and we do have access to their records nor do we set their rates. We believe the above information responds to this review and concludes our handling of this matter. Should your agency need additional information, please contact **************************************

I signed up for Delta Dental of Illinois in January of 2022 and my rate total is $87.68 for myself and my son. In July 2023 I recently signed my mother up for the same dental package and her rate is about $50.10 and I asked why the rates had been changed and I was told that the company decided go up and there rates. However, when I asked about my rate the customer service representative told me that my rate was grandfathered in at $43.84 then I received a letter letting me know my rate a month will be $95.00 a month without a prior email or letter about the increase. I recently talked to a supervisor on today and I asked could I assess my application to let know if I was aware of the price increase on my monthly premium. My complaint is I have an issue about the price increased that the corporation decided to send me a letter a couple months ago. I am sure this is a tactic that this customer does to customers who have individual dental insurance

Re: BBB Review ID ****** Dear Sir or Madam,On behalf of Delta Dental of Illinois, this letter serves as the response to the review submitted by a Delta Dental of Illinois member.Delta Dental of Illinois assesses many factors, such as market trends and data, cost of dental services and usage of the insurance, in establishing rates. A key factor is spreading risk among individuals who purchase these plans. Spreading the risk generally results in better pricing for all. Individual members are pooled with other individual members. These factors are used to establish a risk calculation, which is used to develop rates. These same factors go into establishing renewal rates; however, inflation and the experience of those in the pool play a factor. Initial rates are based on statistical predictions and renewals include actual experience. Rates were increased at renewal because the initial predictions did not match the actual experience. Rates are not always increased at renewal; it all depends on the various data and analysis.Additionally, the Illinois ********** of ********* (***) regulates plans and rates for dental benefit programs in the state. Delta Dental of Illinois plans and rates are filed with the *** and the *** reviews and approves the risk calculations and rates for each plan to ensure they are reasonable and based on correct formulas. Renewal rates are also filed, reviewed, and approved by the ***.We believe the above information responds to this review and concludes our handling of this matter. Should your agency need additional information, please contact **************************************

worst dental insurance company I've dealt with in my life and I've been on this earth for a long time definitely looking for a new insurance company !...this one is almost as bad or worse than United healthcare must be the water in Illinois not sure ...(I think the smaller the company the better off)....but I don't know who's training these people but they've been pretty useless not even going to get into all the details????????

Dear *** or Madam,On behalf of Delta Dental of Illinois, this letter serves as the response to the review submitted by a Delta Dental of Illinois member on September 7, 2023. Our customer service team determined that the reviewer had an issue regarding a claim. The provider's information was not included on the claim form, causing the claim to be rejected. Our team has confirmed that we now have the necessary information to process the claim. A supervisor on our Customer Experience team has contacted the member to discuss the issues with the claim that resulted in it being rejected and informed them payment will be issued. We understand the reviewers frustration and apologize that their service expectations have not been met. We value our members and always strive to provide excellent customer service.We believe the above information responds to this review and concludes our handling of this matter. Should your agency need additional information, please contact **************************************

A nightmare that began April 25, 2023 and is still going on now. I don't know what is worse the U.S. *********** that cannot deliver a certified piece of mailsince June 29, 2023 or the Delta Dental **************** folks at that 1 800 number. Does anyone work in the ********** building? Their CEO is compensated 1.7 million dollars [a nonprofit company]annually while poor people like ** are trying to get a claim processed in a timely manner. I now understand why Delta Dental of ** is getting bad reviews. The media needs to do an expose on this nightmare of a company.

August 2, 2023 Customer Relations Advocate ********************** of ****************** Illinois, ********************************************************************** Illinois ***** Re: BBB Review ID ****** Dear Sir or Madam,On behalf of Delta Dental of Illinois, this letter serves as the response to the review submitted by a Delta Dental of Illinois member on July 29 regarding the processing of their claim. The members claim was originally submitted in April. We needed more information to process the claim, and advised the member and dental provider what was needed through an Explanation of Benefits. In late July, our team confirmed we had the necessary information to process the claim. The claim is now processed and a supervisor in our Customer Experience team has contacted the member to discuss the claim. We understand the members frustration and apologize that multiple calls were needed to address this issue. We are working with our team to retrain on our call escalation protocols. We believe the above information responds to this complaint and concludes our handling of this matter. Should your agency need additional information, please contact **************************************

