DentaQuest
Reviews and Complaints

I cannot believe this! Dentaquest approve only one wisdom tooth removal and denied the main ones that I believe are worse... Their reason?... Because the other 3 are incomplete. O. O by the time they're out, her teeth would be pushed together and overlapping even more. What's makes me upset is that not only does this bothers my daughter to not have them all removed, (I have no alternative insurance and very little income) my sister, who uses dentaquest as well, is having all 4 wisdom tooth (That are all incomplete) removed for 2 of her children. She has way more income than me. I don't get this. My daughter's top teeth are turned completely sideways and the bottom wisdom teeth are laying down facing the other teeth with the root embedded into her jaw. I took a picture with my phone of the x-ray results on the dentist computer during the consultation. They even reported that it's medically necessary. Am I missing something, here?!?

I am a 65 year old man, on Medicare and with Dentaquest (through the Affordable Care Act). I would like to say that Dentaquest is running a fraud on the people of Florida. I have been misdirected by their telephone customer service multiple times, denied payment for services after they first approved services, and been a victim of deceptive practices. Dentaquest should be prevented from doing this to others.

To begin with, the Telephone Customer Line has an average wait time of 47 minutes (according to the 9 call I placed.) This is unacceptable.

The website is difficult and clutzy. It hides paths to information and makes it difficult to navigate, often leading back to the same page. It often refuses to accept my logon ID and other times does. In short, it is a pain in the ###. So I call the help line.

I called the help line last year. I had an emergency, my lower bridge broke and I needed immediate care. The Consumer line gave me a dentist within 10 miles. I called this dentist and they said they were no longer associated with Dentaquest. I called Dentaquest back (and waited another 45 minutes). They just brushed it off and gave me another dentist, Elizabeth Perez Diaz, DMD at Oneco Dental in Bradenton, Fl. I got an appointment. She needed to do immediate surgury. Her office called DentaQuest and the work was approved. Follow-up appointments were necessary and further appointments to make upper and lower dentures were ordered. Again, Dentaquest approved the work..

After the work was completed and my mouth was okay, Dentaquest informed the doctor that they would not pay the claim. The reason was that I hadn't been on the rolls One Year and that I owed the dentist $3500.00 I complained to Dentaquest and was informed that this information was on the web site and I should have seen it. I went beck to the website and scoured it for this clause. I found it deep in the site as a photo caption under a graphic, written in a smaller typeface. The Doctor tried to get them to change their mind but they wouldn't back down. In short, I worked out a payment fee with Dr. Perez Diaz and settled my bill.

I stayed with Dentaquest because there was no other choice. The Affordable Care Act offers no other dental insurance company in Florida.

No, I need a relining of the lower denture, it is too loose. I tried to find a dentist on their website. No luck as the website through me offline several times. I called the Dentaquest Customer Support (after a wait of 45 minutes) and got a dentist in Sarastota who, they said, was accepting new patients. I called the dentist. I was told that they were no longer in the Dentaquest network and were not taking new patients.

Today, I called Dentaquest again. After waiting 30 minutes, I was disconnected. I called again and this time, waited 52 minutes before Customer Service connected. This time they gave me a dentist in Tampa, about an hour away. I called this dentist and was told they do not accept DentaQuest any longer either.

What do I need them for? I get a monthly bill from them and they do nothing for me? They deny payaments that they already approved. Their Customer Service Line misleads customers and sends them in circles. They either have not enough Customer Service people or intentionally mislead through a database which is not kept up to date.

I called them one more time, this time to complain about their lack of service. I was told, "Do you want to discontinue membership?" as the only option. I asked to speak to a manager. I was told "He's busy." I have had enough. I am dropping the policy. What else can I do? Is there some way to prevent this scam and hold them accountable?

Richard Arfin
6006 29th Ave. W
Bradenton, Fl 34209
[protected]

My son had insurance through one provider and had braces put on, mid way through treatment his dental insurance changed and I was required to find another orthodontist. It has been an absolute nightmare from the beginning! Chose DentaQuest and have been given the run around for almost a year! I was told in Oct 2013 that my son needed a continuation of care authorization because one ortho wouldn't touch my son due to him already having braces on. Called DentaQuest NUMEROUS times, they were somewhat helpful but every ortho they recommended declined to see my son. I finally called back and demanded to speak to a manager. SOMEONE got on the phone, not quite sure if it was a manager or not but they were helpful and told me exactly what I needed to do. I went through the process however I never heard back from anyone at DentaQuest, I was always the one to initiate contact in regards to my son's dental care. I called several times between Oct 2013-HJune 2014 and got nothing but "we are still working on it" and "give it another few weeks and call us back and hopefully we will have an update for you"..seriously?!?! I was finally able to get a consultation with a new ortho who agreed to see my son. that was in April 2014. In June 2014 I called DentaQuest to see if the new ortho was able to treat my son and DentaQuest tells me they have no record of the appt my son had with the new ortho..wait, WHAT?!?! DentaQuest set up the appt with the new ortho and they have NO record of it?!? I then called the new ortho to see what the heck was going on, turns out he had to submit his consultation findings to DentaQuest which he either never did or DentaQuest was too lazy to investigate. To make a LONG story short it is now August 2014 and I havent' heard anything from the ortho or DentaQuest. My son hasn't had an adjustment or been seen by any ortho since Oct 2013, his wires have all fallen off and he has broken brackets in his mouth because of the lack of dental care DentaQuest failed to provide. Everything DentaQuest has asked of me I have done for them and my son is suffering from their complete lack of compassion or urgency. I cannot afford to take him to the ortho on my dime and depend on DentaQuest to provide his dental care...which they are NOT doing. Completely disgusted with this so called insurance.

