Peer Review / Mediation Services

If You Have Any Concerns With Your Dental Care, There Is Help.

If you have any concerns about your Arizona dental care and cannot settle it with your dentist, the Arizona Dental Association has a formal dispute resolution process that can help.  This peer review process is available to you as a public service if your dentist is a member of the Arizona Dental Association (AzDA). 



What Is Peer Review?

Many patients find this process to be fair, less costly, less time consuming, and less contentious than going to court.  The peer review system focuses on disputes involving the appropriateness and quality of treatment.  It is not designed for disputes involving dentists’ fees for care, requests for non-treatment compensation such as payment for lost wages, pain and suffering, mileage and medical expenses, disputes involving the dentist’s or staff attitude or communication problems, or disputes that have already initiated litigation.  Peer review is designed to evaluate the appropriateness and quality of dental care provided and reach a binding decision, not to be punitive.

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The Process Of Peer Review

The peer review system has two phases:  Mediation and Evaluative Peer Review. 

The first step, mediation, is an informal process in which a AzDA staff mediator facilitates communication between you and your dentist to assist both of you in reaching a mutually acceptable agreement.  The mediator does not decide a solution: he or she assists you and your dentist, in reaching an agreement.

If mediation is not successful, the case may be eligible for evaluative peer review, which has several steps.



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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.

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Outcomes For Peer Review Cases

The following are potential outcomes of cases resolved via the peer review system:

Treatment is acceptable/appropriate. If the committee determines the treatment is acceptable and appropriate, no refund will be awarded.

Treatment is unacceptable/inappropriate. If the committee determines the treatment is unacceptable or inappropriate, the committee will award a refund to the patient and/or insurance carrier for the amount paid toward unacceptable or inappropriate treatment.

Corrective Treatment. If the committee determines that further harm was caused, necessitating additional treatment, the committee will award the amount estimated to correct the problem.

Acceptable but incomplete. If the committee determines that the treatment provided is acceptable, but the treatment is incomplete, the committee will award a refund of the amount of the treatment that is incomplete.

No determination. If there is insufficient evidence to render a decision, the committee will not make a determination about the case.



How Do I Get Started?

To start the complaint process, do not call or email the AzDA office. Follow the directions/steps below to first determine if we can assist with your complaint.  
  1. Have you tried to reach a resolution with them over the phone or in person?  If you haven’t, do this before looking to launch a formal complaint—this will save you a lot of time, energy, and perhaps stress. 

  2. Verify if the dentist who treated you is a member of the Arizona Dental Association, visit https://findadentist.ada.org.  If they are, continue to #3.  If they are not, the State Board of Dental Examiners may be able to help at 602-242-1492.

  3.  We can only help with complaints that involve the quality of the care you received (if it was substandard) OR the appropriateness of the care you received (if you were not overrated).

    Some examples of complaints we can help with include: 
    - Dentures, crowns, bridges not fitting correctly or keep falling off
    - Told to have incorrect margins on a crown
    - Bad implants, bad crowns, root tips left in after extraction
    - Failed implant or bridge

    Conversely, if you have a fee dispute (you want to get your money back, you feel you were overcharged, or anything else regarding money, billing, or payments), we will NOT be able to process your complaint. We cannot process complaints about money or billing—only complaints that concern the quality of the care you received OR the appropriateness of the care you received. If you have or used your dental insurance, then you need to work with your insurance company and the office where you received your treatment.  If your dental insurance is through an employer, you should speak with your HR representative to have them assist you.  The other option would be to speak with an attorney.

    Additionally, if you felt the dentist or the dentist’s team was unpleasant or rude to you, and you’re unhappy with the way you have been treated, the best course of action is just to find another dentist to treat you. We cannot process complaints about personality and customer service—only complaints that concern the quality of the care you received OR the appropriateness of the care you received.

  4. If you have already filed your complaint with the State Board of Dental Examiners you will have to go through that process.  A complaint can only be submitted by one or the other—not by both the State Board of Dental Examiners and the Arizona Dental Association.

  5. Once you have gone through the 4 steps above and still want to continue, download, fill out, and return these forms.

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