Joel, for a new business that was experiencing starter problems, something happened this week. I feel overwhelmed! So much work I have been stormed overnight. Excited, confused but happy - very happy. If I did not know to follow the numbers I feel like I could use a second van ASAP…. private pay, hospitals, nursing homes, etc. It’s like they all met and decided to give us crazy work at the same time. Everything is worked according to your lessons. You can tell I am excited! Thanks so much.
Hi Joel - We've been in a situation where a camera system on board our vans would have saved us time and money. We see the value in having that extra protection. The past 6 months we've been testing a system now called Nauto and it's not quite meeting our needs, but was offered through Atlas for only the monthly service fees. It was terribly hard to capture the footage when we really needed it. Do you have another camera system you would recommend? We've seen some companies at the TLPA shows, but they're primarily geared to taxis or community transportation fleets. More importantly, they're expensive. We've seen cameras cost $300-$500 and then monthly services fees of $25-$50. That adds up when you have 10 vehicles. Any suggestions?
Hi Joel, I'm watching your Boot Camp Series - only 3 DVDs in. One of the emails you reviewed in the series was referring to a business owner that got started 'USING' a broker...knowing that is was not going to be his only pony in the race and knowing the broker was “his Daddy” – LOL! As I prepare my business plan, the biggest stumbling block for me right now is the Public Utility Commission (PUC) licensing. As I understand it, I can’t start work until I have this license. Can you offer advice and direction?
Joel, we finished watching your third DVD series this weekend. I can't tell you enough, the material and depth of information you share is outstanding. I mean that sincerely because you teach us so much - more than someone could ever discover on their own. We made a lot of notes and will be taking action and making phone calls this week. We are still inclined to retain your one on one services. Thank you again. We will be in touch soon.
Joel I hope you're doing well. In reading your ebook, I pick up on all the subtle (and sometimes not-so-subtle) swipes at government and how it impedes business with taxation and illogical regulation. Preach it, brother! I am blessed with a very comfy day job. However, I decided to start my own NEMT company in the near future. Since I have the comfort of my day job, I am slowly planning and building the foundation. An essential part of this foundation will be to live in and operate in a pro-business, low-tax state. Tennessee is at the top of my list. From doing general Internet research and visiting the various TN State websites, I am unable to find which state agency regulates NEMT business. I am trying to find out if TN is a deregulated market (it appears to be since there's so little information out there on the state government websites). Then I am trying to find out if TN has any special vehicle requirements, yearly inspections, licenses, etc. that a NEMT business would need to comply with. In your ebook, you often speak of all the hoops NYSDOT makes you jump through, and I'm wondering what I can expect in TN before investing in a vehicle. With that being said, I am asking about any knowledge you may have about TN regulations. Perhaps you've worked with someone from the state, and you have some information readily available that you can share? Otherwise, I would need to call the TN Department of Health and start asking questions; I'd rather not do this because I know it will take up a massive amount of time until I find someone there who can answer my questions. I am also curious if there is a way to check any pending bills in the state legislature that may affect a NEMT business if passed into law. Any suggestions and/or links you can provide about TN? Thank you, Alex
Hi Joel, while doing my research for pricing I found several different price ranges. One company does $60 one-way, another company does $50 one-way, but I actually found one that's doing $35 ROUND-TRIP! How can we compete with that price and make money?
Do you allow more than one passenger on the vehicle if they're going to the same facility and the passengers have about the same time frame appointments? I am thinking some passengers might not like it. Thank you again for your valuable help and support.
Hi Joel, i am so excited to get started. I finished the how to build ebook a couple weeks ago and i am half way through the dvd series now. All of your info is amazing and i appreciate it. I am in austin texas and there is a great need for my services. My problem is i cannot get anyone from txdot, the dmv or my countys regulation office to give me clear instruction on operating authority and licensing. DOT tells me they don't provide OA for my business to call my county. My county says the same and the dmv says unless i will be transporting 8 or more at a time i don't need any special licensing. Is this true? Do you have any other insight on how i can get past this step? It seems like as you stated in the ebook all i may need is the proper insurance and vehicle for private pay to get started. I just want to make sure so i can go to my next step. Austin needs me:)
Hi Joel- Business is going great! Just got a contract to beging providing service to a local hospital. Now, we are working to expand our operation. We're moving to a second van, and I'd like to start looking into dispatching software. Obviously dispatching made easy is my first choice, but I was wondering if you have a trial period before I commit to using it. I know eventually I'll definitely need it, I'm just not sure with one Van full time and the second starting as part time I'm going to need it at this second. Any advice? Thank you for all your continued help!
