• Contract information shows your name, address and who received the services on the EOB. You'll also see group and contract information from the claim.
  • Customer service information gives you a toll-free phone number and address you can use to contact us if you have any questions about your statement. You can also find this info on your Blue Cross ID card.
  • Summary of Services shows you:
    • What services you or a dependent received during the statement period, the date of service and your dentist’s name.
    • The charge(s) for the service, any discounts you received and details about the amount you paid or might have to pay.
    • Other benefit information, such as: deductible amount remaining, amount remaining before you meet your annual benefit max and benefit coverage percentage.
    • An explanation of why we didn't cover a service (If we didn't cover it).