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You may see a COVID surcharge on your next bill

Country Roads

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It’s a way to recoup the sudden costs of masks, gloves and sanitizing sprays by passing them to the consumer.

"Cinthya Lavin, a Better Business Bureau spokeswoman for Southeast Florida and the Caribbean, said the surcharges are ethical, as long as businesses are transparent about stating what they are for."




Adapt to a new normal?
 

PigsDad

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My dentist is charging a new $20 PPE fee for every visit. :mad:

Kurt
 

normab

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My dentist is charging a new $20 PPE fee for every visit. :mad:

Kurt

That is interesting. Dentists have been wearing lots of PPE for years now. They really haven’t added that much more! I was at the dentist last week and they looked like they had the same level of Personal protection.
However, I would guess they are sanitizing and cleaning more frequently in areas beyond the exam rooms. Just like everyone else.
 

Luanne

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My dentist is charging a new $20 PPE fee for every visit. :mad:

Kurt
I read several other posts with people saying this. I just had my teeth cleaned. No PPE surcharge. Only difference, besides having to wait outside since there was already one person in the waiting room, having my temperature taken, answering the 4 standard COVID 19 questions, wearing a mask in (but not during the cleaning) was that the hygienist didn't use the water machine to clean and also didn't polish my teeth. She said they are following the ADA guidelines and both of those produce what I call spatter.
 

am1

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To be expected. Also a higher demand for services as places have been closed. The people who will easily pay the extra charge. Others are not so lucky.

Expect prices to rise across the board.
 

bbodb1

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A question on this if I might - was this charge passed on to the insurance carrier and (if so) did the insurance carrier pay it?
 

bbodb1

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Along this line of developments, see what USF is doing now? If COVID-19 resurges and campus closes, USF (at present) will not refund any housing costs.
This will not end well.

 

bbodb1

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I read several other posts with people saying this. I just had my teeth cleaned. No PPE surcharge. Only difference, besides having to wait outside since there was already one person in the waiting room, having my temperature taken, answering the 4 standard COVID 19 questions, wearing a mask in (but not during the cleaning) was that the hygienist didn't use the water machine to clean and also didn't polish my teeth. She said they are following the ADA guidelines and both of those produce what I call spatter.
I'm curious as to how this is considered a cleaning then. And that is not meant to be flippant, but how can cleaning and polishing be excluded? It seems like the value of the visit was significantly diminished in several aspects.
 

Luanne

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I'm curious as to how this is considered a cleaning then. And that is not meant to be flippant, but how can cleaning and polishing be excluded? It seems like the value of the visit was significantly diminished in several aspects.
You've never had your teeth cleaned without the water thing? That's the way dentists and hygienists did it for years. I actually don't like the water thing. The hygienist uses an instrument to removed the tartar. And the polishing really doesn't do much, it's just kind of a finishing step. So yes, I feel like I got a thorough cleaning.
 
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linsj

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My dentist is charging a new $20 PPE fee for every visit. :mad:
Kurt

Same here. Got the email two weeks ago. The two dentists and hygienists were already wearing masks and gloves, so this fee seems unnecessary.
 

TravelTime

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I would not add a Covid surcharge to my client bills. I would face protests. Instead, I will look at what my new costs are if I reopen and start seeing people in person again and adjust my rates appropriately. I have never charged a credit card surcharge because then people will not use credit cards, for example. I encourage the use of credit cards because it keeps my collection rate to close to 100%. And that reduces my stress and anxiety. And keeps us in business. Besides rent and payroll, credit cards fees are my next biggest monthly expense line. But totally worth is to me.

Maybe businesses feel they can't raise prices and people will be more accepting of a small Covid surcharge? In my experience, people hate separate line items and consider that "nickel and diming" but many of us are used to that with travel bills and end up paying. Rental car bills are the worst with so many various fees on top of the cost of the rental car. You are lucky if you can rent a car and get out with less than double what you expected to pay.
 

TravelTime

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Now I think I figured out why dentists are adding a Covid surcharge. Insurance companies have maximum reimbursement rates by billing code. If they bill the insurance company, they will not get extra money. So instead they are passing it along directly to their patients and this is a new revenue stream. I call this nickel and diming. But what can a dental client do except pay the surcharge if they want their teeth cleaned. I would be fine paying it if it means I can get dental services. I would huff and puff under my breath while paying. :shrug:
 
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VacationForever

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I know I am not going to the dentist for the next 12 months unless it is an emergency. Each time I go for cleaning, the hygenists had always said that there was very little to clean and sent me out the door within 15 minutes.
 

