Pediatric Dentist - Dr. Tyler Shawcroft
Pediatric Dentist - Dr. Tyler Shawcroft's Office Information page

Appointments scheduled  |  May I remain with my child during their visit to your office?  |  Finances
Is your office in-network or out-of-network for my insurance?  |  How does your office handle dental insurance?

Appointments scheduled:

Our office attempts to schedule appointments at your convenience and when time is available. Our preference is to schedule preschool and young school age children in the morning as they are less apt to be tired from the day. Dental appointments are an excused absence and we are happy to provide a school excuse. Missing school can be kept to a minimum when regular dental care is continued.

Since appointed times are reserved exclusively for each patient we ask that you please notify our office 48 hours in advance of your scheduled appointment time if you are unable to keep your appointment. Another patient who needs our care could be scheduled if we have sufficient time to notify them. We realize that unexpected things can happen, but we ask for your assistance in this regard.

May I remain with my child during their visit to your office?

We invite you to be present with your child during the first visit to our practice and for preventive care appointments scheduled every six months. These visits should comprise the overwhelming majority of visits to our office. During other visits which will require your child’s undivided attention our staff will accompany them to maximize the chances of a successful visit.

Finances?

Payment for professional services is due at the time dental treatment is provided. Every effort will be made to provide a treatment plan which fits your timetable and budget, and gives your child the best possible care. We accept cash, personal checks, debit cards and most major credit cards.

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Is your office in-network or out-of-network for my insurance?

Cook Pediatric Dentistry participates and is considered in-network for the following companies:

  1. Washington Dental Service – Delta of WA
  2. Aetna Dental Insurance PPO
  3. MetLife Dental Insurance PPO
  4. United Concordia Companies
  5. Washington State Medicaid

And several others...please call the office to ask about yours!

How does your office handle dental insurance?

If we have received all of your insurance information on the day of the appointment, we will be happy to file your child’s dental claim. You must be familiar with your insurance benefits, as we will collect from you the estimated amount insurance is not expected to pay. By law your insurance company is required to pay each claim within 30 days of receipt. We file all insurance electronically so your insurance company will receive each claim within days of the treatment. You are responsible for any balance on your account after 30 days, whether insurance has paid or not. If you have not paid your balance within 60 days a re-billing charge of 1.5% will be added to your account each month until paid. We will be glad to send a refund to you once insurance has paid us.

Fact 1 - NO INSURANCE PAYS 100% OF ALL PROCEDURES
Dental insurance is meant to be an aid in receiving dental care. Many patients think that their insurance pays 90%-100% of all dental fees. This is not true! Most plans only pay between 50%-80% of the average total fee. Some pay more, some pay less. The percentage paid is usually determined by how much you or your employer has paid for coverage or the type of contract your employer has negotiated with the insurance company.

Fact 2 - BENEFITS ARE NOT DETERMINED BY OUR OFFICE
You may have noticed that sometimes your dental insurer reimburses you or the dentist at a lower rate than the dentist's actual fee. Frequently, insurance companies state that the reimbursement was reduced because your dentist's fee has exceeded the usual, customary, or reasonable fee ("UCR") used by the company.

A statement such as this gives the impression that any fee greater than the amount paid by the insurance company is unreasonable or well above what most dentists in the area charge for a certain service. This can be very misleading and simply is not accurate.

Insurance companies set their own schedules and each company uses a different set of fees they consider allowable. These allowable fees may vary widely because each company collects fee information from claims it processes. The insurance company then takes this data and arbitrarily chooses a level they call the "allowable" UCR Fee. Frequently this data can be three to five years old and these "allowable" fees are set by the insurance company so they can make a net 20%-30% profit.

Unfortunately, insurance companies imply that your dentist is "overcharging" rather than say that they are "underpaying" or that their benefits are low. In general, the less expensive insurance policy will use a lower usual, customary, or reasonable (UCR) figure.

Fact 3 - DEDUCTIBLES & CO-PAYMENTS MUST BE CONSIDERED
When estimating dental benefits, deductibles and percentages must be considered. To illustrate, assume the fee for service is $150.00. Assuming that the insurance company allows $150.00 as its usual and customary (UCR) fee, we can figure out what benefits will be paid. First a deductible (paid by you), on average $50, is subtracted, leaving $100.00. The plan then pays 80% for this particular procedure. The insurance company will then pay 80% of $100.00, or $80.00. Out of a $150.00 fee they will pay an estimated $80.00 leaving a remaining portion of $70.00 (to be paid by the patient). Of course, if the UCR is less than $150.00 or your plan pays only at 50% then the insurance benefits will also be significantly less.

MOST IMPORTANTLY, please keep us informed of any insurance changes such as policy name, insurance company address, or a change of employment.

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Pediatric Dentist