I went to my dentist 3 times after getting this coverage in January. Everywhere I look in my Benefits package, in or out of network benefits are the same and they never list any limits regarding what is "allowed" for any service. My first appointment was preventative and is listed as being covered 100% with no deductible and this is per their own site if you look up the codes. Interesting how I get the *** and I owe $110. They only allow $60 for an exam, $103 for full X-Rays, and $72 for a cleaning. I guess they think dentists are actually charity workers?? I don't think I've ever owed a balance after a routine preventative visit with insurance. I somehow owe over $305 for 2 fillings, while they only paid $234 because they expect fillings to cost less than $200 each, so they only allowed $318 out of the total $540 (again, none of these prices are listed anywhere on their site). Within a week, one of those fillings cracked, due to no fault of my own, per my dentist, and to fix that, I owe another $100+, while they paid less than $72 because they expected the evaluation to only cost $54 instead of $80 and only allowed $22 for the $35 Xray necessary to fully diagnose what needed to be done to fix it. Oh yeah - they don't cover the Novocain necessary to get a filling fixed, either. I guess you either have to suffer or tack it onto the rest of your ridiculous bill. I'm waiting on my former employer to send me the 2023 benefits guide because all I have is the one from 2022 they sent me when I hired on, which listed the co-pays for things like fillings as 20%, yet now their site and *** is claiming 80% and I paid for the higher plan with "better" coverage. I would never willingly choose this company again. I'd be just as well off buying some dental plan off a commercial, unless you happen to get your dentistry done in a back alley and then this plan may be worth something.

April 14, 2023 Customer Relations Advocate ********************** of ****************** Illinois, ************************************************************** Illinois 60601-1795 Re: BBB Review ID: ****** Dear Sir or Madam,On behalf of Delta Dental of Illinois, this letter serves as the response to the consumer review regarding Delta Dental of Illinois. Thank you for the opportunity to respond. The following describes our handling of this matter. The member who left the review called our customer service team twice. The member first called on 1/10/2023 to check eligibility; however, our customer experience representative could not find the members information in our system as it was not yet entered. The member called again on 1/26/2023 to check eligibility and we were able to locate the member in our system. Our customer experience representative provided the member with their ID number but did not provide any benefit or plan details as the member did not request any. The members dentist submitted claims for treatment on 3/14/2023, 3/20/2023 and 3/30/2023. The member visited a non-network dentist. Non-network dentists do not have to follow our network guidelines or claims processing policies, and they do not agree to accept our network fees as payment in full. Since the member went out of network, their dentist can bill them the difference between their submitted fee and Delta Dentals allowed amount. Members can choose to go to any dentist; however, they will get the most benefit from visiting a Delta Dental PPO dentist. PPO dentists agree to accept our allowed fees as full payment. They are not able to balance bill members for the difference between their submitted fee and the allowed amount. Therefore, we encourage members to use a network dentist as more than 85% of our claims are paid to network dentists. We believe the above information responds to this review and concludes our handling of this matter. Should your agency need additional information, please contact **************************************

My dentist and oral surgeon submitted claims. They have not paid a *****. When I called and asked why, they said they have not received any claims. My dentist had tried 3 times already after verifying the address and ID #. I believe they do not want to pay...I will be canceling this fraud of a company as soon as my year is up.

Re:BBB Review ID: ****** To Whom It May ********** behalf of Delta Dental of Illinois, this letter serves as the response to the consumer review regarding Delta Dental of Illinois. Thank you for the opportunity to respond. The following describes our handling of this matter. We received a claim for the reviewer on March 6, 2023, for a date of ******* of ******** 23, 2023. The claim was sent via fax, so it had to be manually entered by our **************** team. The claim was entered March 13, 2023, and is still processing. The reviewer contacted our **************** team on March 10 and March 13 to check to claims status, but the claim had not been entered yet at the time of her calls. Delta Dental processes claims quickly and accurately. Claims submitted electronically are processed faster as there is no manual intervention. We believe this resolves this matter. If you have any questions, please contact us at **************************************

If I could give their customer service a rating of zero I absolutely would. The customer service rep was a man, but refused to give me his name. I listed all of the sites I tried looking for the patient's benefit information and he informed me I was on the wrong sites (which was fine) I asked that he stay on the phone with me for an extra minute to make sure I was able to get into the correct site. He said "I'm not going to sit on the phone with you while you figure out login information" (we pre-save our login so it would have taken 30 seconds). I then asked to be sent to a survey, his response was "We don't do surveys." So then I asked to speak with a manager. He then stated "I'm not contacting a manager, because YOU have an issue with our policies. Have a blessed day." Then hung up on me. He also would not help fax the benefit breakdown. Pretty pathetic that their customer service reps aren't willing to help make sure you have the correct information. Nor was I able to talk to a manager about my concerns. - ****** - Dental Office Employee