First, let me thank you and the members for all the valuable information. We have learned a great deal from the many questions and answers. For my question, we are still in the research stages and preparing for starting our NEMT business. Do you advise doing any pre-employment screening? More specifically, do you suggest performing drug/alcohol and motor vehicle report screening?
Hi Joel. Thank you for all you do and sharing your expertise about the NEMT industry. We really appreciate and continue to learn a lot from your material. My questions is, when my driver takes a dialysis patient, the drop off is at 11:00AM and the pick up time is at 4:00PM. Do I just pay for the drop off and pick up if he doesn't have any trips in between? Obviously, we are a new business and are working to build more trips to fill the various gaps.
Hi Joel, I find what appears to be several potential vehicles on the ebaymotors.com as you’ve suggested, but a number of them are not geographically local to me. Have you purchased vehicles outside your area? What is the best way to ensure they meet vehicle requirements for the business? Should I fly there and inspect them, hire a third party inspector, or is it just better to wait for vehicles to become available locally? I sure don't want to buy something sight unseen and get a big (bad) surprise! Thanks for everything you do and have done for all of us!
Hi Joel, What type of credit card terminals are you using and through what merchant? Thank you
Hi Joel I just got a call from a senior citizen apartment and they want to know the price taking the seniors to a restaurant. The facility will be paying for the transportation and they mentioned if we are "reasonable" they will me using us more often similar trips and outings. How much should I charge?
Hi Joel, to be clear, who pays for nursing home, hospitals, and similar trips? When you charge private pay is it always cash or check or should we accommodate credit cards as well? Also, one last questions (for now) when do we start to charge mileage? Thanks
Hi Joel , I did purchase the ebook and have been studying the material, however I want to study your DVDs before getting started. Just wanted to know what is the ideal capital to have starting out (bare minimum). Thanks in advance
Joel, we recently hired a new accounting firm that also writes business plans….but their starting price for writing business plans is $5,000 – and that’s just their basic plan. In your experience, does this sound reasonable? Thanks
I invested in a market analysis and it came with about 85 prospects. I really appreciate the effort your team put into this project. I am very pleased - saves me a LOT of time. Can you provide more guidance on how I can leverage these leads and turn them into sales? What is the best way for me to solicit these facilities? What material should I take with me? Thank you in advance for all of your help and guidance.
Hi Joel, I would like to gather a better sense on how to pay a driver because I am still working and can’t drive. I hope to change this soon as my business grows. Can you share how I should pay my driver so it will be advantageous for him and profitable for me? Thanks
Do you have any experience with VA contracts? I am in the process of starting a business in SW Florida, and plan to use my status as a "service connected disabled veteran" to procure a contract with my local VA. If you have experience with it, I am very interested in your consulting services.
Hi Joel, I am just starting up my business, and have purchased two sprinter vans in great condition. I am searching for places to modify them so that they will accommodate stretchers and wheelchairs, including adding a ramp. The quotes I am getting for modifications are far more than I was expecting. Right now I have the option of reselling the Sprinters and buying vans that are already set up, or modifying the Sprinters. What would you advise? I have the capital to do either, but I don't know if paying for the modifications would save me any money in the long run. Also, if you would recommend the modifications, is there any place you would recommend to do them? Thank you
Hi Joel, I hope all is well! I still refer to your information/materials quite often. Currently, in Virginia, I think we are able to perform NEMT) stretcher/gurney transports? I wanted to confirm this w/you. Also, 1-man stretcher transports are OK, correct?- from reading through some of your other questions, it doesn't seem as if EMT credentials are necessary??---THANK YOU
Hello I'm new to the business . I was hoping someone could provide me with an example of a standard contract. In the process of closing in on a convalescent facility agreement. Thanks in advance for any help provided. PS. I'm in the Los Angeles area.
