Thursday, 18 May 2017


CMS 1500​ - Medical claim form established by CMS to submit paper claims to Medicare and Medicaid. Most commercial insurance carriers also require paper claims be submitted on CMS-1500's. The form is distinguished by it's red ink.

Coding​ - Medical Billing Coding involves taking the doctor's notes from a patient visit and translating them into the proper ICD-9 code for diagnosis and CPT codes for treatment. 

COBRA Insurance​ - This is health insurance coverage available to an individual and their dependents after becoming unemployed - either voluntary or involuntary termination of employment for reasons other than gross misconduct. Because it does not typically receive company matching, It's typically more expensive than insurance the cost when employed but does benefit from the savings of being part of a group plan. Employers must extend COBRA coverage to employees dismissed for a. COBRA stands for Consolidated Omnibus Budget Reconciliation Act which was passed by Congress in 1986. 

COBRA coverage typically lasts up to 18 months after becoming unemployed and under certain conditions extend up to 36 months.

Coinsurance​ - Percentage or amount defined in the insurance plan for which the patient is responsible. Most plans have a ratio of 90/10 or 80/20, 70/30, etc. For example the insurance carrier pays 80% and the patient pays 20%. 

Collection Ratio​ - This is in reference to the providers accounts receivable. It's the ratio of the payments received to the total amount of money owed on the provider's accounts.

Contractual Adjustment​ - The amount of charges a provider or hospital agrees to write off and not charge the patient per the contract terms with the insurance company. 

Coordination of Benefits​ - When a patient is covered by more than one insurance plan. One insurance carrier is designated as the primary carrier and the other as secondary. 

Co-Pay​ - Amount paid by patient at each visit as defined by the insured plan. 

CPT Code​ - Current Procedural Terminology. This is a 5 digit code assigned for reporting a procedure performed by the physician. The CPT has a corresponding ICD-9 diagnosis code. Established by the American Medical Association. This is one of the medical billing terms we use a lot. 

Credentialing​ - This is an application process for a provider to participate with an insurance carrier. Many carriers now request credentialing through CAQH. CAQH credentialing process is a universal system now accepted by insurance company networks. 

Credit Balance​ - The balance that's shown in the "Balance" or "Amount Due" column of your account statement with a minus sign after the amount (for example $50-). It may also be shown in parenthesis; ($50). The provider may owe the patient a refund. 

Crossover claim​ - When claim information is automatically sent from Medicare the secondary insurance such as Medicaid. 

Date of Service (DOS)​ - Date that health care services were provided. 

Day Sheet - Summary of daily patient treatments, charges, and payments received.

Deductible​ - amount patient must pay before insurance coverage begins. For example, a patient could have a $1000 deductible per year before their health insurance will begin paying. This could take several doctor's visits or prescriptions to reach the deductible. 

Demographics​ - Physical characteristics of a patient such as age, sex, address, etc. necessary for filing a claim.

DME - Durable Medical Equipment​ - Medical supplies such as wheelchairs, oxygen, catheter, glucose monitors, crutches, walkers, etc. 

DOB​ - Abbreviation for Date of Birth

Downcoding​ - When the insurance company reduces the code (and corresponding amount) of a claim when there is no documentation to support the level of service submitted by the provider. The insurers computer processing system converts the code submitted down to the closest code in use which usually reduces the payment. 

Duplicate Coverage Inquiry (DCI)​ - Request by an insurance company or group medical plan by another insurance company or medical plan to determine if other coverage exists. 

Dx​ - Abbreviation for diagnosis code (ICD-9 or ICD-10 code). 

Electronic Claim​ - Claim information is sent electronically from the billing software to the clearinghouse or directly to the insurance carrier. The claim file must be in a standard electronic format as defined by the receiver.

Electronic Funds Transfer (EFT)​ - An electronic paperless means of transferring money. This allows funds to be transferred, credited, or debited to a bank account and eliminates the need for paper checks.

 E/M​ - Evaluation and Management section of the CPT codes. These are the CPT codes 99201 thru 99499 most used by physicians to access (or evaluate) a patient's treatment needs. 

EMR​ - Electronic Medical Records. This is a medical record in digital format of a patient's hospital or provider treatment. 

