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Current Location: Contact us > Delta Dental of California Customer Service > DeltaCare USA Enrollee Assistance Forms
     
DeltaCare USA Enrollee Assistance Forms

DeltaCare USA programs are designed to provide you and your family with quality care through a network of participating dental offices. Occasionally a situation may arise where you feel that the service you received from a participating dental office has not met your expectations. We urge you to communicate directly with your dental office if you are displeased with the services provided.

You may contact Customer Service for the DeltaCare USA program for assistance with these or any other issues at (800) 422-4234, Monday through Friday between 5:00 a.m. and 6:00 p.m., Pacific Time.

If you cannot obtain a satisfactory resolution, you may wish to use our secure online Enrollee Assistance Form. The Enrollee Assistance Form is a grievance or formal complaint form.'

You can file your grievance quickly by clicking on the appropriate link below.

Online forms

DeltaCare USA

DeltaVision

*Requires Adobe Acrobat

Letters of complaint can be faxed to (562) 924-6914 or mailed to:

Quality Management Department
M/S QM 600
12898 Towne Center Drive
Cerritos, CA 90708-8579

The Quality Management department will send you a written determination via U.S. postal service within 30 days of receipt of your Enrollee Assistance Form or letter of complaint. Submissions involving severe pain and/or an imminent serious threat to your health will be reviewed immediately.

For all other inquiries and requests, please use our online Customer Service Request Form.

   
 

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