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Disputing a claim should be as easy as possible. Now instead of dealing with a complicated process, you can submit and track claim disputes online directly from your Provider Tools account. Here’s what you need to know to get started.
You may file a grievance in several ways: Online: You can complete a form online at: https://secure1.ddpdelta.org/ddpca_secure/%21complaint.asp. In writing: You can obtain a form from the Customer Service representative or from your provider. Verbally: You may ask the Customer Service representative to take your grievance over the phone.
For login and registration support, submit a web support request. For all other questions, contact us. Need to find a specific form or file a grievance? Find the answer in our Member Resources.
How to report fraud. If you suspect fraud has been committed, you can call the Delta Dental Anti-Fraud Hotline at 800-526-1852 or submit our online form for reporting potential fraudulent activity. You may choose to stay anonymous when you report fraud.
If you suspect that identity theft or fraud has occurred in a dental office setting, use this form to submit the relevant information and we will investigate.
Disputing claims online is easy. Submit, track and manage disputes in Provider Tools. When a claim adjustment doesn’t resolve your issue with a claim, you can use Provider Tools to submit a dispute online for quick and easy processing. Log in to your Provider Tools account. Don’t have an account? Sign up in minutes at deltadentalins.com.
Report potential cases to state and federal law enforcement and cooperate with fraud investigations. Pursue the recovery of funds when fraud is suspected. Terminate contracts when fraud is confirmed. If you suspect someone is committing fraud, report it. Call Delta Dental’s Anti-Fraud Hotline at 800-526-1852.
How to file a grievance. If you're not satisfied with the service your dentist provided, contact the dental office. If your concerns still aren't resolved, you may file a formal grievance. CA DMHC cancellation of health care coverage grievance form.
If you believe that we have failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance electronically online, over the phone with a customer service representative, or by mail.
GRIEVANCE/COMPLAINT FORM INSTRUCTIONS If you have questions, call the Help Center at 1-888-466-2219 or TDD at 1-877-688-9891. This call is free. How to File: 1. File online at www.HealthHelp.ca.gov. [This is the fastest way.] OR Fill out and sign the Cancellation of Health Care Coverage Grievance Form. 2.