Understanding dental insurance can feel overwhelming. Insurance terms often leave patients unsure what they actually owe. In this article, we explain how your dental EOB and breakdown of benefits work following treatment at Premier Dental Clinic.
This guide is ideal for new patients, returning patients checking a bill, or those evaluating dental insurance options. For personalized help, contact our billing team or visit our Financial & Insurance Options page.
How Dental Insurance Works for City Patients
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 services like exams and cleanings are often covered at 100%.
Basic treatments such as fillings and simple extractions are usually covered at 70–80%.
Crowns and other major treatments usually receive the lowest coverage level.
Most dental policies use the 100–80–50 framework.
Learn more about our services to better understand your care options.
Common Dental Insurance Terms Explained
Deductible: The amount you pay before insurance starts sharing costs.
Copay / Coinsurance: A flat fee or percentage you pay after the deductible.
Allowed Amount / Negotiated Fee: The amount used by your plan to calculate benefits.
Annual Maximum: The total amount your plan will pay per year.
Non-Covered Services: Treatments excluded by your policy.
Sample Dental Billing Breakdown for Procedure_Type
This sample is for educational purposes. Your real costs depend on your policy details.
| 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 dental Explanation of Benefits will list similar details.
Dental EOB Explained Simply
After your visit, a claim is submitted to your dental insurance.
You then receive an Explanation of Benefits.
The EOB shows procedures, allowed amounts, payments, and your portion.
This document is informational only.
FAQs About Dental Billing at Premier Dental Clinic
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?
Coverage depends on plan rules and limitations.
Who should I contact if I disagree with my EOB?
Start by contacting the billing team at CityCare Dental.
Options When Dental Bills Are Higher
Unexpected balances sometimes occur. We encourage patients to contact us before treatment when possible.
Request a pre-treatment estimate for major check here procedures.
Ask about payment plans or financing options.
Timing care may help maximize benefits.
Trusted Dental Care in City
Commitment to clear communication and preventive care.
Easy access for local patients.
Experienced in handling dental insurance claims.
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