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2024 Update – Response to Forums

Letter from the CEO

Hi All. First let me state that this is Dr. Baldwin, the owner of Achilles Foot and Ankle Center.

I have read many posts, online reviews, and threads on this forum and I would like to provide factual information about our practice.

I started Achilles Foot and Ankle Center (AFAC) in 2015 after purchasing the practice from Dr. Kenneth Cookus, who served the Richmond community for many years at Parham Doctor’s Hospital MOB 1. I am from Richmond and I am excited to practice in the same place that I was born. As a solo practitioner my practice started out seeing 10-15 patients per day just a few days per week. As the word spread about our practice from patients and referring providers, the practice grew to treating over 40 patients per day by the end of 2016.

In 2017, the first expansion of AFAC occurred and Dr. Elaine Allen and Dr. Sunny Patel joined the practice with me. We still treated patients out of the four treatment rooms available at our original Parham Doctor’s Hospital location. By the end of 2017, AFAC had doubled it’s patient volume by providing quality foot and ankle care to the local community.

As time moved on and our reputation grew stronger in the community, many local podiatrist began to contact me to aquire their practices. From 2018 to 2021, AFAC aquired 4 retiring podiatrists’ practices. Along with the aquisitions, brought other doctor’s to the practice.

By the start of 2022, AFAC was treating over 6,000 patients per month across 9 locations spanning as far north as Ashland, south as Colonial Heights, west as Midlothian, and east as Kilmarnock. We employed 15 wonderful podiatrists and nurse practitioners.

With the rapid growth of the practice to treating almost 10,000 patients per month, I found it necessary to temporarily step away from clinical practice to move into an administrative role to ensure quality care and patient satisfaction were maintained to the highest standard. My official last day of clinical practice was in August of 2022.

I must admit, it was very difficult to transition from the clinical setting to the administrative setting. I quickly learned the behind the scene mechanisms that kept the practice running. I unfortuantely also was exposed to the pitfalls of having such a large practice.

It was my opinion that with extended wait times, increased billing inquiries, and over 100 new patient appointments per day, that AFAC must expand and hire additional podiatrists. At the start of 2023, AFAC hired three additional podiatrists to bring our team to 13 podiatrists and 5 nurse practitioners.

It was always a dream of mine to have 50 providers and 50 locations by the age of 50 ( I am currently 37 years old). I believed that I could take my quality over quanity practice solution and duplicate the model over and over at each location. By summer of 2023, despite countless hours of meetings, planning, training, and consultation with concerned patients, I knew that the practice that employed 150 people and treated 14,000 patients per month was quickly breaking down the model that I hoped to achieve.

Patient complaints, technology issues, and extended wait times are just a few examples that ran through my head each and every day. In May of 2023, I made the decision that I needed to hire a professional administrative team to run AFAC. Rising overhead and rising problems began to take over AFAC as I once knew as an environment in which I knew most patients by first name, and our staff left work happy.

From June 2023 until October 2023, a highly educated and professional team took control of AFAC. Many changes occurred including replacing most of our billing team due to headaches that patients consistently faced. Additional staff was hired, new technology was implemented, and protocols were changed. Yet, to me, the old ways of AFAC never seemed to shine through the dust. By the end of October 2023, I had prepared for the decision to sell the practice to a larger group or hospital system in order for me to return to what I considered a normal life in private practice.

Along comes November 2023 and in the first week our newly hired COO submitted her resignation. Her attempts at changing the practice and attempts to help return AFAC to its once known small feel, home town practice were not successful. I had been working 14+ hour days, seven days per week for more than 6 months. I was barely sleeping thinking about patients and staff and their experiences at the practice. I knew that the large practice, treating 14,000 patients, at 13 locations, with 18 providers would not be successfull in my eyes if it continued the path it was taking. Therefore, I made the very difficult decision that it was time to sell the practice.

I immediately notified physicians and nurse practitioners. I informed them that I planned to return to private practice as a small organization. I first offered the purchase of the practice to our team of physicians prior to contacting any other organization. Within an hour of offer, Drs. Noel Patel and William Eng stated that they would like to take over all locations with the exception of Ashland, Discovery Drive, Midlothian, West Point, Mechanicsville, and Springfield.

A temporary furlough of employees was set on Nov 13, 2023. An offer was accepted by me from Drs. Noel Patel and William Eng to purchase the locations as The Foot Center on November 12, 2023. I informed all employees that certain providers and staff would remain with me at Achilles Foot and Ankle operating out of the Mechanicsville and Springfield location. The doctors that joined me at AFAC included Dr. Aaron Bradley and Dr. Renee Shepherd. The nurse practitioners that joined us includes Ms. Monica Broadnax, FNP and Ms. Mary Highsmith, FNP. Our staff went from 150 employees down to just 25 employees.

It was the goal of The Foot Center to open as quickly as possible with cooperation from AFAC in notifying patients. However, I will admit, with the large volume of patients, notification and scheduling changes were very difficult for us to achieve. We tried our best with phone, email, and signage at our locations but many patients still did not get notifications in time. Many of the doctors that were employed by AFAC continued their practice with The Foot Center. Dr. Sunny Patel and Dr. George Lane joined Synergy Foot and Ankle.

Drs. Bradley, Shepherd, and I along with NPs Broadnax and Highsmith, began treating patients on the second week of November 2023. We still had a large volume of patients to treat as The Foot Center continued to make efforts to open their doors. Our goal was to continue to treat as many patients as possible until patients could transition over to their normal providers at The Foot Center. The Foot Center officially opened in December of 2023.

