Dental Billing Breakdown of Benefits at CityCare Dental

Dental insurance often feels confusing for patients. Terms like deductibles, copays, annual maximums, and coverage percentages are hard to follow. This page walks you through how dental billing and EOBs work at Family First Dental.
Whether you are new to our office or reviewing a recent statement, this guide can help. You can also visit our Financial Options page for one-on-one support.
How Dental Coverage Works in City

Most dental plans aim to lower patient costs and emphasize preventive treatment. 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.
Dental Insurance Example for 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_%%) | 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.
Common Dental Billing FAQs

Why is there a difference between the dentist’s charge and the allowed amount?
Insurance plans set website 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?
We can assist you in contacting your insurance provider.

Options When Dental Bills Are Higher

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.

Plan treatments around your benefit year when appropriate.

Why Patients Choose Our Dental Office

Years of experience helping patients understand benefits.

Serving City and surrounding areas.

Works with a wide range of insurers.

Read what our patients say to learn more.