Enrollee​ - Individual covered by health insurance

Sunday, 14 May 2017

Medical billing Terms

AMA​ - American Medical Association. The AMA is the largest association of doctors in the United States. They publish the Journal of American Medical Association which is one of the most widely circulated medical journals in the world. 

Aging​ - One of the medical billing terms referring to the unpaid insurance claims or patient balances that are due past 30 days. Most medical billing software's have the ability to generate a separate report for insurance aging and patient aging. These reports typically list balances by 30, 60, 90, and 120 day increments. 

Ancillary Services​ - These are typically services a patient requires in a hospital setting that are in addition to room and board accommodations - such as surgery, tests, counseling, therapy, etc.

Appeal​ - When an insurance plan does not pay for treatment, an appeal (either by the provider or patient) is the process of objecting this decision. The insurer may require documentation when processing an appeal and typically has a formal policy or process established for submitting an appeal. Many times the process and associated forms can be found on the insurance providers web site

Applied to Deductible​ - You typically see these medical billing terms on the patient statement. This is the amount of the charges, determined by the patients insurance plan, the patient owes the provider. Many plans have a maximum annual deductible that once met is then covered by the insurance provider. 

Assignment of Benefits​ - Insurance payments that are paid to the doctor or hospital for a patient's treatment.

ASP​ - Application Service Provider. This is a computer based services over a network for a particular application. Sometimes referred to as SaaS (Software as a Service). There application service providers that offer Medical Billing. The appeal of an ASP is it frees a business of the the need to purchase, maintain, and backup software and servers. 

Beneficiary​ - Person or persons covered by the health insurance plan. 

Blue Cross Blue Shield (BCBS)​ - An organization of affiliated insurance companies (approximately 450), independent of the association (and each other), that offer insurance plans within local regions under one or both of the association's brands (Blue Cross or Blue Shield). Many local BCBS associations are nonprofit BCBS sometimes acts as administrators of Medicare in many states or regions

Capitation​ - A fixed payment paid per patient enrolled over a defined period of time, paid to a health plan or provider. This covers the costs associated with the patient's health care services. This payment is not affected by the type or number of services provided.

CHAMPUS​ - Civilian Health and Medical Program of the Uniformed Services. Recently renamed TRICARE. This is federal health insurance for active duty military, National Guard and Reserve, retirees, their families, and survivors. 

Charity Care​ - When medical care is provided at no cost or at reduced cost to a patient that cannot afford to pay. 

Clean Claim​ - Medical billing term for a complete submitted insurance claim that has all the necessary correct information without any omissions or mistakes that allows it to be processed and paid promptly. 

Clearinghouse​ - This is a service that transmits claims to insurance carriers. Prior to submitting claims the clearinghouse scrubs claims and checks for errors. This minimizes the amount of rejected claims as most errors can be easily corrected. Clearinghouses electronically transmit claim information that is compliant with the strict HIPAA standards (this is one of the medical billing terms we see a lot more of lately). 

CMS​ - Centers for Medicaid and Medicare Services. Federal agency which administers Medicare, Medicaid, HIPAA, and other health programs. Formerly known as the HCFA (Health Care Financing Administration). You'll notice that CMS it the source of a lot of medical billing terms. 

Wednesday, 10 May 2017

AMBA certification

The American Medical Billing Association (AMBA) confers the title of Certified Medical Reimbursement Specialist to qualified individuals who pass its certification exam. AMBA also offers a certificate program that teaches medical terminology and ICD-9, ICD-10, CPT, and HCPCS standards for coding medical procedures. You’ll also learn about state and federal regulations, as well as insurance company policies and practices.
AMBA doesn’t recommend taking the exam unless you have on-the-job medical experience, or some other education in medical billing and coding. Continuing education and membership to the organization are also requirements of this certification.

AHIMA certification

The American Health Information Management Association (AHIMA) offers several general medical coding certifications, which demonstrate the proficiency and accuracy required to work in hospitals, clinics, nursing homes, care centers, and private coding businesses.
Certified Coding Assistant (CCA): This is the general-purpose certification for professional coders. The exam requires a high school diploma, but the association encourages medical coding experience or training. AHIMA also requires 20 continuing education units biannually, as well as a fee to remain certified.
Certified Coding Specialist (CCS): This certification is for coders who use their coding skills in a clinical environment, like large hospitals and research institutions. This designation requires specialized training and/or experience, and you’ll need to brush up on your accuracy and proficiency with code systems in order to pass the exam. You’ll also need 20 units of continuing education and a fee to remain certified.
Certified Coding Specialist – Physician-Based (CCS-P): This certification program emphasizes the coding used in physicians’ offices and private practice work environments. AHIMA recommends that you’ve had some combination of work experience or education in coding or managing health records and health information. Like the other AHIMA certifications, this also requires 20 continuing education units every other year (which can be earned from a variety of sources, so check the website for details.)

