Implant fees

[actittle]

Hey guys I have a question about fees for implant work.

I have a doc that wants me to provide him with a soft tissue model and a removable waxup for a single implant. He is going to have the abutment and crown made through someone else.

Normally I would charge $55 for the model and $45 for the waxup for this case but I would also be making money on the abutment and the crown that would follow.

So my question is, should I charge an "implant fee" on this case to compensate for what money I am missing out on by not doing the abutment and crown? I normally charge $45 for the waxup regardless of what type of restoration is to follow.

The reason he is using another lab for the abutment and crown is because their fees are significantly lower than mine but he wants me to do the waxup and sculpting of the soft tissue because of my superior skills.

As always, thank you for your input.

 

[Marcusthegladiator CDT]

It wouldn't be honest to charge more just cause. But I see where your coming from. Let the other lab build the implant and restoration and let the doctor spend 45 minutes adjusting things to seat it. Then hell know where the savings went. And next time, hell let you build.

PS you could always rotate the analog out of its proper position before your pour your model. Then it will make the other lab look bad when it doesn't seat. Just sayin, lol.

 

[actittle]

It wouldn't be honest to charge more just cause. But I see where your coming from. Let the other lab build the implant and restoration and let the doctor spend 45 minutes adjusting things to seat it. Then hell know where the savings went. And next time, hell let you build.

PS you could always rotate the analog out of its proper position before your pour your model. Then it will make the other lab look bad when it doesn't seat. Just sayin, lol.

Well I'm not wanting to charge more just to be spiteful or anything. The way that I go about doing a diagnostic waxup for an implant case simply takes more time than if it were a non-implant case.

 

[Gru]

Same trap, different fee schedule. Add the extra fee as a "design" fee. This is to be credited to the case when the final work comes in. If it doesn't, you get paid. When asked by the doc about it, it's a real opportunity to remind him he uses you for your expertise and experience. Good luck!

 

[sidesh0wb0b]

Gru hit it spot on. a "design" fee isnt being spiteful, but its covering your bases and keeping cash in your pocket (as well as the control of the case). it doesnt need to be an astronomical fee, but something to get the Dr to lean toward sending the entire case to you, or just making it worthwhile for you.
at the end of the day, if something were to go wrong from the 'other' lab, they could easily say that what you did was incorrect.....and in turn create some negative feedback/word of mouth. keeping the control/case in your hands all the way to completion is the best option IMO. the Dr knows it too, thats why hes sending the "design" part to you; your superior skills!!!

 

[actittle]

What would you guys consider to be a reasonable charge for a design fee then?

I'm thinking $50 - $75 per unit.

Is that unreasonable?

 

[sidesh0wb0b]

seems fine to me. i had a Dr once that would get metal try in bridges from me, then send to another lab to save $45 on porcelain.
we started charging the full cost of the crown up front, even though it was just the frame. he ended up sending all the work to us, and a few months later, stated that he loved the shades, occlusion, and contacts far more than the other lab. it was worth the money to cut down his insert times.

 

[Gru]

Make the fee the closest to the value you perceive it to be.
Remember this is to be credited on completion of the case. Don't be tempted to inflate it, just don't lose on it. I started charging a metal frame fee for try-ins on this principle since some don't come back.
More all the time nothing leaves the lab without a bill for it's value- articulators included, if I want them back. I'm very careful to credit for the item on it's return.
Your fee schedule is different than mine, so make the fee reflect it.

 

[actittle]

I like the idea of giving a credit if he sends the rest of the case to me.

I think charging $75 for it is right in line with the rest of my fees.

Thanks for the input Marcus, Gru, Sideshow, and anyone else that contributes to this discussion. I really appreciate you taking time to give me your perspective.

 

[rkm rdt]

I would arrange a meeting with him to discuss your fees and your future with him.

Will you be baking porcelain on another lab's copings in the future?

How about pressing someone elses waxups for emax?

I don't work like that.

 

[jthacke3]

Hey guys I have a question about fees for implant work.

I have a doc that wants me to provide him with a soft tissue model and a removable waxup for a single implant. He is going to have the abutment and crown made through someone else.

Normally I would charge $55 for the model and $45 for the waxup for this case but I would also be making money on the abutment and the crown that would follow.

So my question is, should I charge an "implant fee" on this case to compensate for what money I am missing out on by not doing the abutment and crown? I normally charge $45 for the waxup regardless of what type of restoration is to follow.

The reason he is using another lab for the abutment and crown is because their fees are significantly lower than mine but he wants me to do the waxup and sculpting of the soft tissue because of my superior skills.

As always, thank you for your input.

Like us, it appears your model and wax fees are "break-even" products that open the door to more profitable products to be sent later. Since you are a for-profit business, you need to find a way to make the work worth your time. You should know how much you bill per hour and you should charge appropriately for the production cost. When invoicing the case, you should take this into account.