Hi Joel we have contracted with National Medtrans a broker out of long island. We are located in central NY. We have been having billing and collecting issued with NMT for some time now. When we push for answers or payment. NMT shuts us down and reroutes our client to other transportation providers. Currently their billing and payment process is a mess and very hard to decipher and apply to the correct client transport provided. leaving us unable to correctly maintain our accounts receivables without considerable hassle and time spent. This behavior is leaving us discussed. Our cash flow is important to our success as is a decent respectable relationship with the brokers we have to work with. It feels like bullying and we feel powerless to stop it. we have ben in business for 7 years and have 10 vehicles. we do not have any issues with any other entity. Can you give us some advice here.
Now to my two phased question. I signed up to work with A2C last June and we did alot of business with them. In February we found out that they audit trips and the had been auditing an average 30 percent of trips done every week. they owe us over 60k on audits. How do we go about claiming this money since we do not get any help or returned correspondence from our network specialist? They owe us a very substantial anount of money. Today I received a call from a facility that we provide transportation for. They do not pay thier invoices for less than 60 work days they said they will not be paying us for a stretcher dialysis patient that we have been transporting for over 3 months. Yet they call every month to scedule his appts becuase he is a Medicaid patient and that we should seek payment from Medicaid. Yes this is absurd but it is my reality. Please help.
How and where do you market and find private pay clients that are not on Medicaid?
Hello, I've started a home care agency with your materials, and I thank you for the guidance. However, I'm confused about insurance issues concerning having an employee taking a client to the store or church, etc. using the employee's vehicle. If an accident occurs, how does it work with the employees personal auto insurance, and our company ? Does this fall under our liability insurance since it is officially company business, and if it does, how is the employee reimbursed ? Thank you!
What happened to the contact for VA contracts, I signed up in 2010 and never heard any more. I have actively tried to get in with the VA and get the run around
Hello, I am currently in the healthcare industry, but new to NEMT. I read your eBook & just ordered all of your DVD series's but did not see any strategies targeting Case Managers. I work with lots of Case Managers and know they are a great resource for referrals, especially for Auto / Worker Comp patients. Is this covered in any of your other materials ?
Hello Joel is the business plan downloadable and can it be edited with our logo and other relevant information?
Joel, my area of operation (AO) had three hospitals in one county. All are owned by one company, they have a ZERO tolerance on solicitation for contracted companies. We are contracted by the hospital system but feel like we do not get the most business. My goal is to become the sole provider. How do we get the case workers and case managers who number upward of sixty (60) per hospital total of about 180 individuals to without a though think about calling us first for a discharge without looking like we are soliciting them. I have seen a few vendors get kicked out for following ideas similar to the ones you support in your E Book.
Joel, I have over time come to find that in my community, there are some elderly people that leave at home either alone with a family member or as a couple and in almost all cases they have a pet. This people as nasty I mean so dirty you cannot navigate a wheelchair in their house forget a stretcher. They have piles of trash and junk everywhere, their homes are moldy, and pure uninhabitable, and this is coming from a business owner who grow up in African gehttos so I know nasty when I see it. My question is how can I help this people, can medicare or medicaid compensate us if i formed a company that identifies this people and provide them with the care they need. Is the department of children and family doing something about it. Do I leave this sickly people in their home respect their privacy and walk away, is this why the fire deparment does not do anything about it given they go into this homes to get this people and bring them to the ER. Emotionally I am a mess I cant take it any more, how do I proceed?
- Joel working with brokers in Florida is impossible but you already know this. How do we target Medicare since Medicare comes up all the time
Hi Joel- I just had a quick question about how Medicaid pays etc. Our company is exploring the options of operating in neighboring counties because the reimbursement rate here isn't profitable at all. This may sound like a silly question- but is there a set rate for specific counties in how much they pay NEMT companies? Or is that something that you negotiate with them? I'm trying to figure out how much they are reimbursing other companies and can't really get a sense of a ballpark figure. I'm here in Western Pennsylvania if that helps. Thanks again for all your continued help. Max
Hi Joel, Im back for another question. I frequently call my competition in my area to see what their rates, driver pay, etc etc are. I recently discovered that non of the companies in my area offer stretcher transport. I cant seem to find anywhere whether it is allowed or not for NEMT businesses to perform stretcher transports in Pennsylvania. If its allowed- I see a huge opportunity for my business to grow. If you have any info regarding this please let me know. Again- thank you for all your help and guidance!
