A former Mira Mesa dentist who bilked insurance companies out of hundreds of thousands of dollars by submitting claims for procedures she never performed, including hundreds of supposed root canals, has been sentenced to six years in state prison, the San Diego County District Attorney’s Office announced Wednesday.
April Rose Ambrosio, 59, pleaded guilty to three counts of insurance fraud earlier this year for fraudulently billing insurance companies for $866,700, for which she received more than $400,000 from 10 insurance companies, according to prosecutors.
The DA’s Office said Ambrosio falsely claimed she performed 800 root canals on 100 patients, despite not having specialized training as an endodontist to perform such procedures.
Ambrosio was sentenced earlier this month, and in addition to a six- year prison term, was ordered to pay $405,633 in restitution. Her license to practice dentistry was also suspended last year, a few months after she was charged.
Prosecutors say the fraud occurred between 2014 and 2018.
During that time, Ambrosio billed for work she said occurred on days her office was closed and billed for more than 100 root canals during a three- month period, all of which were supposedly performed for a family of four, according to the DA’s Office. She also billed for root canals on teeth patients didn’t have or double billed for teeth she previously said she performed root canals on, the DA’s Office said.
“The way this defendant bilked the system is astounding,” District Attorney Summer Stephan said. “Unfortunately, when insurance companies get ripped off, consumers ultimately pay the price through higher premiums.”
Ambrosio’s case was investigated over the course of two years by the California Department of Insurance and the San Diego County District Attorney’s Office.
“This medical provider abused the trust placed in her by fraudulently billing for procedures she never performed and was never trained to perform,” California Insurance Commissioner Ricardo Lara said. “Her illegal actions cost California consumers through higher insurance premiums and erodes the trust consumers hold for honest providers in the dentistry field.”
— City News Service