After a June appointment for a bi-annual diabetic foot exam, Dr. Smith unexpectedly changed his well-established practice of billing my insurers for the exam and toenail trim (both covered by my insurers). Dr. Smith billed the insurers for the exam, then billed me separately and personally for the toenail trim. I asked why he did this, 2x verbally and 3x in writing. He ignored my inquiries, was unresponsive, and forwarded the bill to a debt collector agency. This is unsatisfactory.