How to see what your practice really spends with each dental lab

A lab statement tells you what you were charged. It does not tell you what the work cost.

The full cost of a lab includes the minutes spent adjusting its crowns, the visits repeated for remakes and the appointments moved when a case ran late.

This guide shows how to build that picture for each lab in an afternoon, from papers you already have.

Why the statement total is not the cost

Two labs can charge the same fee for a crown and cost a practice very different amounts.

Suppose one lab’s crowns seat in five minutes. The other’s need fifteen, and come back more often.

The difference never appears on a statement. It appears in the schedule, as time that could have gone to another patient.

Four costs sit outside the fee.

• Adjustment time. Minutes at the chair making a restoration fit.
• Remake visits. A second appointment, whoever pays for the second piece.
• Moved appointments. A slot that could not be used because the case was not back.
• Admin time. Sending, chasing and checking, which differs from lab to lab.

None of them is the lab’s fault by definition. Some trace back to the Rx or the scan. They are still part of what each lab relationship costs.

Gather four things

You need one quarter’s worth of each.

1. Every lab statement, with its invoices.
2. Your list of cases sent, by lab and by kind of work.
3. A record of how each case seated. Even rough notes will do.
4. The schedule, to find remakes and moved seats.

If you have no record of how cases seated, start one today and come back in three months. How to give your dental lab feedback has a two-minute form for it.

A quarter is long enough to smooth out one bad week, and short enough to remember.

Paper statements are fine. A phone photo of each page, saved in one folder, is enough to work from.

Build the fee table

Start with what you were charged. One row for each lab and kind of work.

Put rush fees, shipping and other extras in their own column. They are easy to miss inside a total.

Divide the fees and extras by the number of cases. That average is worth seeing on its own.

Compare like with like. A lab that only gets your hardest front-tooth cases will show a higher average, and that says nothing about its value.

Add the costs the statement leaves out

Now put a value on chair time. Use what an hour of the dentist’s chair is worth to your practice.

The practice calculator asks for the same figure, and you can use the number you would enter there.

For each lab and kind of work, add three lines.

A worked row shows the scale. If a lab’s crowns average ten minutes of adjusting across thirty cases, that is five hours of chair time in the quarter.

A worked example of adjustment time

Three numbers from the worked example: an average of 10 minutes of adjusting at each seat, across 30 cases in a quarter, comes to 5 hours of chair time that never appears on a statement.

Average adjusting at each seat

10minutes

Crowns from that lab in the quarter

30cases

Chair time that never appears on the statement

5hours

Add admin time if it differs. A lab that needs three calls a case costs more staff time than one that shows you status.

Be honest about cause as you go. Mark any remake or delay that started with the practice’s own Rx, scan or late answer.

Read the result

Add the fee table and the hidden costs, and divide by cases seated. That is your cost per seated case, by lab and by kind of work.

Three patterns come up.

A higher fee, a lower total. A lab charges more per crown, and its crowns seat with almost no adjustment. It may be your cheapest lab.

A low fee, a high total. The saving on each invoice is spent, and more, at the chair.

One kind of work stands out. A lab is excellent at crowns and costly on dentures. That is a reason to move one kind of work, and no reason to leave the lab.

Look at your own column too. If remakes cluster around thin prescriptions, the cheapest fix is at your end.

Watch your own trend

It is tempting to compare your lab bill with a benchmark. We have not found one with a source worth quoting.

Compare with yourself instead. Work out lab fees as a share of production each quarter, and watch the direction.

A rise is a prompt to look closer. It can mean more remakes, a change in the work you do, or a fee increase you did not notice.

A fall can be good news or a warning. Check that it does not come from work you have stopped offering.

What to do with the numbers

The point of the exercise is a better conversation, with your labs and inside the practice.

• Show each lab its own row. Ask what they see from their side. A good lab will have ideas.
• Move one kind of work, if the numbers say so. How many dental labs should a practice use covers how to split work sensibly.
• Fix your own habits. A complete Rx and a clean scan lower every lab’s cost. Our dental lab prescription checklist helps.
• Look at what you could make in-house. In-house dental lab vs outsourcing covers when that pays.
• Ask about fees with facts. A lab is more open to a conversation about price when you can show volume and a clean record.

Do not lead with price. A lab that seats well and delivers on time is worth more than its fee suggests.

Tell the lab whose work seats cleanly that you noticed. Labs hear about problems far more often than they hear about this.

Patients on the federal dental plan

For patients covered by the Canadian Dental Care Plan, the lab fee is part of the claim.

The plan reimburses lab fees it considers reasonable and customary, and it can ask for the lab’s invoice. CDCP and lab fees covers what that means.

Keep those invoices where you can find them. They belong with this exercise and with the claim.

Keep it going

The first pass takes an afternoon. After that, half an hour a quarter is enough.

Keep the table from last time and add a column. The trend across four quarters is worth more than any single one.

Put the review in the calendar now, so that it happens.

Record how each case seats as you go, so the next review needs no digging. A remake noted on the day is a fact. One recalled three months later is a guess.

Start from one list of cases

All of this depends on knowing which cases went to which lab, and what happened to each.

How to track dental lab cases in your practice covers how to keep that list.

Tusko keeps every lab’s cases in one place for a practice, with the Rx and the messages on each one.

See how it looks for practices.