Resolution of
Disputes
Peer Review is a voluntary informal
mediation/arbitration process that has been developed by organized
dentistry as a free-of-charge public services that allows patients,
third party payers and dentists to resolve disputes over quality of
care and appropriateness of dental treatment issues.
The Akron Dental Society has a Peer
Review Committee and when the Central Office receives a complaint via the telephone or mail a mediation form is mailed to the party making
the complaint. Upon its return it is then ailed to the chairman
of the Peer Review Committee for review, and if within the guidelines
of peer review, a mediator will then be assigned to mediate the case.
The committee will not consider
complaints made beyond one year from the date of the completed service
or if the work in question has been altered without diagnostic aids to
determine the facts.
If mediation proves unsuccessful, the
involved parties will be required to sign a binding arbitration
agreement for the process to continue. If both parties do not
sign binding arbitration, then peer review will end its involvement in
the dispute.
After all involved parties have agreed
to binding arbitration, the Peer Review Committee will conduct a
clinical examination, interview the involved parties and, based on
this information, render findings and recommendations concerning the
case.
When monetary awards are recommended by
the Committee, such awards are limited to the fee charged by the
dentist for the service in question by refund or the elimination of
liability for such amount. Peer Review is prohibited from
awarding punitive damages, issuing fines, adjudicating fee disputes or
making prospective awards.
The local peer review committee
recommendations may be appealed for just cause (i.e., procedural
error, prejudice or bias and/or the local committee's findings are not
supported by the facts which were presented to it) by either party to
the ODA Statewide Subcouncil on Peer Review for a final determination.
