Sick of Insurance Companies Screwing You Over? Read This.
Dentists, let’s be real—PPOs are the worst. Let’s talk about a Dental Appeal Letter Sample
You do the work.
You bill insurance.
You get DENIED or reimbursed pennies on the dollar.
Meanwhile, your front desk is drowning in phone calls, appeals, and endless paperwork.
Reality check: The average dental practice writes off $35,000+ per month in PPO adjustments. That’s $420,000 per year—GONE.
What if you could stop fighting insurance companies and start getting paid what you’re worth?
✅ Over 50% of Americans don’t have dental insurance.
✅ Membership patients say YES to treatment 3X more than PPO patients.
✅ You can build predictable recurring revenue (MRR & ARR) with a membership plan.
In this guide, you’ll learn:
✅ How to write a bulletproof dental appeal letter.
✅ Why membership plans eliminate PPO headaches.
✅ How BoomCloud™ helps practices generate predictable revenue & happier patients.
Let’s go.
How One Dentist Went from PPO Frustration to $500K in Recurring Revenue
Meet Dr. Rachel Lewis.
She was:
❌ Tired of fighting insurance denials.
❌ Losing money on PPO write-offs.
❌ Stressed about inconsistent cash flow.
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.
How to Write a Dental Appeal Letter That Actually Works
Step 1: Use a Strong, Professional Tone
Insurance companies will deny anything they think they can get away with.
Start your letter with authority & clarity:
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 treatment in my office on [DATE OF SERVICE].
The procedure in question—[CPT Code & Treatment Name]—was medically necessary and aligns with standard dental care protocols.
Step 2: Provide Medical Necessity & Evidence
RULE #1: Insurance companies LOVE rejecting claims due to “lack of medical necessity.” Don’t let them.
✅ Include X-rays, clinical notes & ADA guidelines supporting your case.
✅ Use precise language to explain why the treatment was necessary.
✅ Reference specific policy details if applicable.
Step 3: Demand a Re-Evaluation & Set a Deadline
Insurance companies stall to avoid paying. Give them NO CHOICE but to respond.
I request an immediate re-evaluation of this claim. Per dental industry standards, 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]
Why This Works:
✔️ It establishes urgency.
✔️ It makes it harder for them to deny you.
✔️ It shows you’re prepared to fight back.
Want to stop dealing with PPOs altogether? 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™
