When a problem or misunderstanding cannot be resolved between you and a patient, we can help. Our council of dentist-member volunteers follows specific procedures to conduct peer reviews of disputes to help all parties involved reach a fair agreement.
Peer Review Program
Our statewide peer review system is in place to resolve disputes that may arise in the delivery of dental services to the public; in particular, disputes regarding the quality and/or appropriateness of dental treatment, utilization (problems related to dental insurance benefits when treatment is questioned), and/or potentially irregular billing practices.
A peer review committee, comprised of CDA member-dentist volunteers, evaluates all available evidence pertaining to each dispute and follows specific procedures to make a fair and impartial determination. The parties involved are then notified of a committee’s decision by a letter of resolution. If any party to a review can factually demonstrate that a procedural error may have occurred, or that the decision was not based on available facts, an appeal to the Council on Peer Review may be requested. This appeal must be mailed within 30 days of the date the letter of resolution is sent. Any decision of an appeal panel is final and binding.