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Why am I not always required to pay the outstanding amount listed on my Explanation of Benefits?

Documentation of how EOBs work state that I am responsible for any outstanding amount that the insurance does not pay. However, it also states that I do not have to pay unless and until the provider bills me, which they may or may not do. What determines how a provider chooses to make this decision?

As examples, I am often sent an EOB for dental work that shows that the dentist charged far more than they received, but they decide not to bill me. What happens do the outstanding balance? Do they just eat the cost? If so, why? Likewise, I often am billed for hospital visits, even routine things such as blood tests. Why are these billed when others aren't?

What determines how a provider chooses to make this decision?

The provider (e.g. Hospital) makes that decision. How they make that decision is up to the provider and what capabilities/appetite they have to mess with it.

Let's take a doctor's office as an example. You receive services from a doctor. That doctor then files a claim with your insurance company with the services provided and what they "charged" you. The insurance company then responds to the doctor letting them know what services are covered and what amount they pay for those services. (I don't know exactly how/when the doctor is paid by the insurance, but for this question I think it's irrelevant).

They also send you an "Explanation of Benefits" showing what the doctor claimed and what they do or don't cover (and how much). Any item that they don't fully cover (or cover at all) may be billed directly to you by the doctor. That's so you know what the doctor might bill you for over what's covered.

Often, the doctor will just accept the covered amount and not bill you for the rest. It's up to the doctor whether or not they want to deal with that (billing, collections, haggling, etc). They may be content just getting as much as they can from insurance and not dealing with what's left over. Or they might want to make sure you come back to them and don't leave a sour note by billing you over and above what you pay for the insurance.

Most physicians and hospitals "accept" insurance in the sense of agreeing that they will accept reimbursement for a specific service at the rate specified by the insurance company (say $100), and not whatever their "standard" charge is (say $150) for that service (the one they put on their initial bill and which the uninsured are supposed to pay. Many companies say that they will reimburse the service provider for only 80% of the agreed-upon charge ($80) and the physician may then bill the patient for the remaining 20% ($20) of the agreed-upon charge if the physician/hospital so desires. The rest of the money (difference between "standard charge" of $150 and agreed-upon charge of $100) is written off by the provider as a cost of doing business. So why do the providers agree to such reduced payments from insurance companies? Well, insurance companies make the payment relatively quickly and $80 in hand (and the prospect of perhaps getting another $20 mañana) is better than $150 in the bush of which they might get some part after a lot of hassle and perhaps getting collection agencies involved, all of which requires a lot on expense.