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Overview of ADA Recommendations on the Organization and Implementation of Peer Review
You will receive 1 unit(s) of continuing education credit upon successful completion of this course.

Description:
This course describes the ADA’s recommendations on the organization and implementation of dentistry’s peer review system and explains the general process of peer review and mediation.

Author:
American Dental Association, Continuing Education and The Council on Dental Benefit Programs
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Learning Objectives:

Upon completion of this course, participants should be able to:

  1. Identify matters handled through the peer review process
  2. State the purpose of peer review  
  3. Identify the basic process of peer review 
  4. Describe the difference between the mediation and peer review phases of the peer review process
  5. Identify key areas in which dental society peer review policies may differ from each other and from ADA recommendations
  6. Describe the duties of the peer review committee members
  7. Identify the most common remedies offered by the peer review process 
  8. Discuss the issues affecting compliance with peer review decisions

Abstract:
Dentistry’s peer review system is a dispute resolution program that is based on the ethical obligations of the profession to regulate itself and provide its patients with quality oral health care.  This course aims to provide an overview of the peer review process to familiarize new peer receive committee members and dentists who may one day be a party in a peer review case with the general peer review process.  It also points out issues where policy differs from one dental society to another and so alerts the student to seek further information on those points from their state and local societies.  To be effective the peer review process must be confidential, consistent and easily accessible.  Thus, peer review committee members must be thoroughly educated on the ADA’s recommendations on how the peer review system should be organized and conducted.  Those dentists who may be a party in a peer review case must also understand the purpose and process of peer review in order to fully participate in it.  This course describes the purpose, basic process and responsibilities, major differences among constituent dental society programs, and the most common remedies offered through the peer review process.

Outline:
  1. Purpose of Peer Review

  2. Administration of Peer Review

    1. Role of the American Dental Association

    2. Relationship with state boards of dentistry

    3. Differences in policies among states and the ADA

  3. Confidentiality and Neutrality

  4. Matters for Review

    1. Definition of quality of care, appropriateness of care and fee disputes

    2. Time limitations for complaints

    3. Consultation with attorneys and cases in litigation

    4. Dentist to dentist complaints

    5. Interagency reviews

  5. The Peer Review Committee

    1. Volunteers

    2. Laypersons

    3. Specialists

  6. The Peer Review Process

    1. Opening a case

    2. The mediation phase

    3. The peer review phase

    4. Time frames for conducting a case

    5. Appealing a decision

  7. Peer Review Decision Making

  8. Notifying Parties of the Decision

  9. Compliance with Peer Review

  10. The National Practitioner Data Bank 


    References:
    There are no references for this course.




    American Dental Association is an ADA CERP Recognized Provider.

    ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.