Dental Explanation of Benefits at Family First Dental

Dental insurance often feels confusing for patients. Words such as deductible, coinsurance, and annual limits can be confusing. This guide explains how your dental billing breakdown of benefits and dental Explanation of Benefits (EOB) work after your visit at Bright Smile Dental.
This guide is ideal for new patients, returning patients checking a bill, or those evaluating dental insurance options. You can also visit our Financial Options page for one-on-one support.
How Dental Insurance Works for City Patients

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

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.
Common Dental Insurance Terms Explained

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 amount used by your plan to calculate benefits.

Annual Maximum: The yearly cap on insurance benefits.

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_%%) website | Plan_Payment |
| Patient responsibility | Patient_Responsibility |

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

Your dentist sends a claim to your insurance provider.

The insurer reviews the claim and issues an EOB.

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?
Plans may exclude or limit certain treatments.

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

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 procedures.

Ask about payment plans or financing options.

Timing care may help maximize benefits.

Trusted Dental Care in City

Years of experience helping patients understand benefits.

Easy access for local patients.

Works with a wide range of insurers.

Read what our patients say to learn more.