Peer Review Service
For the rare instances when it is needed, the Colorado Dental Association offers a resource for helping resolve complaints that may arise in the delivery of dental services to the public.
Peer Review is not a court and has no disciplinary function. It provides an alternative dispute resolution mechanism, at no cost to either party. Peer Review is a process where the dental profession reviews and attempts to resolve dental treatment problems and misunderstandings through mediation.
The Council on Peer Review and local committees consist of CDA member dentists who volunteer their time to review and assist patients. Unbiased, objective and timely reviews are conducted using the CDA’s format for addressing disputes between patients and dental care providers.
This service has proven most effective when the participants understand its purpose and, just as importantly, its limitations. The information listed below is to help you better understand Peer Review, avoid misunderstandings of the process and see how Peer Review can be of assistance to you in resolving your dispute. Peer Review deals with issues involving quality of care and appropriateness of treatment. Thus, some dental complaints, while valid, are not suitable for Peer Review. There is no guarantee that your complaint will be accepted for review.
- The dentist whom the complaint is against must be a member of the CDA
- The complaint must be regarding quality of care and/or appropriateness of treatment
- The date of discovery must be within two years
- Complaints involving dentists who are not members of the CDA
- Complaints of poor customer service, practice management or fees
- Complaints concerning a staff member’s behavior
- Complaints where a lawsuit has already been filed (an exception to this condition is the instance where a dentist has initiated litigation for the collection of a fee)
- Complaints where the Council on Peer Review finds that the issue has been reviewed or is currently in review by the Colorado Dental Board, other state Peer Review committees or managed care review bodies
If your complaint is accepted for review, the Peer Review committee will initially attempt to mediate a solution. If mediation is unsuccessful and both parties agree to proceed, the next step will be binding arbitration. A three-person arbitration panel will meet to discuss the case, examine clinical records, talk to the patient and the dentist separately and, only if necessary, arrange for a clinical examination. The dentist and the patient will be informed of the committee’s decision and recommendation for resolving the problem. Peer Review is not a court of law, but a voluntary process that relies on the good faith between a dentist and patient and their mutual interest in good dental health.
The dentists who work with Peer Review are not paid for their time and efforts. They are all trained volunteers and, as such, they are expected to conduct fair and impartial mediations.
If your request for review/complaint is accepted for Peer Review, this does not mean the committee is convinced that your dentist has done something wrong. The decision to accept a case is based solely on the information supplied by the patient. Accepting a case simply allows the process to get started.
An unexpected or unsuccessful result of a dental procedure does not necessarily mean the treatment was done poorly or inappropriately planned. The human body is not always predictable.
The Peer Review process may result in your dentist giving you a refund of some or all of the fees paid for a specific treatment. No money above this amount can be paid as part of the Peer Review process. If a dentist does agree to refund some or all of the fees paid, this is not an admission of guilt and should not be construed as such.
The most you can be refunded through Peer Review is the original fee you paid. Payment for pain, suffering, inconvenience, or work performed by another dentist is not within the jurisdiction of the Peer Review process. Monies paid to an insurance carrier are generally returned to that carrier unless the patient is no longer with that provider.
To obtain a copy of the Request for Peer Review Form.
All requests for review must be received by the CDA at least two weeks prior to a scheduled meeting. If a request is received after that date, it will be held for evaluation until the next scheduled council meeting. All requests for review must have PEER REVIEW clearly written on the envelope.
For complaints involving a CDA member dentist in the Colorado Springs area, please contact Sharyn Markus at 719-598-5161 or email@example.com.
For complaints involving a CDA member dentist in the metro Denver area, please contact Marlene J. Pakish, at 303-488-9700, ext. 3268 or firstname.lastname@example.org.
For complaints involving a CDA member dentist in other areas of Colorado or for further information regarding Peer Review, please contact the Colorado Dental Association at 303-740-6900, 800-343-3010 or email@example.com.
For complaints against dentists who are not members of the Colorado Dental Association, please contact:
Colorado Dental Board
1560 Broadway, Suite 1310
Denver, CO 80202
Phone: 303-894-7758 ext 304