Resolving Patient Conflicts
Patient Records
Do I have a right to see my records?
The dentist owns the physical record of the patient and is the legal guardian of the chart and its complete contents, including radiographs (x-rays). While patients do not have the right to possess their original record, they do have the right to see, review, and inspect their record, and to request and obtain a copy of it.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) permits dental practices to charge a reasonable, cost-based fee for copying records. HIPAA requires dentists to provide patients with copies of their records even if the patient’s financial account is unpaid or past due. This is also consistent with Advisory Opinion 1.B.1. of the ADA Principles of Ethics and Code of Professional Conduct.
Insurance Claims
What if I disagree with my insurance coverage?
Please contact your carrier or your employer if coverage is provided through them. You may also contact Montana's Commissioner of Securities & Insurance at https://csimt.gov/insurance-complaints-fraud/ or 406.444.2524.
Problems With Your Dentist
How do I resolve disputes or complaints I have with my dentist?
Even in the best dentist-patient relationship, a problem may occur. First, discuss any concerns you have with your dentist. Many times this will help clear up the matter. If not, the Montana Dental Association offers a dispute resolution system called "Peer Review" to help resolve the occasional disagreement about dental treatment.
Peer Review provides an impartial and easily accessible means for resolving misunderstandings regarding the appropriateness or quality of care and, in certain instances, about the fees charged for dental treatment (see above about insurance issues). Peer review is not a court of law. It exists for the benefit of the patient and the dentist. It is a voluntary process that relies on the good faith between a dentist and a patient and their mutual interest in good dental health.
Peer Review consists of MDA member dentists who will attempt to mediate the problem. They may meet to discuss the case and may examine clinical records, talk to the dentist and patient, and - when indicated - arrange for a clinical examination.
If you believe your case is a matter appropriate for peer review, you may download the Mediation Request Form (PDF). Complete and return to the MDA to begin the Peer Review process. For further information, email: info@MontanaDental.org or call (406) 443-2061.
