What Is an Explanation of Benefits (EOB) statement?
Your Explanation of Benefits (EOB) is a paper or electronic statement provided by your dental insurance company, which breaks down any dental treatments or services that you have received.
The EOB is different from a bill. It is sent to you after your dentist visit, and outlines your costs, the treatments that were covered under your dental plan, and treatments that may not have been covered and why.
Why Is Your EOB So Important?
After you receive your EOB, you will know what, if anything, you owe to your dentist. An EOB presents the opportunity to make sure you are being billed for a service or treatment you actually received, and that the amounts listed are within your expectations. Therefore, understanding the different parts of an EOB is critical to finding and avoiding billing errors.
An EOB provides essential information, including but not limited to, treatments performed, dentist’s fees, insurance payments, amount you may owe for deductibles, co-pays, or procedures not covered by your policy, coordination of benefits information (if applicable), the portion of your annual maximum that has been used, and the amounts you have paid toward the deductible in the current benefit year.
An Example of an EOB
Below is an example of an EOB that you will receive after you have visited your dentist. It is important to note that while not every EOB will be formatted the same, this example contains many of the sections and terms you will find on a typical EOB.
How to Read Your Explanation of Benefits
An EOB from Delta Dental will typically include the following information:
Other Terms That Your EOB Might Reference
These terms will not always be used in your Explanation of Benefits, but it is important to know their meaning in case they appear.
Frequently Asked Questions About Explanation of Benefits
Here are the answers to common questions about EOBs.
No, an EOB is not a bill. On the most basic level, your EOB will provide a breakdown of the dental services that you received, the amount Delta Dental will pay to your dentist, and any portion you will be expected to pay the dental office. A bill for any amounts you may owe will come separately.
The dentist will bill your dental insurance company after you’ve received dental treatment, and then you will receive an EOB, typically before you receive a bill from the dental office for any amount you may owe.
Please contact your local Delta Dental to manage your Delta Dental benefits. On your local Delta Dental web portal, you can view plan information, download forms, view claims, track dental activity and go paperless!
Looking for more information? Brush up on some of the dental insurance basics:
If you have additional questions or require further support, connect with your local Delta Dental.
This article was developed jointly by Delta Dental Plans Association , Delta Dental of Arizona and Delta Dental of Wisconsin.