Explanation of Benefits
Solve the Mystery of the EOB
The dentist may have relieved your toothache, but does reading your Explanation of Benefits (EOB) statement give you a headache? Now you can read easy with the help of Max Ryan, a no-nonsense detective determined to understand his dental EOB in our “Solve the Mystery of the EOB” video.
Detective Ryan and his confidential source will walk you through your EOB, and help to define terms such as Contract Dentist Savings and Maximum Approved Fee, and explain why it’s important to stay in network.
“Solving the Mystery of the EOB” is part of the “Benefit from Your Benefits” video series, exploring topics that invite individuals, dentists, companies and anyone interested in dental benefits and oral health to better understand their benefits.
You can avoid paper EOBs and take advantage of your dental benefits by visiting the Consumer Toolkit. The Consumer Toolkit hosts member information indefinitely, and is secure and accessible 24/7.
When you’re in the Consumer Toolkit, you can sign up for paperless EOBs, view your claims information, find a dentist, print an ID card or view your benefits and eligibility. Don’t have an account? Registration is free and simple. Just follow these steps:
Visit our website homepage or the Consumer Toolkit information page.
At the bottom left, under Toolkits & Resources, select Consumer Toolkit from the dropdown menu.
Select New User, and follow the prompts to register.
Done! Now, you’ll have access to your dental benefits at your convenience.
Do you have a question about your EOB that wasn’t answered in the video? Read our frequently asked questions and their answers below!
Q: Where can I find my subscriber ID on the EOB?
A: Your subscriber ID is not listed on your EOB. For many, your subscriber ID is your Social Security number.
Q: Where can I find my current balance?
A: Your current balance is listed under the patient payment column. You should always make sure that the balance owed on the EOB matches what is due to the dentist.
Q: Is my EOB considered a bill?
A: No, your EOB is NOT a bill. The EOB explains what procedures were covered under your benefits plan, as well as any procedures that might not have been covered, and why they were not covered. Your dental office will bill you directly if you have a balance due for services following a visit.
Q: What do these codes mean?
A: On your paper EOB, you will have a description of service. However, in the Consumer Toolkit your EOB will instead list a procedure code. Click on the procedure code in the Consumer Toolkit to open a new window with a description of the procedure.
Q: Does the dental office receive an EOB or just me?
A: EOBs are sent to the dental office and member. EOBs are mailed directly to members following a dental visit, except when you do not owe a balance. If you do not owe a balance but would like to review your EOB, you can find it in the Consumer Toolkit.
Q: This is showing a patient account number. Is that my subscriber ID?
A: No, your patient account number is in reference to your account number with your dental office. Your subscriber ID is not listed on your EOB. For many, your subscriber ID is your Social Security number.
If you have questions about an EOB, please contact customer service at (800) 524-0149.