Pass the AAPC Certified Professional Coder Examination

The AAPC offers twenty-one specialty examinations in medical specialties, such as cardiology and pediatrics, which you can take without earning a CPC or other certification. These exams are conducted in the same way as the CPC exams, but the content can vary slightly. Take a look at the AAPC’s list of specialty credentials to see what coding and other topics you will need to study.

Planning for the Exam

As noted above, the AAPC offers three main medical coding certifications and a number of specialized additional certifications, all of which are earned by examination. All of these examinations are multiple-choice based in medical coding, with some access to a medical coding manual allowed. In addition, the CPC-P exam includes questions on health insurance reimbursement.
All of AAPC’s exams are structured in a similar way: 150 multiple-choice questions, with the exam proctored at a specific location. The subjects of those questions vary; a CPC exam covers most topics in a general sense, while the other exams get increasingly focused on specific skills. All their exams provide you with five hours and forty minutes to finish, as well as providing you with an opportunity to retake the exam once at no additional cost.
AAPC charges a set fee for each of their examinations, which includes membership in the group – $300, or $260 if you have joined AAPC as a student. There is no formal educational requirement, although AAPC recommends that you earn an associate’s degree. You will also need to have two years of experience as a medical biller and coder to be fully certified. However, if you complete the exam without this work experience, you will still receive certification as a coding apprentice (CPC-A, CPC-P-A, etc.) and will earn your full credential as long as you work in the field and complete continuing education.
When you arrive at the exam site, you will be permitted to bring coding manuals with you. Here’s what you can bring:
  • A CPT book (AMA standard or professional edition); no other publisher’s work is allowed.
  • An ICD-9-CM codebook of your choice.
  • An HCPCS Level II codebook of your choice.
  • Officially published corrections to any errors in the above books.
  • For specialty exams only, relevant anatomical charts and sample worksheets for the specific field you are testing on; check the AAPC site for full details.
The questions in the exam are structured so that these books, as well as reasoning and understanding of medical terminology, anatomy and physiology, will permit you to succeed.
You will also need to continue studying in order to keep your certification, along with remaining a dues-paying member of AAPC. You will be expected to complete 36 Continuing Education Units (CEUs) every two years. This is less demanding than it may seem; you can earn a CEU each month by completing an small test in AAPC’s journal, and workshops, online webinars and conferences give you plenty of opportunities to make up the difference.

Preparing for the Exam

AAPC offers a range of exam preparation products, and there is a great deal of material on medical billing and coding available at bookstores. What’s more, you may already be studying medical billing and coding as well as related topics in formal courses at a school or other institution. Here are some tips that may help you prepare more effectively, as well as deal with other problems leading up to your certification exam.
  • If you’re stressed by the prospect of an expensive exam, remember that your payment comes with one free retest. AAPC will provide you with a full report of how you performed, including exact scores and notation of areas where you need to focus your studies. It may be helpful to think of your first try as practice.
  • Remember that you are permitted to bring in codebooks; you will not need to memorize the entire coding system you are being tested on, but instead you will need to know how to quickly and efficiently find out the codes you need. Focus your practice on learning to look up codes quickly and accurately, as well as on medical terminology.
  • A powerful way to study uses flash cards. Write down the information you are studying on a series of them, and go through the entire stack. If you get one right, place it in the “once weekly” stack; if you get it wrong, place it in the “once daily” stack. Review the “once daily” stack daily, moving correct answers into the “once weekly” stack, and do the same for the “once weekly” stack. This combines regular review with a focus on what you truly need to cover.

