Peer Review

Even in the best dentist-patient relationship, a problem may occur. First, discuss any concerns you have with your dentist. Many times this will help clear up the matter. If you are still not pleased, the KDA has an established dispute resolution system called Peer Review to help resolve the occasional disagreement about dental treatment.

Begin a Peer Review Application

WHAT IS PEER REVIEW?

In its simplest terms, Peer Review is a voluntary mechanism by which the Kansas Dental Association’s Peer Review Committees review matters concerning, but not limited to: the reasonableness of fees, quality of care, utilization of services and appropriateness of treatment.

Read: Peer Review Program Helps Patients and Dentists Resolve Disputes

 

WHAT IS THE FUNCTION OF PEER REVIEW?

It is the responsibility of a Peer Review Committee to explore to the extent necessary all matters referred to it and to do so within a period of time that makes its efforts effective and expeditious. It is the obligation of such Committee to conduct unbiased and objective hearings. The Committee has an equal responsibility to all involved parties.

WHAT ARE THE DUTIES OF THE COUNCIL ON PEER REVIEW?

The duties of the Council on Peer Review are to uphold Kansas Dental Association’s and American Dental Association’s high standards of professional care, conduct and code of ethics; to review complaint cases submitted by the patient, dentist or third parties; maintain records of all cases and their resolutions for the period of time specified by the Peer Review Manual; and to finalize matters within thirty days in most cases.

Peer review does not: force itself on either party (however, all parties to a Peer Review proceeding are asked to abide by the decision of the Committee) or claim to be a court of law; review cases currently in litigation or cases presented to the Kansas Dental Board; or award punitive damages.

WHO SITS ON THE PEER REVIEW COMMITTEE?

The Committees are composed of dentists well respected in their professional community. In most instances a lay person also serves on each of the Committees.

WHAT PROCEDURE IS USED?

• The Chairman of the Council on Peer Review reviews the complaint to see if it falls within the realm of Peer Review.
• A copy of the complaint is then forwarded to the Chairman of the Peer Review Committee who appoints a member of the Committee to act as mediator.
• Within ten days, the mediator contacts all parties via telephone and tries to reconcile differences. THE MEDIATOR DOES NOT EXAMINE PATIENT.
• If the case is resolved by the mediator, a written report is submitted by the Chairman and the case is closed.
• If the case is not resolved by the mediator, the latter informs the chairman by written reportthat further action by the entire Peer Review Committee is warranted.
• The chairman schedules a meeting of the Peer Review Committee.
• The patient and dentist are asked to sign the request form, indicating his/her willingness to be examined and to accept the decision of the Committee.
• Because Peer Review is not a court of law, attorneys are excluded from Peer Review proceedings.
• Content of all cases is kept in the strictest of confidence.

• One may appeal the decision of the Committee within 30 days by submitted a written request based upon:  Procedural error; inconsistency of Facts, Findings and/or New Evidence; Prejudice or Bias; or at the Chairman’s Request.

Other avenues of complaint review can be to the Kansas Dental Board or the Civil Court System.

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