Hi Joel! I just want to start off by thanking you for all your direct and indirect guidance you've given me over these last few months. Your book was incredibly insightful and I doubt you recall, but I emailed you a couple months ago about a problem I was having with getting the proper insurance for a normal amount (not 14k). I was a little more than shocked when I received a call from you within 15 minutes! You were so helpful and went beyond just my basic question. I can't thank you enough for what you've done. I have a lot of questions, I'm sure I'll post some more, but for now I'll start with hiring employees. I started my company and I was/am doing all the driving/answering calls/accounting etc. Things have been getting quite busy over here since we've started working with a few hospitals and nursing homes. I'm working on getting a second Van and with a second Van comes the search for a employee/driver. I'm a little concerned with how I'm going to pay the driver. I don't know how busy the second vehicle is going to be, and I don't want to be paying a driver to just sit around and wait for 2-3 rides a day. How do you suggest going about paying a part time driver? Just pay for the hours he works? Pay commission for the trips he completes? Please advise. Again, thank you for your continued help for all of us working to make our business succeed. I hope to hear from you soon.
Joel for one on one, I'm not too sure about your fee structure can you please break it down.
Hello Joel. I am in the Upstate, NY area and want to start and NEMT Business in the Hudson Valley Region. I have purchased serveral of your ebooks and am saving to purchase your seminar series dvds.I am short on cash and it has been a desperate strggle to save up the money and I noticed that your 60 day consulting offer includes the MDT seminar and traing dvd. Should I opt for this instead of trying to buy all 3 dvd series first? I will need the consulting eventually as I will be starting with nothing, not even the funding or a vehicle. I hope to apply for grants and loans and will also need to at some point invest in your MDT plan and market Analysis. Thanks for your time.
Hello Joel. I am desperately wanting to start an NEMT business in the Upstate NY area and Have purchased and read cover to cover your ebooks "How to build a million dollar NEMT", "Dispatching for Dollars", and "How to find Private pat clients". I currently work for The Veterans Administration in the Transportation department Transporting Ambulatory and Wheelchair patients. However paycuts, furloughs and a lack of upward mobility have me desperately wanting to become my own boss and take charge of my financial future. I recently got a message from your online manager saying that NYC no longer issues Medicaid Provider Numbers, and I was wondering if that will apply. To someone starting an NEMT OUTSIDE of the city, specifically in the Hudson Valley Region? And if so should I only focus on Private Pay and Contract Bids once I start my company.
Hello Joel, I arrived at a clients house to find out that my client would not be attending PT. How should I invoice this type of dry run? Same client during a transport we were half way to PT decided to cancel due to feeling ill. How do I invoice for my time during these type of scenarios? Thank you
In my area within a radius of 20 miles we have 4 hospitals all under the same company. they are big on solicitation and are willing to break a contract if we solicit case managers, social workers or any hospital staff. problem is we are not getting as many phone calls from the four hospitals although the have told us repeatedly that we do a fantastic job. We know they hate our competitor who is a bigger company and has been in business for 17 years BUT the continue to use them. their vans are constantly in and out of the for hospitals. the General transport manager has told me to give it time we are a new company and most of their staff are still getting to know us we started in 2014 feb how do I make my name known without seemingly to be soliciting.
Joel, when a facility asks us to take a patient to an appointment using one of our stretchers and the doctors office does not have a bed or stretcher to transfer do we charge for stretcher use at doctors office per hour of use. Do we charge the doctor or the facility, this is because we may end up missing another stretcher transport or being late given all our stretchers may be in use. Or, do you have another proposal. currently we do not have a reason to but another stretcher.
Not a question but a comment to someone that said Joel's info was not relevant. I have used this site on and off for years and it has saved me time and money each time. As for revelancy much of this information does not go out of style over time. Most marketing info ,payables, receivables, facilities, legal, insurance etc, is the same as it was when I first got into this business. When a question is raised Joel answers with complete information and as much facts that can be obtained for that question. The one comment was that it takes Joel 5 years to give an answer was assinine to say the least. My question have always been answered in a timely manner. For the record I have owned a home healthcare agency for 13 years and a NEMT business over 3 years. Over $1.6 sales in 2014 and hoping for $1.8 2015. Just fact to say I have b een around the block. BTW I spend over $54,000 a year in royalties for my Homecare Agency. I think the $10 bucks a month for this information is quite a deal. If anyone wants to call me to verify anything that has been said in this little rant Joel has my permission to give you my e-mail. Now that this is out of the way I can go back to making Money! PS. So glad for the amatures. Makes it easier for the real pros.