Study Guides

These resources can help you prepare yourself for medical billing and coding certification. Some of these are unofficial and others are produced by the AAPC or other professional groups.
  • Quizlet: Medical Billing and Coding – This resource provides you with free, student-made online “quizlets”. There is no cost for them, and you can be certain they were made to address genuine student needs.
  • – A free and searchable guide to ICD-9’s code standards, which are the primary topic of your certification exams.
  • Step-by-Step Medical Coding (2013 edition) – A guide to understanding medical coding by a veteran in the field. The latest update to a long series of yearly issues; earlier editions are still largely valid, although you should look up, and keep in mind, what changes have taken place in coding practice.
  • Official CPC Certification Study Guide – Published by the AAPC and written by the same panel that writes the CPC exam, you can be certain this guide will tell you what you need to know. It includes sample questions of all sorts, a specially prepared study guide, and a series of practical examples.

Sample Tests

Taking practice examinations can help you find your own weak spots for further study, as well as having benefits as a learning practice in its own right. These are some sources for sample medical coding and billing tests, which will let you test your learning without pressure and at little or no cost.
  • Medical Coding Consultants – These training specialists provide a wealth of resources on the AAPC certification exam and other medical coding topics. Look for the light blue entries to find the free resources.
  • Career Coders: Test your Knowledge – These sample questions, provided by a medical billing and coding instructional company, let you test your knowledge in specific fields, such as ICD-9, Medicare/Medicaid, and medical terminology.
  • AAPC – Online Practice Exams – AAPC offers a series of online practice exams in all of their certification, providing you with quick feedback, detailed explanations of the reasoning behind various questions’ answers, and as many retakes as you like. They are only available for a fee, although you will get a substantial discount with AAPC membership.

Saturday, 6 May 2017

Medical Billing and Coding Certification

As the healthcare and insurance industries require accuracy and compliance with complex regulations, medical billers and coders are held to these same standards. Certification is a way of showing your dedication and expertise. While you may not necessarily need a medical coding certification to get an entry-level job, you will find that your opportunities for career advancement multiply once you’ve achieved such a distinction. You’ll be more likely to demand a higher salary, earn a position of leadership, and perform different kinds of work.
Certifications are available for various professionals that work in the medical records and health information field. They’re also offered by a number of different organizations. As you plan your career goals, do your research to get the basic facts about certification and opportunities for specialization. Then consider a timeline for gathering the education, training, and experience that will help you pass the certification exam that’s right for you.

Explore Certification and Continuing Education

Important information about the types of certification available for medical billers and coders is explained in the following section.

