Limitations Of Peer Review System
The following types of complaints are NOT within the scope of peer review system:
Cases which do not meet “time” criteria
Excessive passage of time alters clinical conditions. Therefore, a complaint will not be reviewed if it is received more than three years from the date treatment was completed, or more than one year from the date the complainant became aware of the problem, whichever occurs first.
Cases in litigation
The peer review system is designed to resolve patient/dentist disputes. Consequently, no inquiry will be accepted for peer review if either party has initiated litigation (including small claims court or sending a 90-day notice of intent to sue); have initiated or have gone through a formal arbitration process and/or both parties have signed an arbitration agreement concerning any aspect of the dental services which might otherwise be reviewable.
Cases petitioning for non-treatment monetary awards
Requests for reimbursement for time lost from work, pain and suffering, mileage and medical expenses cannot be accepted in the peer review system as it is not a punitive system, but rather an evaluative one.
Cases about fees
A peer review committee may not comment on a dentist’s fees. To do so may be construed as price fixing.
Cases not related to treatment
Questions concerning matters other than dental treatment (e.g., a dentist’s attitude, communications problems, etc.) are outside the purview of the peer review system.