Dental EOB at Elite Dental Care

Dental insurance often feels confusing for patients. Terms like deductibles, copays, annual maximums, and coverage percentages are hard to follow. In this article, we explain how your dental EOB and breakdown of benefits work following treatment at CityCare Dental.
Whether you are new to our office or reviewing a recent statement, this guide can help. You can also visit our Financial Options page for one-on-one support.
Dental Insurance Basics for City Residents

Dental insurance is designed to reduce out-of-pocket costs while encouraging preventive care. Many plans follow a standard coverage structure:

Preventive services like exams and cleanings are often covered at 100%.

Fillings and basic procedures are typically covered at a moderate percentage.

Major dental services tend to be covered at approximately 50%.

Most dental policies use the 100–80–50 framework.

See common procedures we perform to better understand your care options.
Key Terms on Your Dental Breakdown of Benefits

Deductible: An initial out-of-pocket amount required by your plan.

Copay / Coinsurance: Your share of costs once insurance applies.

Allowed Amount / Negotiated Fee: The maximum fee your insurance recognizes for a service.

Annual Maximum: The total amount your plan will pay per year.

Non-Covered Services: Treatments excluded by your policy.
Example: How Benefits Apply to Procedure_Type

These numbers are examples and not exact quotes. Actual coverage depends on your specific dental plan and remaining benefits.
| Item | Example Amount |
| ------------------------------ | -------------------------- |
| Dentist’s standard fee | Base_Fee |
| Plan’s allowed amount | Allowed_Fee |
| Deductible applied | Deductible_Amount |
| Plan payment (Coverage_%%) | Plan_Payment |
| Patient responsibility | Patient_Responsibility |

Your insurance statement will reflect these line items.
How to Read Your Dental Explanation of Benefits

The dental office submits billing to your insurer.

You then receive an Explanation of Benefits.

The document outlines insurance and patient responsibilities.

An EOB is not a bill.
FAQs About Dental Billing at Premier Dental Clinic

Why is there a difference between the dentist’s charge and the allowed amount?
Plans calculate benefits using negotiated rates.

Does preventive care really cost nothing?
Preventive visits usually require no payment when in network.

What happens when I reach my annual maximum?
You may be responsible for full costs afterward.

Why are some services not covered?
Some procedures are not included under specific policies.

Who should I contact if I disagree more info with my EOB?
Our office can help review your claim.

What to Do if Costs Are Higher Than Expected

Out-of-pocket expenses can increase depending on plan rules. Planning ahead can reduce unexpected costs.

Request a pre-treatment estimate for major procedures.

Discuss flexible payment solutions.

Timing care may help maximize benefits.

Why City Patients Trust Bright Smile Dental

Experienced dental team focused on patient education.

Convenient location and flexible hours in City.

Works with a wide range of insurers.

Read what our patients say to learn more.