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The dentists have been hit hard economically by Covid, more than many other professionals. Many could not work for at least 2 months (or worked very few hours) and they are probably not back to normal even now. In most cases they are also small businesses and they have the burden of inventory, paying staff, rent etc. But unlike restaurants, the dentists do have some pricing power because there is no alternative, many treatments have to be done and very few people will cancel or postpone a cleaning because of the PPE charge. I do not find the additional $20 excessive.
 

bogey21

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I have an appointment with my Cardiologist next Tuesday which I am going to keep.. I also have an appointment to get my teeth cleaned mid July. I already moved it once from April and may move it forward again...

George
 

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I have an appointment with my Cardiologist next Tuesday which I am going to keep.. I also have an appointment to get my teeth cleaned mid July. I already moved it once from April and may move it forward again...

George

I need to set up a dental appointment. I have been hesitating because I moved and have not yet been able to find a new dentist. But I can’t postpone it much longer. It has been more than a year. My last dentist emailed to say they are re-opening so I assume all the dentists around me are open. I will gladly pay them a Covid surcharge. I feel really bad for how this has impacted dentists. I am sure they have taken an even bigger hit than doctors. The entire healthcare field is suffering. Patients probably do not realize how bad health care professionals are getting hit because they assume doctors and dentists are rich. Doctors and dentists are really just small business owners. I hope they all were eligible for the small business loans to keep their practices afloat since March. I think many small health care practices may need to close down. That will be a disaster for the economy and the health care industry as well as the ability to access medical services.
 
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jonmaiman

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I just had a cleaning this past week. Hygienist was in full PPE including gloves, face shield, etc. as usual (pre-covid 19). Standard cleaning with scaling to remove tartar build up and polishing. Water gun and suction had one time protective coverings and/or fittings. My temperature was taken upon entry before my cleaning. The waiting room is spacious enough that it was easy to social distance. This dental practice is very good about keeping to their schedule so folks are rarely waiting more than a few moments after they check in. All patients wore masks in the waiting room and only removed them during treatment. Outside gloves were prohibited to prevent cross contamination. I don't use gloves and just wash my hands anyway for exactly the same reason. I assume no special PPE charges since they just submitted the visit to my insurance and didn't ask for any additional payment when I was leaving.

This is a large practice with a few hygienists and a couple of dentists. Treatment area is an open air design with cabinets for the equipment and supplies forming dividers approx. 7 feet in height between treatment areas. There is a couple of foot gap to the ceiling. Bottom line, nothing is a %100 risk free but I felt my dentist had done a good job of trying to minimize the risks. For them this is normal and how they ran the practice Pre-Covid-19 other than face masks and temperature checks for patients.

--Jon
 

LannyPC

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I just had a cleaning this past week. Hygienist was in full PPE including gloves, face shield, etc. as usual (pre-covid 19). Standard cleaning with scaling to remove tartar build up and polishing. Water gun and suction had one time protective coverings and/or fittings. My temperature was taken upon entry before my cleaning. The waiting room is spacious enough that it was easy to social distance. This dental practice is very good about keeping to their schedule so folks are rarely waiting more than a few moments after they check in. All patients wore masks in the waiting room and only removed them during treatment. Outside gloves were prohibited to prevent cross contamination. I don't use gloves and just wash my hands anyway for exactly the same reason. I assume no special PPE charges since they just submitted the visit to my insurance and didn't ask for any additional payment when I was leaving.

This is a large practice with a few hygienists and a couple of dentists. Treatment area is an open air design with cabinets for the equipment and supplies forming dividers approx. 7 feet in height between treatment areas. There is a couple of foot gap to the ceiling. Bottom line, nothing is a %100 risk free but I felt my dentist had done a good job of trying to minimize the risks. For them this is normal and how they ran the practice Pre-Covid-19 other than face masks and temperature checks for patients.

I had this exact same experience last week. Fortunately, there was no out-of-pocket surcharge for me.
 

jme

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I have something to say regarding this subject. Something probably not understood before.

There is a lot of misinformation here, and frankly a lot of ignorance as to what is required of professional practitioners to return
to work and to continue working into the future.
We practicing dentists, whether a GP or an Oral Surgeon, or Endodontist, or Orthodontist, or Periodontist….(and for that matter all Medical practitioners and Physicians, with all of their specialties represented,
who similarly answer to their state and federal associations and to specific higher organizations, whose guidelines and directives they must follow.)

We all must adhere to the strict recommendations of OSHA and the CDC, to name the two most prominent organizations to whom we are accountable.
Then comes the individual state professional association who issues and maintains our actual licenses to practice, to our federal organizations (for me, the American Dental Assoc, for Physicians the AMA),
and even to our Individual Liability Insurance Companies. At the very least, it’s complicated, and it is also extremely costly.

