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| ENROLLEE ASSISTANCE FORMS |
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Our goal is 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 also contact our Customer Service Department for assistance at (800) 422-4234, Monday through Friday between 5:00 a.m. and 6:00 p.m., Pacific Time.
If a satisfactory resolution still cannot be obtained, you may wish to use our Enrollee Assistance Form. The Enrollee Assistance Form is a grievance or formal complaint form.
You can obtain an Enrollee Assistance Form quickly by clicking on the link below or by calling our Customer Service Department at (800) 422-4234, and we will mail one to you.
*Texas and Florida residents
*Requires Adobe Acrobat
Enrollee Assistance Forms and letters of complaint can be faxed to
(562) 924-6914
or mailed to:
Delta Dental Insurance Company
Quality Management Department
M/S QM 600
12898 Towne Center Drive
Cerritos, CA 90708-8579
We 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.
We thank you for the opportunity to better serve your dental needs. |
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