My Insurance company says they pay 100% for my dental treatment, why do I still owe money?

We hear this question often. Usually the patient has looked at his EOB (explanation of benefits statement) which tells you what the provider paid and notices that the fee charged by the dentist exceeds the fee guide amount set by the insurance company. The fee covered by the provider is whatever has been negotiated between your employer and the benefit provider, and is directly dependent upon the premium you and/or your employer pay for your specific benefit policy. This is why coverage can vary even between the employees of a same company or other patients covered by the same Benefit Provider.

 

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