Complaint Resolution – The Peer Review Process
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. The dentist should be able to address your issue. Simply bring it to the practitioner’s attention by calling the office. If you do not wish to discuss the dispute or “confront” the dentist, send your complaint in writing – certified mail, return receipt requested, will guarantee receipt. When you contact the dentist, make sure you are prepared to discuss:
• The involved date-of-service (treatment date)
• Your issue, and
• An outcome that will make you happy
By contacting the dentist with your issue before going through other grievance processes, you will likely resolve your issue quickly.
If you concern is still unresolved, the TDA has an dispute resolution process called Peer Review.
Peer review is an informal process through which problems or disputes can be resolved at the
local level by mediation or panel review. It is neither a court of law nor a punitive
action hearing. The TDA Peer Review Committees consist of TDA member dentists who volunteer their time and expertise to assist patients and dentists. The volunteers who serve on these committees are dentists who were selected by the leaders of their local societies because of their reputation within the dental community, especially as it relates to their technical knowledge, clinical skill and judgment.
Matters accepted for Peer Review
• Appropriateness of Care: The Peer Review Committee shall determine the professional acceptability of planned or completed treatments, consistent with diagnosis. In other words, did the dentist provide appropriate treatment for the condition that existed?
• Quality of Treatment: The Peer Review Committee shall determine the acceptability of completed treatment based on the standard of care expected by the profession. In other words, was the treatment performed by the dentist done correctly?
Matters not accepted for Peer Review
• Any complaint that doesn't concern the appropriateness of care or quality of care is not accepted.
• If the case involves a payment and/or billing dispute, it is not accepted.
• Complaints of poor customer service, practice management or concerning a staff member's behavior are not accepted.
• Insurance complaints and/or disputes are not accepted.
• If litigation has been initiated, the case will not be accepted.
• If a complaint has already been filed with the Texas State Board of Dental Examiners, it will not be accepted.
If you would like to initiate a complaint, please call the Complaint Resolution Hotline at 800.832.1145 x 153 or send an email to firstname.lastname@example.org. The following information must be included:
• The first and last name of the treating dentist.
• The city where the treatment was performed, and
• A very brief description of the complaint. Details of the complaint will be required at a later time.
Upon receipt of the required information, you will be provided with the appropriate contact information.
If you are looking for a new dental provider, please visit https://findadentist.ada.org/ to find a member dentist near you.