Another Day, Another PPO Headache—Is This Really the Best Way to Run Your Practice?
Let’s set the scene.
You just performed a simple tooth extraction (D7140).
You submit the claim to insurance…
And then you wait… and wait… and wait…
DENIED! Or worse—insurance “approves” it but pays you pennies on the dollar.
Meanwhile, your front desk is stuck on the phone fighting for a fair reimbursement.
Sound familiar?
Reality check: The average dental practice writes off $35,000+ per month in PPO discounts. That’s $420,000 per year—GONE.
Here’s the truth:
✅ Over 50% of Americans don’t have dental insurance.
✅ Membership patients accept treatment 2X-4X more than PPO patients.
✅ You can build predictable recurring revenue (MRR & ARR) with a membership plan.
In this guide, you’ll learn:
✅ What the D7140 dental code is & how to appeal a denial.
✅ Why a membership plan is the best alternative to PPOs.
✅ How BoomCloud™ helps practices generate predictable revenue & happier patients.
Let’s go.
How One Dentist Ditched PPOs & Added $500K in Recurring Revenue
Meet Dr. Emily Carter.
She was:
❌ Drowning in PPO write-offs.
❌ Losing thousands every month due to low reimbursements.
❌ Frustrated with insurance denials on simple extractions (D7140).
Then, she made ONE SIMPLE CHANGE—she stopped relying on PPOs and launched a membership plan.
Fast forward 12 months:
She dropped 3 low-paying PPOs.
Her practice added $42,000/month in predictable recurring revenue.
Case acceptance skyrocketed (because patients had a simple way to pay).
That’s the power of saying goodbye to PPOs & embracing memberships.
What is the D7140 Dental Code & How to Stop Losing Money on It
What is the D7140 Dental Code?
D7140 is the ADA insurance code for a simple tooth extraction.
Definition:
✅ “D7140 – Extraction, Erupted Tooth or Exposed Root (Includes Local Anesthesia and Suturing If Needed)”
It’s one of the most common procedures in dentistry.
BUT HERE’S THE PROBLEM:
What D7140 Should Be Worth: $250 – $450
What Most PPOs Pay: $80 – $150
That means for every 100 extractions you perform, you’re losing $10,000+ per month.
The True Cost of PPO Write-Offs:
You perform 50 extractions a month
PPOs underpay by $200 per case
$10,000 lost PER MONTH
$120,000 PER YEAR—GONE!
So, what’s the fix? Stop relying on PPOs & start offering a membership plan.
How to Appeal a Denied D7140 Claim (Because Insurance is the Worst)
Follow these steps to fight a denial:
✅ Step 1: Send a Strong, Professional Appeal Letter
Subject: Appeal for Claim Denial – [Patient Name, Date of Service, Claim Number]
To Whom It May Concern,
I am writing to formally appeal the denial of claim #[CLAIM NUMBER] for [PATIENT NAME], who received a simple extraction (D7140) in my office on [DATE OF SERVICE].
The procedure was medically necessary and aligns with ADA & standard dental care protocols.
✅ Step 2: Provide Clinical Justification
RULE #1: PPOs love denying claims due to “lack of medical necessity.”
What to Include:
✔️ X-rays showing the tooth’s condition.
✔️ Clinical notes detailing symptoms & patient discomfort.
✔️ A breakdown of why the extraction was necessary.
✅ Step 3: Demand a Re-Evaluation & Set a Deadline
Insurance companies stall to avoid paying.
I request an immediate re-evaluation of this claim. A response is expected within 30 days of this letter’s receipt.
Please confirm receipt of this appeal and provide a timeline for resolution. I am available for further discussion at [Your Contact Information].
Sincerely,
[Your Name, Your Dental Practice]
Want to STOP relying on insurance & start getting paid what you’re worth? Check out BoomCloud™
Why Membership Plans Are Better Than PPOs
RULE #2: Membership patients don’t need insurance. They just say YES.
How a Dental Membership Plan Works:
✅ Patients pay a low monthly or annual fee for preventive care.
✅ They get exclusive discounts on additional treatments.
✅ You generate predictable recurring revenue (MRR).
Why This Works:
✔️ Membership patients spend 2X-4X more than PPO patients.
✔️ Case acceptance skyrockets (because cost isn’t a barrier).
✔️ You create LOYALTY & RETENTION.
Want to launch your membership plan & ditch PPOs? Check out BoomCloud™
