If you are not happy with the treatment you have received from a dentist, or you have a problem with an insurance company not paying a claim, there are steps you can take toward a resolution. The IDA suggests first approaching the dentist to resolve an issue. The next step, if needed, is the IDA mediation process to resolve “quality-of-care” issues. However, we strongly suggest patients first take the following steps to resolve disputes:
Step 1: Talk to your dentist
Bring your issue to the attention of the dentist. The dentist or office manager should be able to address your issue. Simply bring it to the practitioner’s attention by calling the office. If you do not wish to discuss the dispute or “confront” the dentist, send your complaint in writing – certified mail or by facsimile will guarantee receipt. When you contact the dentist, make sure you are prepared to discuss:
- The involved date-of-service (treatment date)
- Dollar amount in dispute
- Your issue, and
- An outcome that will make you happy
By contacting the dentist with your issue before going through other grievance processes, you will likely resolve your issue quickly.
Step 2: For unresolvable treatment issues, contact the IDA
The IDA has a Peer Review process to consider “quality of care” issues. This process addresses only disputes about quality of care. It does not address complaints regarding poor customer service, appropriateness of fees, insurance issues, billing disputes, staff problems or office policies. If your complaint meets the IDA Peer Review “quality of care” criteria, you may complete the form below for assistance through the peer review process. The process is as follows:
- The patient receives forms to complete and return to the IDA office in Indianapolis (request the forms below)
- The forms are reviewed to see if the issue meets quality of care criteria
- The forms will be sent to a local district dental society for consideration by a panel of dentists
To request Peer Review forms, you must complete and submit the following form:
After submitting this form, please check your email (including spam/junk folders) for a response from the IDA. The IDA email will include additional information and a link to a Peer Review form where you can give additional details about your dispute. A mediation-trained dentist will contact the involved parties and make every attempt to help you and the dentist reach a mutually satisfactory resolution. If mediation is not successful, the case proceeds to a committee hearing where a panel of dentists will review findings and recommendations for a resolution. This process is non-binding and voluntary and is allowed by Indiana state law.
In all cases, do not send originals, only copies. Briefly describe the issue or dispute. Suggest a resolution that would be fair and satisfy you. Be courteous and calm.
Ed Rosenbaum, Director of Professional Services 800-562-5646 EdR@INDental.org