Delta Dental will provide you with an Explanation of Benefits (EOB) after a dental visit. You might wonder what all the numbers, codes, and terms mean. Let’s look at what a common EOB from Delta Dental includes.
- Your visit information is at the top and includes the patient and dental office information, plus your claim number, which you’ll need to make any inquiries.
- Area/tooth code/surface is the area that was treated, the date of service is when treatment occurred, and the procedure description explains what the dentist did.
- The submitted amount is the amount the dentist charged, the maximum approved fee* is the amount that Delta Dental participating dentists agree to accept, contract dentist savings is the amount you saved by staying in network, and the allowed amount is the cost allowed by Delta Dental and used to calculate payments. In most cases, this is the same as the maximum approved fee; however, in some instances, this amount may be less than the maximum approved fee, and you may owe the difference.
- Not all plans have a deductible, but if yours does, it appears in this column. The co-pay percentage is the percentage that Delta Dental pays.
- Payment is the total amount Delta Dental would pay, and patient payment is the amount you would pay. Pay to indicates where Delta Dental sent its payment. If you stay in-network, it will likely have a P for the provider.