Complaints

The complaint text that is displayed might not represent all complaints filed with BBB. Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business.

• Initial Complaint

  Date:04/14/2025

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  My son had braces (spacers)put on in Jan 2022. They pretreatment was finished in November 2022 and the actual braces to straighten his teeth were installed on Dec ******. ********** was told multiple times that he received two treatments and the insurance only paid for one. It was finally noted in November 2024 that the two treatments were noted and submitted. They did pay for the 1st treatment but never paid for the second treatment. I have spent over 30 hours on the phone attempting to get this resolved. Supervisors arent available and never call back. I was told by ******** on March ******* that a payment for the second phase would be sent on March 28th. I called on April 2nd and nothing has been sent. The orthodontist has been waiting over 2 years on this payment. They keep getting different confirmation numbers. The orthodontist and I have been getting the run around. I have attached all of the confirmation numbers that the orthodontist has received. Now ************** said it has been too long. The orthodontist and I have been trying to get ************** to pay for the second phase since Feb 3, 2023 and we keep getting different reasons and excuses.

  Business Response

  Date: 04/22/2025

  Hello,
  We have received the complaint and will respond to the member directly within 30 days. 

  Customer Answer

  Date: 04/24/2025

   
  Complaint: 23204648
  
  I am rejecting this response because they refuse to call back. I waited for over two weeks for a supervisor call and no one called back. Their policy is to call back customers within 48 hours. 
  
  Sincerely,
  
  ***** *****

  Business Response

  Date: 05/02/2025

  Hello, this member complaint is open and currently pending on Case ID **********. This complaint was received on 04/22/2025 and can take up to 30 days for resolution. ************ will respond to the member directly within 30 days regarding this complaint. Thank you.

  Customer Answer

  Date: 05/07/2025

   
  Complaint: 23204648
  
  I am rejecting this response because:
  They just need to pay **** and **** for the work they did and the numerous times they billed the insurance company.  We were told multiple times it would be paid and kept getting different excuses and different codes. One phone call that I made, Delta  wanted the orthodontist to commit insurance fraud by the way a representative told them how to get it resolved. They agreed to get the braces done and have been billed several times, now they just need to pay the $3,995.
  Sincerely,
  
  ***** *****

• Initial Complaint

  Date:02/19/2025

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  May 15, 2024 claim date for my daughter, ***** ****** ******** This claim was filed incorrectly. According to the past 15 years of claims for my daughter, the total cost of this claim should be covered.The claim was for $525 and they only covered $186. I have to pay $389 out of pocket.I have called and spoken with them on numerous of occasions with them saying they would call me back. This past call the week of 2/4/25, I was on the phone for an hour and passed around to several different people. They said someone would call me back. No call back was received.

  Business Response

  Date: 02/19/2025

  Hello 

   

  Please have your adult dependant fill out an authorization form in order for us to submit an appeal.

   

   

  Thank you 

  Customer Answer

  Date: 02/20/2025

  I/my daughter filled out a form Summer of 2024 to allow me access to speak on her behalf for claims.

  Business Response

  Date: 02/27/2025

  Hello

   

  Thank you. The claim shows it was sent back for review on 2/11/25 this usually takes aroung 7-15 business days. Once this is complete we will issue either a letter or a new explanation of benefits. 

   

  Thank you 

  Customer Answer

  Date: 03/03/2025

   
  Complaint: 22960470
  
  I am rejecting this response because:  today is the 14th day according to their "time frame."

  Once the "time frame" suggested is complete, a better decision can be made.
  
  Sincerely,
  
  ******* ******

  Business Response

  Date: 03/17/2025

  Hello

   

  The adjustment was made to the claim, a new statement was issued on 3/14/25 through mail, please allow 7-10 business days for this to be received. 

