I just found out today, 8/12/2022, because I called them to make sure that their accounting reflected the payment last month for an xray. Yes I was told that was posted but then they informed me that I had an outstanding bill of $20 from a year ago. What!!! They never billed me, nor was there ever a statement issued to inform me anytime during the year. What was even worse is that their "patient portal" website doesn't work and I informed them 4 times of that. It still doesn't work. When they told me about the year old bill (today) they then told me they sent it to Collections. Again, no notice that they were going to do that NOR have I ever heard from the collection agency in a year. I am a stickler for paying my bills so I drove the 30 miles to town to pay the $20 at one of their locations. I was charged $21.26. Yes, I was charged a collection fee for their incompetence. I spent the entire day calling them and asking to talk to anyone of authority but I guess no one works there because I am still waiting. From other reviews I just read this seems to be their procedure: not communicating with their customers and then sending the bills to Collections. NO WAY TO DO BUSINESS!