My office was 100% shut down for 9.5 weeks. Zero income, ongoing overhead. The economic disaster of that is really incalculable at this time, as the impact continues to show itself.
Just returning to work will only be the first baby step. It may take a year or two to heal and simply get back on track.
It’s not like a regular business re-opening and all of a sudden everything is packed with customers and wonderful.
We local dentists have now returned to work—not sure about most, but we are at a production level of about 30% because of recommended patient appointment spacing, adhering to lower patient levels
to reduce exposure risk. I assume it’s pretty much the same across the board. It is understood by us all that to do otherwise right now would be negligence.
We must protect patients, employees, and ourselves, and ultimately the families of all of those and beyond.

PPE (Personal Protective Equipment) is "as good as mandatory" by our State Dental Board because we can be held liable if anything happens due to non-compliance by any office. Patients can report any practitioner, colleagues can report other practitioners, and Liability Insurance Companies can cancel all coverage if they have cause, and that would kill any practice instantly. We all want to comply, and we all have, to my knowledge,
but it has come at great personal cost to all. It took time to gather the PPE——2+ months for most everyone---- and it’s still ongoing. I foresee that it will never stop…the new normal.
Not to mention that the PPE ran out early on, and many, many items were simply 100% unavailable, so we had many back-orders. For weeks and weeks some things were not available at all.
Many offices chose to remain closed until everything was ordered and received and new office policies implemented.
The PPE is the easy part—the new “pandemic” office procedure and protocol is the truly time-consuming and most complicated part.
And there's a warning and specific protocol about any procedure that produces an aerosol at this time,
so we either eliminate that treatment modality (ultrasonic machine for cleaning, instead doing hand scale)
or polishing (there's a proper & safe way to do that (we haven't eliminated). But at no point in time is any treatment compromised
or not properly given---it may simply be revised to accomplish the same result.

Someone here said something about, “well they already had masks and gloves….”
That’s a good one.
It goes FAR BEYOND masks and gloves. As for products it also involves face shields, bouffant caps, new specialty scrubs or uniforms for the whole staff, approved gowns, hand sanitizers,
wipes that kill all bacteria and germs, plus viruses--- TB, Coronavirus, and all other viruses. Also consider countertop barriers between patient and front desk employees, a dozen new forms and documents
that must be distributed to patients (several signed by patients), rest room sanitization, reception area sanitization, and in many cases Room Ventilation systems and Water Quality Control measures.

Also disposable plastic barriers that fully cover treatment chairs, various types of equipment in each treatment room including imaging devices,
special disposable oversized plastic tray covers on which instruments are placed,
and new sterilization protocol involving even the steps taken in transferring the USED dirty instruments after each appointment over to the pre-sterilization area of the ultrasonic cleaners,
then to the sterilization autoclaves, and then back to the patient rooms. It’s a much more time-consuming and expensive exercise now. And the time it takes to turn over a treatment room has caused
us to take additional time for the appointment so it can be done thoroughly and properly. So the production again is lower. There are also new front office protocols too lengthy and boring to elaborate on here,
one example being how simple patient record-keeping must be handled now.

Also 2-day pre-appointment health screening phone calls to each and every patient (12 questions), followed up by the same screening process for each and every patient (same 12 questions) upon arrival at each appointment (a document that must be kept), plus signing a long “treatment consent" form at each and every appointment, issued in our case by none other than our Liability Insurance Company itself. How a patient pays now required purchasing from our bank a touchless payment system, whether it be credit card, electronic check transfer, debit card, etc. (Two machines to accomplish that). Even an occasional pen used in the front office by a patient or employee must be wiped down with the expensive virus-killing solution after each use, and the countertops must also be wiped down after each patient. Every product must be approved by several organizations,
including FDA and NIOSH.

And the kicker---I have TWO offices.... 3 days and 2 days, so a lot of my expenses are doubled.

So, is it ‘just a mask and gloves”? Personally I find that insulting and farcical, although not intentional.
There's a lot of stuff and issues that people are not seeing, so they assume everything behind the scenes is same-old, same-old.
Nothing could be farther from the truth.


Please take a look at a few of our guidelines we much adhere to below.......Please read them.
There’s also a link to the “Extra Fee” that we charge for PPE per visit, and how that originated nationally. You will understand after reading. And let it be known, it wasn’t us!
As I understand it, all Insurance companies were advised by governing bodies that they will be required to provide coverage for this, so it’s not some new greedy policy that dentists came up with to steal a new increase. The fee itself it a token fee, imho, and does not come anywhere close to covering all we have had to implement to keep going…..and mind you, we had to do it while still suffering from
an extreme economic disaster, having been shut down and having to purchase practice things from personal savings. It is justified.