AAPC certification

The most well-known agency that administers and oversees certifications for medical billers is The American Association of Professional Coders (AAPC). It also tracks required continuing education units through a system that records the knowledge you’ve gained from classes, conferences, seminars, and other educational opportunities on a variety of topics. The AAPC offers general certifications, as well as 21 specialty certifications.
General certifications: The main certifications are the Certified Professional Coder (CPC), Certified Professional Coder – Hospital Outpatient (CPC-H), and Certified Professional Coder – Payer (CPC-P).
Specialty-specific coding certificationsYou can choose to focus on a particular area in the healthcare industry and pursue certification to demonstrate expertise in that area. These specialty certifications emphasize coding problems related to those fields, as well as professional requirements to work in these areas. You don’t necessarily need to acquire a general coding certification to obtain one of these specialty certifications (see the AAPC website for accurate and up-to-date information about specific requirements), but you will find that a variety of certifications make you more versatile and marketable to employers.
Use the following list to discover the wide variety of medical billing and coding jobs that are available across all sectors of the healthcare industry.
  • Ambulatory Surgical Center (CASCC™): Also known as outpatient surgery, ambulatory surgical centers (or same-day surgery) perform medical procedures that do not require overnight stay. This specialization requires knowledge of surgical procedures. You’ll interpret notes provided by medical professionals and convert them into medical codes that accurately represent highly specific information. There are no prerequisites for this certification exam (other than AAPC membership,) which is designed to simulate the transcription of case notes.
  • Anesthesia and Pain Management (CANPC™): Anesthesiologists administer drugs to patients for their symptoms or as part of their surgical procedures. You’ll be expected to know how to choose the right CPT codes for different procedures, as well as how to use modifiers for anesthesia cases. You’ll also be tested on determining time units and total units for cases that require anesthesia.
  • Cardiology (CCC™): Heart health is a growing sector of the healthcare industry. Passing the examination for this certification demonstrates that you have a knowledge of cardiological surgical practices and equipment, such as stents and pacemakers. Because heart health is often related to other vascular procedures and has associated insurance regulations, this coding specialization presents unique challenges. You’ll be expected to know how to code for surgical procedures such as catheterization, placement of pacemakers, and peripheral vascular procedures.
  • Cardiovascular and Thoracic Surgery (CCVTC™): This certification demonstrates that you possess knowledge of the treatment, equipment, and testing procedures associated with cardiovascular and thoracic surgery (surgeries performed on the heart, lungs, and greater vessels in the chest). You’ll need to possess both technical knowledge of Medicare billing rules and medical knowledge of the heart and circulatory system.
  • Chiropractic (CCPC™): Chiropractic services involve manually adjusting a patient’s spinal system, which is considered complementary or alternative medicine. Medical billers and coders working alongside chiropractic professionals need to be able to navigate the specific ways that insurance companies reimburse these practitioners. You’ll also need to be aware of its diagnostic procedures in this field.
  • Dermatology (CPCD™): Dermatologists diagnose and treat diseases related to the skin. Billers and coders working with dermatologists need to have knowledge of these skin conditions and related treatments. This means you’ll have to familiarize yourself with the anatomy of human skin and the classification of its disorders. You should also be knowledgeable of procedures such as debridement, lesion excisions, and flaps.
  • Emergency Department (CEDC™): Billers and coders who have this specialized certification have obtained proof of their expertise in accident and trauma codes, as well as some knowledge of pain management and sedative treatments. Because this dynamic subfield requires you to work quickly on your feet, you’ll need to be very familiar with associated codes.
  • Evaluation and Management (CEMC™): The healthcare industry relies upon a system of classifying codes not only to bill insurance companies, but also to track health information for planning purposes. Coding professionals in this specialization work to manage the costs incurred by medical offices and hospitals and help ensure quality treatment. As you’ll be tested on both billing regulations and your coding proficiency, you’ll do best after earning broad professional experience in the field.
  • Family Practice (CFPC™): There’s a variety of health information that billers and coders must manage in family practice settings. You’ll need to understand general insurance reimbursement regulations and know how to accurately sequence codes when several procedures are performed together (as in an annual checkup.) You should also have general knowledge of pediatric medicine.
  • Gastroenterology (CGIC™): Gastroenterology is the field that treats gastric disorders. You’ll need to be knowledgeable about each abdominal organ in order to code very specific conditions and procedures. You can expect to learn codes used for procedures such as ERCPs, colonoscopies, and esophageal dilations.
  • General Surgery (CGSC™): This certification demonstrates your expertise in the field of billing and coding surgical procedures. With a variety of surgeries performed each day, you’ll be tasked with quickly and accurately transcribing operating room notes into codes. You’ll need to also understand the set of rules regarding private and public insurance reimbursement. The AAPC recommends that you complete this certification after having plenty of work experience as this exam is based on simulated coding scenarios.
  • Hematology and Oncology (CHONC™): This certification signifies that you have an expertise in coding issues related to the treatment of cancers and blood disorders. These can include bone marrow treatments, chemotherapy and hydration, and blood tests. These procedures are particularly complex, requiring that billers sequence on-going care that requires a number of treatments. Insurance providers also have stipulations about compensation for surgeries and drug-based forms of disease treatment and management.
  • Internal Medicine (CIMC™): Internal medicine is the treatment and prevention of adult diseases. You’ll have to be comfortable using codes to classify vaccinations, blood draws, and other minor procedures and surgeries. This specialty requires high attention to detail and accuracy, and your best preparation for the exam is real-world experience.
  • Obstetrics Gynecology (COBGC™): This medical coding specialty requires training and experience working in women’s health. To manage the health records and information in an OB/GYN office, you’ll need to be familiar with the procedures used in prepartum, postpartum, and childbirth care. You’ll have to stay up-to-date on gynecological concerns and complex sets of regulations maintained by insurance providers.
  • Orthopaedic Surgery (COSC™): Coding orthopaedic surgeries requires a basic familiarity of the anatomy of the human skeletal system and its functions, as well as its related surgeries. These include fracture repairs, spinal surgeries, and other types of procedures for a variety of disorders. You’ll also need to demonstrate knowledge of insurance and billing regulations, including Medicare rules regarding shared visits, teaching situations, and consultations.
  • Otolaryngology (CENTC™): Billters who work in the ENT specialty (ear, nose, and throat) have to learn the diagnostic procedures and treatments used by ENT specialists, including nasopharyngoscopies, laryngoscopies, and sinus surgeries, The AAPC recommends having work experience in this field because it requires a familiarity with insurance regulations, Medicare, and billing procedures for common surgeries and procedures.
  • Pediatrics (CPEDC™): Achieving this professional certification demonstrates that you have training and experience managing the health information of children. You will need to possess general knowledge of pediatric medicine, as well as common procedures (like immunizations.) Pediatric care also requires knowledge of a wide range of treatments, many including multiple procedures or visits. The examination for this certification is based on sample doctor’s notes, so it’s a great advantage to have professional experience.
  • Plastics and Reconstructive Surgery (CPRC™): Coding procedures for this field of medicine can be complex because of the highly specific kinds of procedures and surgeries performed. Because this field is also the site of elective and cosmetic procedures, you’ll need to organize data accurately for patients who are undergoing restorative surgeries so their insurers can cover their expenses. Medical coders who have experience working with plastic surgeons are more likely to succeed on this certification examination.
  • Rheumatology (CRHC™): Rheumatology is the study of the treatment of joint disorders, such as arthritis. Medical billers and coders who earn this certification demonstrate general knowledge of the procedures, treatments, and medical devices and equipment used in patient care. You will also need to have an understanding of Medicare and other forms of public and private insurance billing procedures. Rheumatologists work with patients over multiple visits, and treatment can be extensive, which requires rheumatology coders to keep track of repeat treatments.
  • Surgical Foot and Ankle (CSFAC™): To earn this certification, you’ll have to develop knowledge of common foot and ankle problems, as well as their associated medical treatment options and equipment. You’ll have to turn doctor’s notes into codes that accurately convey the forms of treatment provided, and know the ins and outs of Medicare and insurance billing. The AAPC recommends that you have significant clinical experience as a coder in this subfield before taking the certification examination.
  • Urology (CUC™): Medical coders working with urologists must develop an understanding of urinary tract issues for patients of both genders, as well as knowledge of male reproductive health issues. If you choose to specialize in this subfield of medicine, you’ll need to accurately code ancillary procedures performed in a urologists’ offices, such as injections and urinalysis. You’ll also have to be familiar with codes for procedures performed in hospitals, such as biopsies, cystoscopies, and prostatectomies.