To: Dentaquest, via fax [protected]

From: DL

Date: December 4, 2012

Re: Appeal for denial of coverage

To Whom It May Concern:

When we enrolled in Dentaquest this year, we switched from our regular dentist to a new dentist to become our “dental home’. On the recommendation of J’s orthodontist, we had Children’s Dental Care of Delray Beach, Inc./Dr. Wymann examine J and take an x-ray of a tooth that needed to be extracted in order to continue his orthodontic care. Dr. Wymann informed us that the tooth was “submerged”, actually interfering with the root of the tooth it was above, on an angle and set up to cause damage to itself. Dr. Wymann easily concluded that this was not a simple extraction and needed to be done by an oral surgeon. We received a recommendation to see Dr. Norkin and promptly called Dentaquest customer service to make sure that we properly followed protocol.

Based on the pain J was in, the fact that the permanent tooth was set up to suffer damage and the fact that we were told this was urgent, we quickly saw Dr. Norkin. At this time, we also had our old dentist take a look. Our old dentist told us an oral surgeon could only do this type of extraction. A submerged tooth in such a precarious position, we were told, had to be removed by an oral surgeon.

Dr. Norkin examined J, assured us that both dentists had made the right call. They sent the form in to Dentaquest to file the claim. Stacy told us that she had seen better results with mailed in claims rather than electronically submitted. She coded the claim with 7210. We deferred to her, although we were worried about the amount of time that had passed since our 11/8/12 appointment with Dr. Wymann. We called Dentaquest every day since to follow up on the claim.

Yesterday, we called Dentaquest to see what happened with our claim. We were told it was denied. The rep told us that the code was too high. We then called back Dr. Norkin’s office to see if there were variable codes that are used for this situation to try to understand what happened, perhaps a coding error on their part? They told us oral surgeons ONLY used code 7210 or higher.

We then called EVERY OTHER oral surgeon within a 15 mile radius to see if they would examine J and told them about the coding issue. Maybe the oral surgeon recommended to us by the Dentaquest dentist was being too aggressive? Nope. They all said that they did not code anything less than 7210. They said that only dentists used lower codes. Here are the offices we called (got list from Dentaquest list of approved providers), who we spoke to and their phone numbers:

Norkin & Bland. Spoke with Stacy @ [protected]
Dr. Ramon Perez. Spoke with Michele @[protected]
Boca Jaw Surgery, Dr. - Ron Katz . Spoke with Amanda @ [protected]
Oral Facial Reconstruction & Implant Center. Dr. - Kurt Friedman. Spoke with Anne [protected]@ [protected]
Dr. John Pasqual. Spoke with Nicole @ [protected]
Dr Philip Pine . Spoke with Mary @ [protected]

Both dentists we saw told us this type of emergency, submerged tooth can only be removed by an oral surgeon. Every oral surgeon we called told us that they have to remove this type of tooth.

This is not a cosmetic or frivolous procedure. The reason why we have health and dental for our children is precisely for this reason. Dentaquest covers tooth extractions. J must have this procedure – his condition will deteriorate if it is not resolved urgently.

Please, Dentaquest – approve our appeal! I don’t think the issue is whether or not he needs this extraction. I believe the Dentaquest position is that it does not need to be done by an oral surgeon? If that’s the case, find me a dentist that will do it! All we ask is for my son to receive timely treatment in a safe environment. This is all we ask for in return for our premiums. Please help us. We don’t know how to make this happen for J and cannot afford to pay cash for such an expensive procedure. Tell us how to have this done within the Dentaquest parameters. Please.

I look forward to your prompt response.

DentaQuest is the carrier selected by Fla Healthy Kids which covers children up to age 19 in our state. My daughter was given a referral from her dentist to have her wisdom teeth out. After weeks of phone calls which gave me misinformation I finally got approval to take her to an Oral Surgeon. The surgeon sent her xrays and a report to DQ stating she was having headaches, inflammation and all 4 teeth were impacted. DQ denied the upper teeth and only approved the lowers. My daughter loses her insurance on August 31st because she turned 19 and DQ has dragged out the approval process horribly. I have appealed the decision but the receptionist said they do this to Kids all the time and never repeal their decision sticking parents for hundreds of dollars out of their own pocket. My daughter will get the lowers taken out next week and probably not be able to do the uppers until much later because we don't have the money to prevent her going through this procedure twice.