How to Read Your Explanation of Benefits (EOB)
What is an Explanation of Benefits?
We send you an Explanation of Benefits (EOB) statement each time we process your dental claims. The EOB shows the dental claims your dentist submitted and how we processed your claim.Simply put, your EOB statement is an important record of your dental services and benefit coverage.
For quick, convenient and confidential access to your claims and eligibility information, an online EOB is also available if you sign in to My Dental Benefits. It’s a good idea to keep your EOBs, in case you have questions about your claims.
Reading an EOB
The EOB has four major sections:
- Claim information: Includes the member and patient name, ID number and the specific claim number and identifies the dentist
- Service and coverage information: Identifies dates of service, charges, what was paid, discounts, deductions and any uncovered expenses
- Explanations: Provides additional information for the above sections. For example, if a claim is not paid in full, the EOB notes what benefit limitations or exclusions apply.
- Patient summary: Details the benefit period, amount applied to the individual program dollar maximum and group number