Avoiding Dental Malpractice Claims: Peer Review

Dental Malpractice Prevention > Working With the Board

In our last post, we discussed how dentists can be proactive in mitigating malpractice suits against their practice. Working with the dental board to resolve issues can be intimidating, but the process doesn’t have to be. Part of working out any potential claims with the dental board involves peer review, where fellow professionals evaluate the appropriateness and fairness of dental treatment. In this post, we’ll dive deeper into what to expect and how that works to ease your mind. Most importantly, ensure you carry Dental Malpractice Insurance.

How does a peer review work?

A Peer Review Committee, composed of TDA member-dentist volunteers, evaluates all evidence that is available pertaining to each dispute and follows specific guidelines in order to make a fair and impartial decision.  If any party involved in the process feels that a Committee’s decision is incorrect due to additional information becoming available or information that is contrary to the outcome of the review, an appeal may be made to the TDA Council on Peer Review.  An appeal must be mailed within thirty (30) days of the date the letter of resolution is sent.  Any decision of the Council is final and binding, says Texas Dental Association.

What guidelines does this process follow?

The peer review must be conducted by the board of dentistry that the dentist is a member of. Next, an agreement form must be signed by both parties before starting the review, and thy are both required to be given an opportunity to speak to the board during the complaint hearing.

To start reviewing any case, the association must obtain a record release approval from the patient to avoid violating HIPAA laws. Finally, if a Peer Review case goes to a panel hearing, the patient will be examined by at least three dentists unless the patient has had the treatment redone prior to the hearing. Whatever decision the board decides on will be written and sent to each party in a resolution letter.

Exclusions.

The peer review process is effective, but not all cases qualify for this model of resolution. The following types of claims are excluded:

  • Cases that seek financial reward.
  • Cases that involve civil litigation.
  • Cases that are not based on treatment, such as communication or clerical errors.

Cases that do not fall within the time limit: 3 years or more after treatment, or 1 year after the patient discovered the issue.

About Walker & Associates Insurance

At Walker & Associates Insurance, we have been a leader in helping to protect businesses and families since 1960. Our coverages are written to cover your business inside out. For more information, we invite you contact us today at (800) 213-7126.

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