Calif. dentist charged with 75 counts of billing fraud

2016 09 29 11 39 46 810 Scales Of Justice 400

A California dentist has been charged with insurance fraud for submitting reimbursement claims to private insurance companies for dental work that allegedly was never performed. The dentist submitted claims for nearly $600,000 covering 623 root canals in 75 patients, according to state authorities.

April Rose Ambrosio, DDS, of Mira Mesa was charged with 75 counts of making false claims for dental services in a complaint filed June 10 in San Diego Superior Court. Dr. Ambrosio was also hit with related fraud and embezzlement charges for the claims.

Dr. Ambrosio billed $593,000 to eight insurance companies, including Delta Dental, Principal Life Insurance, Metropolitan Life Insurance, and other providers, state officials claimed. She ultimately received over $200,000 from the allegedly fraudulent claims.

In one example cited by authorities, Dr. Ambrosio submitted claims for 110 root canals that she claimed she performed for a single family of four in a three-month period in 2016. These claims alone totaled $61,700, according to a complaint filed by the San Diego County District Attorney's Office. She allegedly billed for 28 root canals supposedly performed in another patient.

The California Department of Insurance spent two years investigating the case, according to authorities. Dr. Ambrosio allegedly had been overbilling for procedures since 2016.

"This is a case of repeated and flagrant fraud by a medical professional," said Summer Stephan, San Diego district attorney. "Unfortunately, when scam artists bill for dental services not rendered, they get rich at the expense of honest consumers who ultimately pay the price through higher premiums."

If Dr. Ambrosio is convicted on all the charges, she faces up to 83 years in prison. Her next court date is September 5.

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