Hello Joel, I'm trying to get a quote for insurance, but would like assistance on answering this question from the adjuster. "Could you please advise of the estimated annual gross revenue and number of transports you are anticipating for the upcoming year?" I know that there are a lot of factors that could influence what happens. I am in the DC Baltimore area , and will start with one vehicle. But I would like to give some answer that might seem realistic. Thanks in advance for your assistance .
Hi Joel, I think that I have located a vehicle and am in the process of getting a loan for it. It is a 9 passenger and the seats fold up to fit 2 wheelchairs. I guess that I just need some encouragement. I am so nervous about starting and having to pay the bills for car payments, insurance, etc. I took out a loan for $15,000 (should have asked for more) and that makes me nervous. I work full time (although I wish that I did not have to so that I can dedicate my time to the business) besides I don't like my job, so I will have to hire someone to work for me. Do you think that $5000 is enough to start? If so, how would you use it? Please include encouraging words. Thanks so much
Joel, Thank you for your timely response. Also wanted to know how you know the real condition of vehicles when buying from out of state. Do you go to check them out? Also, how do you know if they will pass your state's inspection? Thanks
Hi Joel, I wanted to invest in your mdtseminar option 2 this week but I have few questions . Does this include million dollar home care program because I need it as well because right now,that is what I am doing. Also what else do I need to buy because I am a bit confused with all the programs and I need to buy what can give me enough informations about the business to jump start. Bottomline,is mdtseminar the right one to buy.Davies
Hi Joel, Would you recommend a mini van with a manual lift or a full size van with an electric lift? I've been looking at full size vans because they require less manual work from employees which may decrease the risk of injuries, but may be more costly to repair. 2) In choosing a full size van, initially or eventually, would you recommend an e150, e250 or e350? 3) If purchasing a van from out of state how would I know the real condition of it or if it will pass my state's inspection. Thanks so much
Hi Joel, I am working on starting an NEMT business. I have finished your million dollar transportation book and am watching your million dollars transportation DVD #5 right now. A few questions came up. First one is about licensing. I am confused with the regulations and licensing requirement of starting an NEMT business. It seems like in the state of CA, I have to file appropriate license/permit from the county DOT, and CA PUC, and also do I need authorization from the Dept. Of Human and Health services? Plus other city permits? DoE's the licensing based on where your business location is or where your vehicles are going to operate? I am living at the border of several counties. If my vans are travel among different counties, do I need multiple permits then?
Hi Joel, I will be starting my business very soon. My major concern is starting with one van and having to turn down work because the van is already booked. What do you tell the hospital staff after you've just been approved to provide services for them? Would't this give my company a bad reputation? Thanks
Hi Joel, I am unable to quit my full time job or work any other shifts besides days. Do you have any suggestions on how to work full time and start the business? Also, I know every case is different but on average how soon have you seen owners able to take a decent pay, say $65k/year? Thanks
Hi Joel, Thank you for taking time out of your busy schedule to assist those of us in need with your knowledge and expertise. I've enjoyed your e-book and refer back to it often. You are a blessing to all! I find I'm getting pretty discouraged in our (my and my husbands) NEMT business. Right now we're making enough money to pay our monthly business bills and have a smidge bit extra to put away to eventually purchase more vehicles. Right now we're a two-vehicle business. We do strictly Medicaid persons who are members of an HMO (CARE WISCONSIN). But we're lucky if we get 20 calls a week. That said, I've been researching our local cab companies to see what they charge for their rates as we would like to branch off into private paying clientele. I'm discouraged for a few reasons: 1. All our local cab companies offer wheel-chair accessible vehicles, we do not. We are strictly ambulatory. 2. All our local cab companies charge flat rate fees for in-town transits (approx. $3 a trip) and we charge a flat $10 p/u fee (first 5 miles are free) and $1.36 per mile after that. So we are much more expensive for our local in town clients than the normal taxi companies. Who wants to pay $10 to go across town when they can pay $3? What's the difference between our NEMT and the cab company other than they offer wheelchair accessible transit and we do not? Who's going to want our services? It's very disheartening. If it wasn't for our contract with Care WI we wouldn't have any business at all. We have tried to contract on with MTM but they are saturated with drivers already and I can't seem to get a return call from them at all. I'm struggling to maintain a positive attitude at this time. Any advice or insight is appreciated. Thanks so much!