   

  Thank you 

• Initial Complaint

  Date:09/24/2024

  Type:Service or Repair Issues
  Status:

  UnansweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I have an appointment today 9/24/24 at 8:00 AM in *********** *********************************** for a routine cleaning 100% covered by my DeltaCare USA dental insurance. DeltaCare USA Enrrolle No ************ Group No ***** - ***** I don't have any pain or gum bleeding. I requested the assistant not to deplete all my ************ coverage so I can have some coverage for the rest of the year if needed. It is a practice that the office previously did for my wife. After a discussion, I requested to talk with the manager's office, so I repeated my request. The manager told me the ** would be free because I'm a new customer. I said OK, go ahead with the process. Once finished, the dentist diagnosed me with a deep cleaning. I said OK, but let's do the routine cleaning my insurance covers. After that, the office manager showed me a proposal with the treatment recommended by the dentist. Again, I said OK, let me see how I will pay for the treatment (about $730), but please do my routine cleaning that is 100% covered by my DeltaCare USA dental insurance. The manager denied the treatment, stating that I needed a deep cleaning. I called the insurance company, and they justified the office process. So, the insurance is advertising coverage that when you request the office raise the treatment, you have to pay for a service that is not required and avoid the covered service. It looks like everything is arranged to increase the service and pay more. I'm requesting that the office and insurance provide me with the service coverage that I'm paying for or provide me with the fee services amount of two (2) routine cleanings with another dental provider for me, my wife, and my daughter covered by the insurance. It looks like a joint practice between the office and the insurance company. I will raise this issue if it is not resolved soon. All ** and documents are in the office. I was upset and did not request it. I'll file this complaint with the ************* also.

• Initial Complaint

  Date:07/11/2024

  Type:Customer Service Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Trying to add our dental care provider to get a cavity taken care of for our 8 yr old daughter. The dentist as well as my husband have been trying to reach *********** they are in network. Neither the dentist nor my husband can get in contact with anyone. I will have to pay $600 out of pocket now, even though we pay to have dental insurance.

  Business Response

  Date: 07/24/2024

  Hello, 

   

  Please respond with your enrollee id. 

   

  Thank you 

• Initial Complaint

  Date:05/25/2024

  Type:Product Issues
  Status:

  UnresolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  ********** denied reimbursement of sedation for a child who had 4 wisdom teeth removed, 2 of which were impacted and required bony extraction. I am a pediatrician myself; there is no question that sedation was standard of care. And yet ********** denied the sedation charges and never told us that they denied them or why. We only learned of the denial from a surprise bill from the dentist 8 mo later. When we went to appeal with **********, they systematically created hurdles. When we cleared the hurdles, they said too much time had passed to appeal and they closed the appeal. ****** subcontracted Delta as part of the CA ACA. **********'s behavior represents gross negligence, and their systematic prevention of appeal could be construed as intentionally fraudulent behavior. We are looking for a reimbursement of the charges of $412 for sedation. More details below Our son had 4 wisdom teeth removed bilateral impacted molars and bony extractions requiring sedation on 8/22/23 ********** denied reimbursement of sedation We never received anything from Delta about the denial We learned of the denial in April when the dentist billed for sedation charges that were denied We immediately called ********** grievance line to appeal We were told by Delta that we can appeal and that an agent would reach out to take the appeal We never heard from Delta they never reached out or called We called Delta again and they said Oh we gave you the wrong info. The window to speak to an appeals agent has passed. You need to submit an appeal by writing We submitted the appeal in writing ********** never reviewed it Instead, they incorrectly sent us a letter saying the appeal is closed until we sign a HIPAA release This was not appropriate, as the patient is a minor and I am his parent They also provided an incorrect mailing address to return the release When we submitted those forms, Delta closed the appeal without reviewing it under the grounds that 180 days had passed

  Business Response

  Date: 06/05/2024

  Hello, 

   

  Your complaint has been received and routed to our grievance and appeals team for review. 

   

  Thank you 

  Customer Answer

  Date: 06/06/2024

   
  Complaint: 21760105
  
  I am rejecting this response because: ********** did NOT respond at all.  They acknowledged that a complaint was made, and that's it. They have a long track record of not responding to consumer complaints on BBB and have an F rating. And in this case, their behavior suggests systematically denying consumers a way to appeal and systematically creating hurdles, all of which can be considered consistent with fraudulent behavior.

  ***Warning to consumers, employers and any health plans who are considering subcontracting dental insurance to Delta Care (which ****** Permanente in ********** did in this case):

  Delta is not behaving with integrity -- see BBB rating of 'F'

  Delta inappropriately denies reimbursement for treatments that are standard of care (e.g., sedation for a pediatric case of bilateral impacted molars with bony extraction)

  Delta systematically creates barriers preventing consumers from appealing their inappropriate denials.

