Dental insurance often feels confusing for patients. 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.
This guide is ideal for new patients, returning patients checking a bill, or those evaluating dental insurance options. If you need individual assistance, our billing team is happy to help.
How Dental Insurance Works for City Patients
Dental plans are structured to make preventive care more affordable. Coverage is often divided into categories based on treatment type:
Routine checkups and cleanings are usually covered in full.
Basic dental work often receives partial coverage of around 70–80%.
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: The amount you pay before insurance starts sharing costs.
Copay / Coinsurance: Your share of costs once insurance applies.
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: Treatments excluded by your check here policy.
Sample Dental Billing Breakdown for Procedure_Type
This sample is for educational purposes. Actual coverage depends on your specific dental plan and remaining benefits.
| 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 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.
FAQs About Dental Billing at CityCare Dental
Why is there a difference between the dentist’s charge and the allowed amount?
The allowed amount is set by the insurer.
Does preventive care really cost nothing?
Many plans cover preventive services at 100%.
What happens when I reach my annual maximum?
You may be responsible for full costs afterward.
Why are some services not covered?
Some procedures are not included under specific policies.
Who should I contact if I disagree with my EOB?
Our office can help review your claim.
What to Do if Costs Are Higher Than Expected
Unexpected balances sometimes occur. Planning ahead can reduce unexpected costs.
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
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Easy access for local patients.
Experienced in handling dental insurance claims.
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