Tuesday, 2 May 2017

Start Your Own Business

The medical billing and coding field is expected to grow steadily in the next few decades. As health informatics change and the healthcare industry continues to expand, coders and billers will be in demand to cope with the increased burden of processing information that changes hands during a medical procedure. Third parties sometimes perform billing and coding operations, and there are opportunities for entrepreneurs to build their own billing and coding business.
One of the interesting benefits of starting a billing and coding profession is the ability to work from home. Because the job requires mostly clerical work that can be done on a computer, a medical biller and/or coder does not need to work from a medical office or even interact with patients directly. However, starting your own coding and billing business will not be easy. Even if you are working from home, you’ll have to stay in frequent contact with your clients, health insurance companies, and clearinghouses. Explore the following tips to running your own successful billing and coding business:

1) Get certified

Certification is not formally required for medical billers and coders, but if you’re starting your own business, you’ll want to have a certification from a school or training program that’s recognized by either the American Health Information Management Association (AHIMA) or the American Association of Professional Coders (AAPC). This certification will assures prospective clients that you have achieved a certain level of expertise and dependability.

2) Get experience

Before you start your own billing and coding service, you’ll want to get some experience working at a healthcare provider’s office. While it might not make sense to start your own at-home business working for someone else, you’ll have a very hard time finding any clients willing to entrust the sensitive health information of their patients to an unknown third party. Working for an established provider grants you a reference, proof of your legitimacy, and possibly even future clients.

3) Know the law

As you pursue certification, you’ll undoubtedly learn the regulations and laws that govern the day-to-day tasks of a medical biller and coder. However, don’t forget about local, state, and federal laws, as well. If you’re going to run your own billing and coding service, you’ll need to apply for a business license. You may also need to apply for special licenses within your state. Some medical billing agencies, for example, must be registered as collections agencies. You may also need to get a federal tax ID number for your small business. It’s worth the time and money to consult a professional accountant or financial adviser when it comes to setting up these licenses.

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