What is EOB in Dental Billing? What all you should know about EOB?

How to fix errors in Dental Billing
December 18, 2018
Tips for Provider Credentialing Process
December 31, 2018

EOB or Explanation of Benefits is a document that a patient receives after visiting a dentist. It is an explanation of the procedures that were performed during your visit to the dentist. An EOB encompasses the dentist’s fee, the portion paid by your provider and any extra amount the patient may owe. 

EOB can be in the form of either deductible, coinsurance or an uncovered service. It also includes an update of the total annual maximum that has been used and the amount that has been paid by the patient towards their deductible.

The EOB form generally has 4 major sections:

  1. Claim information, which includes the patient’s name, ID, Claim number and dentist name.
  2. Type of service and coverage that identifies the date of service, charges, paid amount, discounts, deductions, and any uncovered expense.
  3. A section that provides an explanation of the above-mentioned information.
  4. Another is the patient summary that includes the benefit period and so on.

In addition to just showing the way a claim is being processed, EOB forms also let your dentist know whether any remaining balance is due by the patient. It elaborates a simple way to track the services you receive and the expenses associated with your healthcare. It also details what portion of the services have been paid and what portion were not covered earlier.

An EOB is filed to ensure that all services have been paid and processed correctly. It should not be confused with a bill, EOB is not a bill. EOBs are explained in the code descriptions.

A patient must look out for the below-given information while reviewing an EOB.

  • Is this EOB from your insurance provider?
  • Does it have the right patient information like Name, Date of Birth etc?
  • Is the policy number mentioned correct?
  • Are the dates correct?
  • Is the listed diagnosis correct?
  • Has any service been denied? If yes, why?

It is very important to understand your insurance benefits. For any queries or concerns, you can anytime reach your insurance provider. So, instead of getting surprised with unexpected billing charges, you must keep a detailed record of copays, services or any kinds of payments made. 

EOB is the ultimate medium that helps you to understand how your dental insurance plan works. So, make sure to get an explanation of your benefits next time when you visit your dentist, to know about services already availed by you and services yet are covered under your insurance plan.