50
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cerecdoctors.com
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quarter 4
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2012
Anthony Kraft | Seymour, Wis.
If they need a build-up, we charge for it. I will say
that with CEREC, the number of build-ups has
decreased, but I still like to have proper form with smooth
transitions associated with my preps. If I say to myself, “it
needs a build-up,” then we do one. We always explain to our
patients that a build-upmay be needed and that this is the cost.
They have never really balked at this. We really explain the
benefit of this procedure to our patients and they all seem to
get it. Hope this helps.My thinking is, if you are doing thework,
then you should be compensated for it. I would not charge a
build-up by cementingmy restorationswith composite cement.
My two cents for what it is worth. Good luck.
if I
didn’t
pay $130k, I could keep charging more; but instead,
my patients are benefiting and I’m losing income; seems sort
of counterintuitive. Shouldn’t it be win-win? I hate to admit it,
but itmakesme understandwhy some docs charge a same-day/
CEREC fee (even if it’s only on thosepatientswho youWOULD
have done a build-up for traditional C&B but not for CEREC ).
Anyway, my current crown fee is about $100 less than the
region’s average. Maybe I’m just getting ornery.
Thoughts? How do you handle BU income? When do you
charge?Or, do you just consider it the cost to playwithCEREC?
Baron Grutter | Gladstone, Mo.
Jeffrey Caso (Faculty) | Merrick, N.Y.
I agree. I do a separate build-up on all endo-treated
teeth and charge for it. If it needs it, I do it. At 27
and a half, Gordon Christensen (or was it Rella?) said that
build-ups under CEREC were appropriate and would help
in the future if e.max needed removal. You only had to cut
through a uniform thickness all around. So, my two cents: do
what you feel you need to on each case and charge when you
do. Just like before CEREC. If it doesn’t need it, then so be it.
Alright, so to make things clear, everyone here
that knows me knows that I probably would have
to be bankrupted to get rid of my CEREC. So, I’m not going
anywhere, but I’m curious about others’ thoughts on this:
It’s been touched on before, but I don’t remember much
coming fromother threadsonthis issuewithregardtocharging.
As it stands, I’m perfectly happy with the way things are
going, but I want to make sure I’m not overlooking something
obvious. Before I had CEREC, I’d say roughly 80 percent 85
percent of my crowns had BUs. Since CEREC, that’s probably
dropped to 25 percent. Asmuchmoney as CEREC saves, at ~50
percent decrease in BUs, I don’t think it’s necessarily savingme
the $125 ($250*.50) that I’m not charging out. I’m curious how
others approach build-ups. Here are the things I’ve heard:
1.
“
I just factored it into the cost of a crown.”
Not sure how
that would work for a larger PPO practice. I’m currently
about 55 percent PPO.
2.
“
When I do a bonded crown, I just charge for a BU regard-
less since my Bonding Resin IS a BU material.”
I get the
logic, but not so sure of the ethics/legalities.
3.
“
I have NO IDEA. But I know that I’m losing profits.”
Yikes, but that’s pretty much where I’m at.
Currently, probably 80 percent of my build-ups are done at
the time of seat. Iwill do a traditional crown-prep leaving deep
decay/old filling/closed endo-access and make my crown.
Then, I will remove the decay/filling, and/or do my endo and
just fill the BU prep with my bonding resin as I’m seating
the crown. I feel that makes a homogeneous seal and should
even help to lock the crown on. Also, as [cerecdoctors.com
co-founder Armen Mirzayan] points out, it leaves the really
deep areas covered until the very last minute.
The thing is, that is pretty close to the same idea as #2.
Personally, I don’t like that my business profit margin is
decreased because I’ve invested in technology to make my
patients’ experience and restorationmore ideal. Inotherwords,
in this recurring section of cerecdoctors.commagazine
,
we share a sample of conversations occurring online:
A CEREC user poses a question to the cerecdoctors.com community regarding build-ups and how to charge for them –
if at all. Here, several readers weigh in on build-ups and the bigger issue of patient experience.
The Pink Elephant
in the Room: Build-Ups
d i s c u s s i o n f o r u m
| | |
Compiled from
www.cerecdoctors.com/discussion-boards/view/id/13775
link