Our scheduling team work diligently to attempt to contact patients to inform them about The Foot Center at the start of December 2023. By the second week of December, almost all patients who wanted to transition to The Foot Center had done so succesfully.

Light was finally at the end of the tunnel. The newly formed team at Achilles Foot and Ankle Center made a goal to treat patients with quality care in a family oriented environment. We worked hard to get as many patients seen by the end of the year due to resetting of deductibles in the new year. Most patients were pleased with the services that were provided. I was extremely happy that things were starting to return to what I remember to be original Achilles Foot and Ankle Center.

Dr. Bradley and I left for our family vacations on December 18, 2023. Dr. Shepherd and NPs Broadnax and Highsmith held down the practices while we were gone.

By the end of December we received notification from Dr. Bradley that he would not be returning to practice for reasons he wished to not disclose at the time. As a close friend of Dr. Bradley, I was deeply concerned as communication had come to a complete stop. Many patients have received the notification that we were required to distribute at the start of the new year, 2024. It was very difficult for all providers and staff to return to clinics with what appeared to be the unknown status of Dr. Bradley. However, the team really dug deep to try to keep everything together with providers treating both their own patients and Dr. Bradley’s patients. I am truly appreciative of each and every employee that has worked the many late evenings over the past couple of weeks.

I am happy to say that Dr. Bradley and I have met and discussed his departure. I am very supportative of friends and staff who make the often difficult decision to do what is best for themselves and their family. For Dr. Bradley, a group practice, regardless of the decrease in size, did not fit the needs of his family. Dr. Bradley and I both agreed that we had made many modifications to help as much as possible and that opening his own private practice would be best. After deep discussion, Dr. Bradley and I want all patients to know that we both plan on supporting each practice as Dr. Bradley grows his own practice to ensure all patients receive the best quality care.

I want to debunk all of the information that I have read on Reddit.

First, a thread started with “A little birdy told me they are/were under investigation for fraudulent billing at the minimum.” I can attest that Achilles Foot and Ankle Center is not under any investigation for fradulent billing with commercial insurance carriers, medicaid or Medicare. We provide all requested documentation to all insurance carriers as they request. The insurance carriers make the decision whether the documentation provided by the doctor or nurse practitioners meets their requirements for reimbursement. All providers attempt to utilize the best treatment options available and at time billing errors do occur which we quickly remedy should it be necessary. Currently, our billing team is available Monday – Friday from 9AM until 5PM to assist any currest, past or future patient with billing inquiries. We simply ask that patients remember that we are a very small staff now and we are answering questions from the time period when the practice employed 150 employees; the team is working very hard and answering inquiries in the order they receive them.

Second, another thread stated ” I had a horrible experience with lab bills from them earlier this year. Do you know anything else you can share? Or how I would learn more to see if I was impacted?”. Our practice is fortuante to have an in house lab for our providers use. This allows quicker results at a lower cost to the health care system. When billing in an office (unlike a lab like LabCorp), an individual charge is submitted for each bacteria tested. The charge is submitted to your insurance on the date the lab test was actually run and not on the date the patient was in the office. Patients will see multiple charges on a date of service that was a date for which they were not in the office because we test for the most common bacteria found in our community. For example, if testing a wound for Staph, Strep, and Ecoli, three separate charges would appear on your EOB. Our charge is roughly $40 per bacteria tested and our average insurance contractual reimbursement is $34 per bacteria. We only submit to insurance plans for which we participate.

Third, another thread stated ” Someone I know worked there as a doc until a few months ago. It was highly implied to me that, though my friend had no proof, they were committing billing fraud, and also they had expanded very rapidly and none too smartly. She said they laid off 80% of their staff last week or the week before. “. Again, our practice is not committing billing fraud. We have used the same CPT codes and protocols since 2015. I will agree with the statement that the rapid expansion greatly effected the services provided. As I stated earlier, the practice furloughed employees for 48 hours while the offer to purchase multiple locations was reviewed.

Fourth, another thread stated ” I literally just went to the Mechanicsville office today for the first time. Nothing seemed out of the ordinary and the doctor I saw, was knowledgeable and professional. I can’t speak to the billing, as it likely be a few weeks until I receive anything from them.” I and everyone at Achilles Foot and Ankle truly appreciate patients that are recognizing our efforts to provide the best quality care in Central Virginia.

Fifth, another thread stated ” This thread just made me check my invoices and they charged my insurance 5 times for the take home dressing for my ingrown toenail removal! They also charged for the same procedure code three times after my second office visit. I got a bill from them at the beginning of November and have ignored it because something seemed off. Glad I didn’t pay it wow. ” We do offer collagen dressings to aid in surgical wound healing. You can review literature found on the web that describes how post surgical wound dressings decrease infection, decrease scarring, and increase the speed of any wound healing. Patients sign for the dressings and do not have to accept the dressings. Typically, 10 dressings are included in the kit. Anthem requires that we submit 1 unit of dressing per day for 10 days after the patient’s visit. All other insurance plans allow us to submit all 10 units on one claim. I hope this helps explaining why the CPT code appeared 5 times for the wound dressing as your insurance plan must have been Anthem.

I hope that this clears everything up for everyone concerned in the community. If anyone has any questions or other concerns, you are more than welcome to send me an email which is found on our company website. I do not feel comfortable posting my email address on the forum because of potential spam.

Our team is composed of good, hard working people. We care for everyone who enters our practice, patients and staff alike. You can read the many positive reviews of our current providers which speaks for itself. I hope this also clears the air for many patients of Dr. Bradley as we will soon be able to work together on transitioning your continued to care to Dr. Bradley.

Thanks,

Dr. Baldwin

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