March 2, 2023 Re:BBB ********************** To whom it may concern,On behalf of Delta Dental of Illinois, this serves as the response to the above referenced review submitted on February 23, 2023.We apologize that the reviewer had a frustrating experience that did not meet our high customer service standards for all those we serve. To be able to best review and address this experience, we need more information, including the date, time, telephone number they called from, or the member details will allow us to further research the call. Please contact our customer service at ************ or ******************************* Should the Bureau need additional information, please contact **************************************

RUDE customer service ever for providers! Not helpful! Bottom of the barrel employees! Delta Dental should go back to customer service training! Shameful! And they don't care!

Re:BBB ********************** To whom it may concern,On behalf of Delta Dental of Illinois, this serves as the response to the above referenced review submitted on December 6, 2022.We apologize that the reviewer had a frustrating experience that did not meet our high customer service standards for all those we serve. To be able to best review and address this experience, we need more information. Please contact our customer service at ************ or ******************************* Should your agency need additional information, please contact **************************************

Horrible, dishonest company (Delta Dental ins. company) that first denies, denies, denies, then lies and then won't talk to you or honor their words. We were told that we were covered the exact same way when I called to inquire about coverage for a dentist taking over for our now retired dentist. The cust. service rep said no changes and payment/coverage would be same. Well it wasn't according to them when the claims came through after our visits to the dentist and my call ahead of time to Delta to verify this issue. Afterward, they kept telling me that I was given the right information until finally another supervisor said I was give the wrong info after all. Also told I would get reimbursement for the difference in the cost due to their error. I was then told the check was being mailed 8/8 for approximately $500. Well, no check has come, ,as of 9/2, and sinse then they're dodging my calls and won't call me back, so I filed a complaint with BBB and the Illinois ***** of insurance. It's been almost 2 weeks now and they haven't even responded to the complaints. Do yourself a favor and find another insurance company. This one is dishonest and unprofessional and will lie straight to your face on many occasions.

On behalf of Delta Dental of Illinois, this letter serves as the response to the review submitted by a Delta Dental of Illinois member in regard to their service and claims coverage.This member also filed a complaint with the BBB, which we responded to. We found that one payment was mailed August 31, 2022 and another being processed and will be mailed today, September 7, 2022. A customer service supervisor contacted the reviewer last week and left a message and is reaching out to the member again today. We agree that the service provided to the member was not up to our standards. We first spoke to the member July 26 and advised we would request an exception for a claim adjustment. On August 8, a supervisor called the member and informed them that the exception was granted. That same day, a representative was tasked with adjusting the claim. The claim was complex, and the representative needed assistance, but erroneously did not forward for additional review. On August 24, the representative caught their error, forwarding the claim for adjustment assistance, which resulted in the August 31 payment to the member. However, this was only one of the members claims. When we received the members complaint, upon investigation, we realized there were two other claims, and these were adjusted as well with a check being issued to the member today, September 7. Our team will be taking this as a learning opportunity to provide additional training, which will assist our supervisors and entire call center team in creating the best possible customer experience. We believe the above information responds to this review. Should your agency need additional information, please contact **************************************

Delta Dental is a bait and switch. They are happy to cover 6-month cleanings and 80% of fillings, but beyond that, everything has an exception. It is listed a cosmetic, even if it is needed for you to chew correctly. If you think they are interested in their customers or anything other than a profit, try again. This service is sponsored by my business. I will be recommending that we drop them as a copany and will be moving to alternate coverage if they do not..

August 26, 2022 Customer Relations Advocate ********************** of ****************** Illinois, *********************************************************************, Illinois ***** Re:BBB File Number389571 Dear Sir or Madam,On behalf of Delta Dental of Illinois, this letter serves as the response to the review submitted by a Delta Dental of Illinois member on August 23 regarding their coverage for a specific procedure.As part of our research to respond this BBB review, we discovered the member contacted our *************************** via email with specific details about this complaint on August 22. Before the review and email, we have no record of the member contacting our *************************** regarding ********************** services and their dental benefit program coverage. We do have record of claim denial for a procedure that is not covered under the members plan. This week, the members dentist submitted a pre-estimate of benefits for a different procedure.The member is covered by a group plan, which means the group determines benefits, specifically what and how services are covered. We follow group benefit plans and process claims based on these specifications. Our **************** Team is working with the dentist and member to review services and benefit plan coverage. We believe the above information responds to this review. Should your agency need additional information, please contact **************************************