Of course these things must be paid by consumers, but know that it's indirectly now because it will be required to be covered by the individual insurance companies and not the patient per se.
There might be some who must pay a portion out-of-pocket, but in this rare and serious pandemic situation, it’s the right and safe thing to do.
I must protect my staff, their families, and myself and my family, and guess what—the patient too.
I accept and have always treated Medicaid patients because I believe it is what I’m called to do. Anybody and everybody. The fees received are very low, less than 1/3 of normal fees,
yet I still provide all the same level of treatment, and protection via PPE, to all that enter my doors.

(Cars added catalytic converters way back when, and there are other countless examples of extra charges, but this is one that could be life-saving.
Hospitals do it by itemizing every single piece of anything….like an individual 2x2 piece of gauze….. and far more.)


Guidelines from organizations to whom we are accountable for PPE and EVERYTHING ELSE:

CDC:
https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html?

OSHA:
https://www.osha.gov/SLTC/covid-19/dentistry.html

American Dental Association:
https://success.ada.org/~/media/CPS...ha-guidelines-dentistry&utm_campaign=covid-19



American Dental Association PPE reimbursement: (legislation pending on this)
a short excerpt:
"Statement on Third Party Payer Reimbursement for Costs Associated with Increased Standards for Personal Protective Equipment (PPE) The safety of patients, dentists and dental team members has been and always will be the American Dental Association’s (ADA) utmost concern. The ADA has issued interim recommendations aligning with those from the Centers for Disease Control (CDC) for use of personal protective equipment (PPE). Given these interim recommendations, the ADA anticipates that the cost for each patient visit will substantially increase for procedures performed in the dental office. Third party benefit programs should either (1) adjust the maximum allowable fees for all procedures or (2) allow a standard fee per date of service per patient to accommodate the rising costs of PPE. Not doing so is deemed an automatic reduction in reimbursement rates.

Prior to such adjustments taking effect, dental offices may wish to use CDT code “D1999 - unspecified preventive procedure, by report” to document and report the use and cost of additional PPE. Dentists can use this code once per patient visit/claim to attempt to cover the cost of PPE. Dentists should develop a standard office policy to document the additional PPE that will be used across all patients. This documentation methodology will justify a standard fee across all patients. Alternatively, dentists may wish to add a note in the patient’s record to document the details of PPE uniquely necessary for the visit when charging different fees based on the level of PPE used.
When adjudicating such claims, the ADA believes that it is inappropriate for any third party benefit program to unfairly place the cost burden on dentists by disallowing or bundling charges for PPE on the pretext that the payment for additional required PPE is included in the payment for any other procedure billed for the visit.
Denied claims are typically billable to the patient. For Medicaid patients, please check with your state Medicaid agency."
 
Last edited:

chapjim

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Presumably, by listing it as a surcharge, it might go away some day. If the additional cost is reflected as a price increase, it won't.
 

TravelTime

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I have something to say regarding this subject. Something probably not understood before.

There is a lot of misinformation here, and frankly a lot of ignorance as to what is required of professional practitioners to return
to work and to continue working into the future.
We practicing dentists, whether a GP or an Oral Surgeon, or Endodontist, or Orthodontist, or Periodontist….(and for that matter all Medical practitioners and Physicians, with all of their specialties represented,
who similarly answer to their state and federal associations and to specific higher organizations, whose guidelines and directives they must follow.)

We all must adhere to the strict recommendations of OSHA and the CDC, to name the two most prominent organizations to whom we are accountable.
Then comes the individual state professional association who issues and maintains our actual licenses to practice, to our federal organizations (for me, the American Dental Assoc, for Physicians the AMA),
and even to our Individual Liability Insurance Companies. At the very least, it’s complicated, and it is also extremely costly.

My office was 100% shut down for 9.5 weeks. Zero income, ongoing overhead. The economic disaster of that is really incalculable at this time, as the impact continues to show itself.
Just returning to work will only be the first baby step. It may take a year or two to heal and simply get back on track.
It’s not like a regular business re-opening and all of a sudden everything is packed with customers and wonderful.
We local dentists have now returned to work—not sure about most, but we are at a production level of about 30% because of recommended patient appointment spacing, adhering to lower patient levels
to reduce exposure risk. I assume it’s pretty much the same across the board. It is understood by us all that to do otherwise right now would be negligence.
We must protect patients, employees, and ourselves, and ultimately the families of all of those and beyond.

