What is Peer Review?

The Third District Dental Society follows the guidelines provided by the New York State Dental Association Peer Review program which provides a confidential, impartial and timely mechanism to resolve dentist-patient disputes about appropriateness of treatment and the quality of care rendered by Third District member dentists. There is no cost for this service.

Concerned about your care? When you choose a Third District member, your dentist is committed to providing the highest quality dental treatment possible. If you have a concern about the care provided to you, the first thing you should do is go back to your dentist. Often discomfort after treatment can be fixed with an adjustment or additional care.

The Committee's purpose is to resolve disputes about the quality of care and appropriateness of treatment rendered by its member dentists. They review and mediate disputes among patients, dentists and dental benefit companies.

Fee dispute? Fee disputes are private matters between doctors and patients. Dentists establish fees individually and independently of each other. Peer Review addresses questions of “usual or customary fees” only in cases involving dental benefit companies. Fee disputes must be settled privately between the dentist and patient, or by the courts, and can’t be resolved by Peer Review or any other public agency. All members are required to participate in Peer Review and to abide by the decisions of Peer Review Committees.

Peer Review is a dispute resolution process. NYSDA and the Third District offers this as an alternative for patients to resolve complaints about treatment quality.

Peer Review cannot hear complaints that are before (or have already been resolved through) the courts or the New York State Education Department.
There is no charge for Peer Review.
Peer Review is objective and confidential.
Peer Review can only evaluate treatment completed within the past two and a half years.
Dental treatment must be paid in full or the patient will be required to send the balance due with the Agreement to Submit to Peer Review to be held in escrow until a decision is made on the case.
The parties are encouraged to consult with an attorney to fully understand the terms of the Agreement to Submit to Peer Review.
When Peer Review finds treatment unacceptable, the dentist is directed to refund only the fees received for that treatment.
Peer Review does not make punitive awards.
When treatment is found to be appropriate and the care provided acceptable, all outstanding patient fees are remitted to the dentist.

How Does It Work? Both the patient and the dentist submit the Agreement to Submit to Peer Review. A mediator will contact them to try to resolve the dispute. If mediation is unsuccessful, the Peer Review Committee conducts a hearing. The committee is made up of three volunteer dentists. These dentists examine all patient records and other evidence submitted. They interview the dentist and the patient. They individually examine the patient’s mouth. A decision letter will be sent to the parties involved indicating whether the dental treatment was or was not acceptable.

How Do I Find Out More? If work was completed in a member dentist of the Third District Dental Society (Albany, Rensselaer, Columbia, Green, Ulster or Columbia Counties), you must contact the Third District office at (518) 782-1428 to discuss your case and obtain an Agreement to Submit to Peer Review and a Guide to Peer Review.

This information is provided by the Third District Dental Society and the New York State Dental Association