Many patients struggle to understand dental insurance. Words such as deductible, coinsurance, and annual limits can be confusing. This page walks you through how dental billing and EOBs work at Elite Dental Care.
Whether you are new to our office or reviewing a recent statement, this guide can help. For personalized help, contact our billing team or visit our Financial & Insurance Options page.
Dental Insurance Basics for City Residents
Dental insurance is designed to reduce out-of-pocket costs while encouraging preventive care. Coverage is often divided into categories based on treatment type:
Preventive care is commonly paid at 100% by dental plans.
Fillings and basic procedures are typically covered at a moderate percentage.
Crowns and other major treatments usually receive the lowest coverage level.
Many plans follow a 100–80–50 coverage model.
Explore our dental treatments to better understand your care options.
Dental Billing Terms You Should Know
Deductible: The amount you pay before insurance starts sharing costs.
Copay / Coinsurance: The patient portion owed for covered services.
Allowed Amount / Negotiated Fee: The contracted rate agreed upon by in-network providers.
Annual Maximum: The total amount your plan will pay per year.
Non-Covered Services: Procedures not covered under your plan.
Example: How Benefits Apply to Procedure_Type
These numbers are examples and not exact quotes. Final amounts vary by insurance plan.
| 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 EOB will show similar information.
Understanding Your Dental EOB
After your visit, a claim here is submitted to your dental insurance.
You then receive an Explanation of Benefits.
The document outlines insurance and patient responsibilities.
An EOB is not a bill.
Dental Insurance Questions Patients Ask
Why is there a difference between the dentist’s charge and the allowed amount?
Insurance plans set contracted fee limits.
Does preventive care really cost nothing?
Routine care is often fully covered.
What happens when I reach my annual maximum?
Insurance stops paying once the maximum is reached.
Why are some services not covered?
Plans may exclude or limit certain treatments.
Who should I contact if I disagree with my EOB?
We can assist you in contacting your insurance provider.
Managing Unexpected Dental Costs
Unexpected balances sometimes occur. We encourage patients to contact us before treatment when possible.
Ask for insurance estimates before larger treatments.
Discuss flexible payment solutions.
Strategic scheduling can reduce costs.
Trusted Dental Care in City
Experienced dental team focused on patient education.
Easy access for local patients.
Acceptance of many major dental insurance plans.
See our patient reviews to learn more.