Peer Review
Request for Dental Services Review Form
Peer review is a process by which the dental profession reviews and resolves problems or misunderstandings regarding dental treatment. Peer review exists for the benefit of the patient, the dentist and the third party. Every dental society has established a system of review to resolve the occasional disagreement about dental treatment that a patient and a dentist have not been able to resolve themselves. A peer review committee consists of dentists who volunteer their time and expertise to consider questions about the appropriateness or quality of care or, in certain instance, about the fees charged for dental treatment. The members of this committee will be impartial, and their services are available to anyone who chooses to utilize the process. A peer review committee will initially attempt to informally mediate a problem. If necessary, an arbitration panel may meet to discuss the case, and may examine clinical records, talk to the patient and the dentist and, if necessary, arrange for a clinical examination. The dentist and the patient will be informed of the committee’s decision and recommendation for resolving the problem. Peer review is not a court of law. It is generally a voluntary process that relies on the good faith between a dentist and patient and their mutual interest in good dental health.
The Peer Review process is supported by the Metropolitan Denver Dental Society and has a long history of helping to resolve disputes between patients and member dentists. This service has proven most effective when the participants understand its purpose and just as importantly, its limitations. The information listed below is to help you better understand Peer Review, avoid misunderstandings of the process and see how Peer Review can be of assistance to you in resolving your dispute.
1. Some dental complaints, while valid, are not suitable for Peer Review. Peer Review deals with quality and appropriateness of care. Therefore, there is no guarantee that your case will be accepted for review.
2. Please note that matters not accepted for Peer Review are:
a. - Litigation: It is not within the authority of Peer Review to accept cases in which a lawsuit has been filed. An exception to this condition is the instance in which a dentist has initiated litigation for the collection of a fee.
b. - Cases in which the dental care provider is not a member of the Metropolitan Denver Dental Society.
c. - Cases in which the Council on Peer Review finds that the case has been reviewed or is currently in review by the State Board of Dental Examiners, other state peer review committees, third party carriers or managed care review bodies.
3. The dentists who work with Peer Review receive no pay for their time and efforts. They are all trained volunteers and as such, they are expected to conduct fair and impartial mediations.
4. If your case is accepted for Peer Review, this does not mean the Council is convinced that your dentist has done something wrong. The decision to accept a case is based only on the information reported by the patient. Accepting a case allows the process to get started.
5. The Peer Review process may result in your dentist giving you a refund of some or all of the fees paid for a specific treatment. No money above this amount will be paid as part of the Peer Review Process. If a dentist does agree to refund some or all of the fees paid, this is not an admission of guilt and should not be construed as such.
6. An unexpected or bad result of a dental procedure does not necessarily mean the treatment was done poorly or inappropriately planned. The human body is not always predictable.
Please contact the Executive Director, at (303) 488-9700, ext 3267 or exec@mddsdentist.com with any questions or concerns.
Request for Dental Services Review Form