If it were me, I would first consider the overall relationship with the doctor and take a "big picture" approach to the billing. If he allows you to make make money elsewhere, I would take it easy. If you're his "single central only" lab, I'd stick it to him. That being said, I would probably charge him your normal model and wax fees (plus shipping) plus an arbitrary "Design Fee" of perhaps $50-$75 that you would "Happily refund to him upon receipt of the rest of the case."

You have to create a disincentive for him to send it elsewhere. Docs who chase lab's loss leaders or are cheapskates don't care about building relationships and tend to stumble over dollars to pick up dimes. I had a doctor send a denture case over two weeks ago to have us pour his models and return so he could make his own bite blocks to save our $50 charge. Of course it cost me $25 to pay my delivery driver for two extra round trips so I lost $75 in revenue to accommodate his cheapness. I billed him for it on the back end by charging him a transportation fee of $25 to make up for those costs. When he calls to complain, I will explain our position, probably waive the fee, and explain the terms by which we are willing to do business in the future.

I have no fears of losing this doctor because he doesn't allow us to make money. Our resources are better spent elsewhere. You should take the same approach with this guy.

 

[BobCDT]

Hey guys,
I think there is another point to be made here. You should have a margin on every product and service you provide. If you cant get it, your better off not providing the service. Sorry, but working and pricing products at cost hurts you and the entire industry. I understand that things like diagnostic wax ups can be difficult to make a buck on. But, in today's digital environment it's become easy.
Here's a diagnostic wax up that I designed in about ten minutes in 3Shape, milled in a Roland, glued it to the model. Spent about 15 minutes touching up the wax by hand. Total labor about 40 minutes including prepping the cast. This was milled from a wax 98mm very white opaque disk. We charge $39 a unit and made $312 for 40 minutes labor. I would love to just do these all day long. The day of hand waxing diagnostic wax ups for free is over!

 

[dmonwaxa]

AC, gru, sos; why give a credit. Thats work you have done and should get paid.

 

[jthacke3]

Hey guys,
I think there is another point to be made here. You should have a margin on every product and service you provide. If you cant get it, your better off not providing the service. Sorry, but working and pricing products at cost hurts you and the entire industry. I understand that things like diagnostic wax ups can be difficult to make a buck on. But, in today's digital environment it's become easy.
Here's a diagnostic wax up that I designed in about ten minutes in 3Shape, milled in a Roland, glued it to the model. Spent about 15 minutes touching up the wax by hand. Total labor about 40 minutes including prepping the cast. This was milled from a wax 98mm very white opaque disk. We charge $39 a unit and made $312 for 40 minutes labor. I would love to just do these all day long. The day of hand waxing diagnostic wax ups for free is over!

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Bob--your point is well taken but the big difference in your case is economies of scale. The case we're talking about in this thread is a single tooth wax involving mounting and a soft tissue model also--a reasonable amount of labor. All these things become profitable the larger the case becomes. Unfortunately its not practical or good for business to charge one fee for a single unit wax up and different fee for a full arch. You have to keep it really simple for doctors or they go elsewhere, as this doctor has shown. Our lab doesn't do free wax ups but I know a lot of other labs do. We generate a lot of revenue by doing large cases but if they are under six units, they are completed at close to cost.

We've done lots of big waxing cases with our 3shape/roland but the fact is that there are some docs that are so picky about what they want, milling isn't as good as hand waxing just yet, especially if you have really skilled waxers that work for you. Not every dentist will accept a commodity product in the current market.

Jim Thacker
Utah Valley Dental Lab

 

[Tom Moore]

Most problems in life dealing with others is about feeling unappreciated for what you bring to the relationship or the other way around.

One price if you do the finished case and another if not make sense to me.

The current model has the dentist getting cheaper work and the other lab is is being allowed to work cheaper on the back of your expertise.

This is not a win/win as you are pricing this type of work now. I have found it's the only way it will work long term.

 

[dmonwaxa]

If the good doc hires an architectural firm to design his house or office the same firm offers construction services, does that firm give a design credit if the job to build is given to them?

 

[jthacke3]

If the good doc hires an architectural firm to design his house or office the same firm offers construction services, does that firm give a design credit if the job to build is given to them?

I don't see why not. It may not be the industry norm but people give discounts in every industry to get work in the door. I'm familiar with a high-end laboratory in the west who regularly offers a refund of the wax up charge off the finished case if completed within six months. What's the difference between offering a free wax up or a $50 per unit discount? I would give the free wax up every time. Its an effective promotional offer to get work in the door and encourage dentists to do wax ups in the first place. Wax ups for comprehensive cases make the end result more predictable and reduces the "back and forth" adjustments when doing elective dentistry, which saves the lab money overall.

Bottom line--pricing is the most effective tool we have in shaping dentist behavior. Charge a lot for products and services you don't want to do and be flexible when trying to shape what the dentist prescribes. We do all we can to guide them to our most profitable products and our core strengths.

Jim

 

[SamanthaADS]

We've gone to doubling our waxup fee and then crediting back 50% when we do the rest of the case. That way we're making money on the waxups - especially for the Cerec practices who want us to put all the work into the waxup and then scan and mill the case themselves.

Samantha