What does EOB mean?| Explanation for an Explanation of Benefits (EOB)
Figuring out dental insurance terms and documents can feel like reading a foreign language. One document that often leaves patients scratching their heads is the Explanation of Benefits (EOB).
What is an EOB?
An Explanation of Benefits, commonly referred to as an EOB, is a statement sent by your dental insurance company that shows the costs of services or treatments the company has covered on your behalf and any charges you’re responsible for.
While it may look like a bill at first glance, an EOB serves a different purpose. Instead of showing the amount you owe, it is a summary of the claims processed by your insurance company. It shows in detail what services were provided, their costs, and how much your insurance covers. If your procedure with your dentist was fully covered, you won’t receive an EOB. That’s because the rate the dentist requested was covered by us.
Why is an EOB important?
An EOB provides information about any outstanding payments owed to your dentist. It also helps verify that you've been accurately billed for the services and makes sure the charges align with your plan’s coverage.
It’s important to review your EOB to check for any billing mistakes. Typically, an EOB provides information such as the treatments administered, dentist fees, insurance reimbursements, potential costs for deductibles or copays, details on procedures not covered by your policy, coordination of benefits (if applicable), status of your annual maximum, and your contributions toward the deductible in the current benefit year.
An EOB is a way to keep all parties involved informed. It allows us to communicate what exactly you are financially responsible for. You shouldn’t ever pay any more or any less than what is stated on the EOB.
If your EOB says, “not chargeable to patient” anywhere, this indicates that the dentist has to accept the coverage amount and can’t bill you the difference if their charge is higher (called balance billing).
What to do if there is a mistake on your EOB
You shouldn’t need to take any action when you receive an EOB. However, if you didn’t have the services listed or if something looks to be incorrect from what you recall during the treatment, it’s important to contact us.