I feel I have been ripped off by Delta Dental twice in two years. I went to two separate dentists and had an evaluation done each time. They each gave me a breakdown of my cost and the cost Delta Dental would pay. At the 1st Dentist, Delta Dental was contacted and an approval was given. Then, after the procedure was completed I was billed for the full amount by the Dentist and received a denied claim letter from Delta Dental. The dentist said I am responsible for reading the fine print and paying for what Delta Dental won't. Delta Dental says if they made a mistake its still my responsibility. I have to read their manual of coverage and understand the fine print. So, they do not understand their coverage and can make a mistake, but I am expected to understand it??!!
At the second Dentist, I was told I would pay this much and Delta would pay that much. Plain and simple right? After the procedure was completed, I paid my amount and walked out the door. Guess what, I received a declination letter from Delta Dental and the Dentist says I am now responsible for what the Dental won't pay. This just is not right.
I work for a Health Care Insurance company. Can you imagine a Doctors office telling a patient that Insurance will cover their operation, and then the Insurance company telling the patient, no, you are responsible for the whole amount, (maybe we made a mistake) after the operation was completed? We would quickly be all over the front pages of the newspapers. I feel ripped off and will drop my coverage with Delta as soon as possible. Its worthless and I will not do business with a company that places the burden on me to understand their fine print. Its just wrong for a Doctors office to tell me orally or in writing what my financial responsibility is and have it be completely false. Then, point to the fine print...
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