Hi Joel,I will like to know if 60 day one on one coaching opportunity cover all what you need to learn and start Nemt and non medical home care businesses.The seminars,dispatching,licensing,legal,marketing,insurance,employees,and business plans.Does it cover all your ten viable promotional websites you always displayed on your newsletter.Please advice where to start but I want the best you can offer to know everything about the business.Thanks
Hi Joel, Thank you for your prompt response to my question. I was really surprised to see it answered so quickly. I have a follow up to it. You mentioned that you started with about $10,000. Can you give me the breakdown of how you used the $10,000 when you started your business? Was part of it used to keep you afloat for 6-12 months or did you use personal funds to keep afloat? I'm concerned about what I'll need in the first 12 months? Thanks again.
Hi Joel, I have purchased your ebook and I am excited about getting started. I have a few questions, 1) can you list the start up expenses? 2) Should I wait until I have that amount to start the business? 3) How long on average does it take to have a driver working steady at least part time?
Afternoon, I am now working for a home care facility as my full time job. I am trying to get the driving company up and going but have been having trouble with gaining insurance companies. The home care company has offered to write a letter saying they need our services and see the demand. What type of letter should they write? what should be included and is there a format. I think this letter will be a persuasion to the insurance companies to accept a contract with us. Thank you
Afternoon, I recently started working for a home care facility. They would like to use our company for services and would like to set up a contract but I am unsure of how in depth it needs to be and would love some help with this. Thank you
I didn't know you prepared business plans. I had one prepared by another company and was wondering if you would assist me in getting my business up and going. I need guidance and direction on how to secure funding and grants if available. I purchased your manual several weeks ago and have been using it as a guide. It is very good - very informative. Thank you very much.
What steps do I need to get started for non medical home care and non emergency transportation service with your system. We have been doing medical staffing for seven years but we like to taste other avenues with your advice on these new areas of the business. Which of the materials do we need to buy.
Hi Joel, I have been in business for almost 3 yrs now. I'm contracted with four different workman comp companies that keeps me pretty busy BUT i can tell its only allowing me to have a good job for myself and not allowing me to grow to have a good business for myself and expand with employees so i need another source of income and thats where possible medicaid contract with MTM comes into place. I am contracted with Polk County transit here in Florida were i have performed medicaid trip on an as needed basis. So my rate for Polk county was at a much higher rate due to my 'as needed status". So i have no idea whats the going rate for medicaid trips. I just finished you ebook and it REALLY has my mind going a thousand miles an hour... I thought i was hungry and excited when i started this business but man i'm really fired up, knowing what ive learned from your ebook. I've made many mistakes but you cleared ALOT of issues up for me Thanks again.... But back to the medicaid issue Im planning on trying to get a contracted with MTM but i dont have any idea what s a fair rate here in my area for medicaid trips. (Polk County Florida)... Thanks Joel and may God keep blessing you abundantly.... P.S. I WILL BE INVESTING IN YOUR DVDS SERIES...
Hi Joel, I am putting together a plan to position my company for sale in the next 5 to 10 years. Do you have any materials available to review on the subject. As of now we are a 10 vehicle company and we are totally debt free. I want to make my company as attractive as possible and have it completely turn key for a potential buyer. I have also entertained the possibility of selling the company to the employees. I have some time and we are profitable now. I am interested in developing a good exit strategy to start working towards.
Hello our company is in Virginia and Logisticare has turned us down for business. However we still have dialysis centers that want to do business. Is there any way that we can get a Medicaid-Medicare number without have to use the borker?
Hey Joel, still plugging away here and ready to hire first employee(s). Question is, who pays? Who pays for the: Drug/alcohol test? Background check? Drivers license check? State-required training? etc... These are all things required by the state and most can be done within a certain time period and not before their first trip, although I would definitely at least do background and drug test ASAP. I was thinking: IF I pay for it and if they leave within a certain period afterwards - say 90 days - I withhold that amount from their pay. Or, make them pay or I pay and that's just the cost of doing business. Thanks.
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