PPE (Personal Protective Equipment) is "as good as mandatory" by our State Dental Board because we can be held liable if anything happens due to non-compliance by any office. Patients can report any practitioner, colleagues can report other practitioners, and Liability Insurance Companies can cancel all coverage if they have cause, and that would kill any practice instantly. We all want to comply, and we all have, to my knowledge,
but it has come at great personal cost to all. It took time to gather the PPE——2+ months for most everyone---- and it’s still ongoing. I foresee that it will never stop…the new normal.
Not to mention that the PPE ran out early on, and many, many items were simply 100% unavailable, so we had many back-orders. For weeks and weeks some things were not available at all.
Many offices chose to remain closed until everything was ordered and received and new office policies implemented.
The PPE is the easy part—the new “pandemic” office procedure and protocol is the truly time-consuming and most complicated part.

Some here have said something about, “well they already had masks and gloves….”
That’s a good one.
It goes FAR BEYOND masks and gloves. As for products it also involves face shields, bouffant caps, new specialty scrubs or uniforms for the whole staff, approved gowns, hand sanitizers,
wipes that kill all bacteria and germs, plus viruses--- TB, Coronavirus, and all other viruses. Also consider countertop barriers between patient and front desk employees, a dozen new forms and documents
that must be distributed to patients (several signed by patients), rest room sanitization, reception area sanitization, and in many cases Room Ventilation systems and Water Quality Control measures.

Also disposable plastic barriers that cover treatment chairs, various types of equipment in each treatment room including imaging devices, special plastic tray covers on which instruments are placed,
and new sterilization protocol involving even the steps taken in transferring the USED dirty instruments after each appointment over to the pre-sterilization area of the ultrasonic cleaners,
then to the sterilization autoclaves, and then back to the patient rooms. It’s a much more time-consuming and expensive exercise now. And the time it takes to turn over a treatment room has caused
us to take additional time for the appointment so it can be done thoroughly and properly. So the production again is lower. There are also new front office protocols too lengthy and boring to elaborate on here,
one example being how simple patient record-keeping must be handled now.

Also 2-day pre-appointment health screening phone calls to each and every patient, followed up by the same screening process upon patient arrival—a document that must be signed, along with a long “treatment consent" form, issued in our case by none other than our Liability Insurance Company itself. How a patient pays now required purchasing from our bank the touchless payment system, whether it be credit card, electronic check transfer, debit card, etc. Even an occasional pen used in the front office by a patient or employee must be wiped down with the expensive virus-killing solution after each use, and the countertops must also be wiped down after each patient. Every product must be approved by several organizations,
including FDA and NIOSH.

So, is it ‘just a mask and gloves”? Personally that’s insulting and farcical.
There's a lot that people are not seeing, so they assume everything behind the scenes is same-old, same-old.
Nothing could be farther from the truth.


Please take a look at a few of our guidelines we much adhere to below.......Please read them.
There’s also a link to the “Extra Fee” that we charge for PPE per visit, and how that originated nationally. You will understand after reading. And let it be known, it wasn’t us!
As I understand it, all Insurance companies were advised by governing bodies that they will be required to provide coverage for this, so it’s not some new greedy policy that dentists came up with to steal a new increase. The fee itself it a token fee, imho, and does not come anywhere close to covering all we have had to implement to keep going…..and mind you, we had to do it while still suffering from
an extreme economic disaster, having been shut down and having to purchase practice things from personal savings. It is justified.

Of course these things must be paid by consumers, but know that it's indirectly now because it will be required to be covered by the individual insurance companies and not the patient per se.
There might be some who must pay a portion out-of-pocket, but in this rare and serious pandemic situation, it’s the right and safe thing to do.
I must protect my staff, their families, and myself and my family, and guess what—the patient too.
I accept and have always treated Medicaid patients because I believe it is what I’m called to do. Anybody and everybody. The fees received are very low, less than 1/3 of normal fees,
yet I still provide all the same level of treatment, and protection via PPE, to all that enter my doors.

(Cars added catalytic converters way back when, and there are other countless examples of extra charges, but this is one that could be life-saving.
Hospitals do it by itemizing every single piece of anything….like an individual 2x2 piece of gauze….. and far more.)


Guidelines from organizations to whom we are accountable for PPE and EVERYTHING ELSE:

CDC:
https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html?

OSHA:
https://www.osha.gov/SLTC/covid-19/dentistry.html

American Dental Association:
https://success.ada.org/~/media/CPS...ha-guidelines-dentistry&utm_campaign=covid-19



American Dental Association PPE reimbursement: (legislation pending on this)

Wow, thanks for sharing. It makes me really appreciate what dentists are going through to re-open safely. I will not complain at all when I get my cleaning this year.
 
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