• Initial Complaint

  Date:05/13/2024

  Type:Service or Repair Issues
  Status:

  UnansweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Automated phone system hangs up on callers after selecting to speak to a representative ************

• Initial Complaint

  Date:03/07/2024

  Type:Service or Repair Issues
  Status:

  UnansweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Following a medical issue, I was unable to work and left without dental insurance. I purchased ************** through AARP because it listed routine cleanings as being FREE. I went to an appointment today, which I believed would be a dental cleaning. Instead, I received a proposed bill for $5414, $1195 of which was the cleaning portion of the bill. This is a huge scam. I can pay my former dentist out of pocket and save myself thousands. Do not purchase DeltaCareUSA insurance.

• Initial Complaint

  Date:12/14/2023

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  ***** care *** is my insurance. I went to my normal dentist and was told there was some thing that looked weird in my gums and they wanted me to see a specialist. I made an appointment with a specialist so now thats about two or three weeks later that they could see me. They told me there is an infection and that they need to do a root canal. I have waited two weeks now and not heard anything. I called the specialist. They said theyre still waiting for ***** care USA to authorize the root canal. Ill call ***** *** myself to ask why its taking so long and magically. They will now put it through they magically got it today. They now told me I have to wait 14 to 30 days more for it to be authorized. So the insurance company as well aware that I have an infection in my tooth that is breaking down the bone and I need a root canal and they are allowing me to sit here and just take their time and it will be about two months that I have an infection in my mouth, ruining the bone according to the specialist and I need a root canal.

  Business Response

  Date: 01/18/2024

  Good afternoon, 

   

  Delta Dental has approved and paid for a root canal for date of service 1/4/24. A payment was issued to your provider on 1/12/24.

   

   

  Thank you 

  Customer Answer

  Date: 01/19/2024

   
  Complaint: 21008492
  
  I am rejecting this response because: ***** care ignored the facts of the actual complaint, based on the dates when I did this. They took an extended time to approve the root canal, and I even had to call again to see if it can be approved. They kept telling me to wait. They eventually after extensive time did approve the root canal, but since then my tooth became infected I had fevers and chills, and I had to start antibiotics because of their delay in care. 
  
  Sincerely,
  
  ***************************

• Initial Complaint

  Date:08/07/2023

  Type:Product Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  DeltaCare USA sent me two letters about an alleged grievance that I filed. Case ID ************ did not file a grievance.I have called DeltaCare at the numbe provided in the letter ************. They do NOT answer the phone. I have been on hold for over 30 minutes listening to music.I have no way of know why they sent this to me and why they filed a grievance on my behalf without my approval or knowledge

  Business Response

  Date: 08/28/2023

  Hello, 

  After further review it looks like on 7/5/23 you called in requesting to speak with a manager due to speaking with a rude customer service agent prior to this. We apologize this was created without your consent and this should have been explained further to you because of your dissatisfaction. 

   

  Thank you

  Customer Answer

  Date: 08/29/2023

   
  Complaint: 20436135
  
  I am rejecting this response because:  I never filed a grievance.  Please retract this
  
  Sincerely,
  
  ***********************

  Business Response

  Date: 09/05/2023

  Hello, 

   

  Thank you for your response

• Initial Complaint

  Date:07/24/2023

  Type:Billing Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Delta ****** was supposed to pay balance of $984.00 of emergency dental services which occurred on 5/5/22. I have a letter from my dentist regarding payment responsibilty for myself and for Delta ******. I got a bill from Rose ****** in February 2023 after they got tired of waiting for payment from Delta ****** and I had to pay out of pocket. The work that was done was critical to my health for a terrible job done by another dentist which cause serious absess and infection in my mouth. I had called Delta ****** numerous of times and was always put on hold for over an hour and having to hang up.

  Business Response

  Date: 08/01/2023

  Good morning, 

  Please respond with your enrollee id. 

   

  Thank you

  Customer Answer

  Date: 08/02/2023

   
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
  
  Sincerely,
  
  ***********************