Return-path: Received: from smtpin129-bge351000 ([10.150.68.129]) by ms112.mac.com (Sun Java(tm) System Messaging Server 6.3-7.04 (built Sep 26 2008; 64bit)) with ESMTP id <0KDJ000U96F4Y6H0@ms112.mac.com> for rscoby2@mac.com; Thu, 15 Jan 2009 13:01:52 -0800 (PST) Original-recipient: rfc822;rscoby2@mac.com Received: from ccm15.constantcontact.com ([66.151.234.152]) by smtpin129.mac.com (Sun Java(tm) System Messaging Server 6.3-7.03 (built Aug 4 2008; 32bit)) with ESMTP id <0KDJ00CXN6F305D0@smtpin129.mac.com> for rscoby2@mac.com (ORCPT rscoby2@mac.com); Thu, 15 Jan 2009 13:01:52 -0800 (PST) X-Brightmail-Tracker: AAAAAQAAAUA= Received: from p2-ws509.ad.prodcc.net (unknown [10.252.0.102]) by ccm15.constantcontact.com (Postfix) with ESMTP id 4DDB71BC80BB for ; Thu, 15 Jan 2009 15:05:50 -0500 (EST) Message-id: <1102402628131.1102390195137.123.9.51160003@scheduler> Date: Thu, 15 Jan 2009 16:01:51 -0500 (EST) From: "Conomikes Associates, Inc." Reply-to: scobyr@conomikes.com To: rscoby2@mac.com Subject: Conomikes Reports for January 15, 2009 MIME-version: 1.0 Content-type: multipart/alternative; boundary="----=_Part_32113_888419572.1232053311798" X-Mailer: Roving Constant Contact 0 (http://www.constantcontact.com) List-Unsubscribe: http://visitor.constantcontact.com/d.jsp?p=un&v=001Vzv-UqW3G57RI3Dful0_-VQj6t6SCPsqfJcT42mBnInxMjYR4ksZwg== X-Return-Path-Hint: ESC1102402628131_1102390195137_123@in.roving.com X-Roving-ID: 1102390195137.123 X-Lumos-SenderID: 1102390195137 X-Roving-CampaignId: 1102402628131 X-Roving-StreamId: 0 ------=_Part_32113_888419572.1232053311798 Content-Type: text/plain; charset=iso-8859-1 Content-Transfer-Encoding: 7bit ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Medical Practice Management & Practice Profitability January 15, 2009 In This Issue Front-Desk Collection Challenges Economic Blues Trickle Down Good News for the Virtual Office Visit Controlling Personnel Costs Dealing with Change Five Tips for Managing Well. Confirming Agreement on a Decision When Your Patients May Want to Have Their Own Electronic Medical Record Health Clinics Slow Expansion Young Adults Most Likely Group to Be Uninsured Tips to Tame Talkaholics Employers Downsizing Maternity Leave New e-Rx Standards to Take Effect April 2009 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ================================================================================ Quick Links Our Website [http://rs6.net/tn.jsp?e=001HrCR4Bq4MGiSL_ZR6ew21Qp950MuoC3_xb5zxsBhwbMCU1pkODXfUfghlyeIG1mz9G71t_WpUxL5iqsYNDAfOaCb_vl2Fh_ZJkseAoEAVudhUQwhpv596w==] Products [http://rs6.net/tn.jsp?e=001HrCR4Bq4MGiSL_ZR6ew21Qp950MuoC3_xb5zxsBhwbMCU1pkODXfUfghlyeIG1mz9G71t_WpUxL5iqsYNDAfOaCb_vl2Fh_ZJkseAoEAVudhUQwhpv596w==] Services [http://rs6.net/tn.jsp?e=001HrCR4Bq4MGiSL_ZR6ew21Qp950MuoC3_xb5zxsBhwbMCU1pkODXfUfghlyeIG1mz9G71t_WpUxL5iqsYNDAfOaCb_vl2Fh_ZJkseAoEAVudhUQwhpv596w==] ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Dear Richard Scoby, Welcome to our new, improved electronic edition of Conomikes Reports. You will be getting more from us, twice as much as in the past. We hope you enjoy our new format which also allows you the ability to easily pass along important articles to others at your practice. I welcome any of your comments and suggestions to help us bring you what you need to face the challenges at your practice. Sincerely, George Conomikes, Editor and Publisher ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Billing & Collections Front-Desk Collection Challenges Increase in 2009 It is reported that, for private insurance plans, the average deductible is jumping from $500 to $1,000 for 2009. This means that your practice front-desk is going to have more explaining and work to do with those patients. More... [http://rs6.net/tn.jsp?e=001HrCR4Bq4MGhIbJXp81ZLqBcvis0zR7txHzoCendWIew8RRvSDahJ6ZJmdgT_8WkLnM2yIql9NEVNxA1tktgG19MDKQ89_B7A1GpB5467ZaI6EwOWttPfWjAtFJpaZ5hJcZmAcvrYhf-EpO2c121NsRr89_QnH-2dfb0apUxBX9F7x0VNtj2Hww==] ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Billing & Collections Economic Blues Trickle Down to Some Physicians Some physicians are feeling the repercussions of the recession that began in December 2007 and deepened during the financial crisis in the fall of 2008. * Fifty-six percent of hospitals told the American Hospital Association in November that physicians were seeking more financial support, ranging from reimbursement for on-call duty to outright employment. * Roughly 1 in 2 physicians plan to attend fewer continuing medical education conferences in 2009 that require overnight travel, according to a September survey by the publication Medical Meetings. * Some physicians received fewer holiday gifts, a sure sign of belt-tightening among patients.More... [http://rs6.net/tn.jsp?e=001HrCR4Bq4MGiffTkQsEqEvfn0PalwEDqNjslcvET9SQPiSkiNjhAhDJ3THKndqCKjOINkoOuwKkpKGZfFExkSwcWD3hwU3lLjklTg8pmWbj4CnVCZ5ZMnIy6BSmwaqGNiYhLUGpjothVs62inmlbxq0wWxDZPZT0AnktFaEEBOBiFT-YLp0jfJA==] ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Coding Good News for the Virtual Office Visit Web-based doctor visits are increasing in popularity, and patients and providers alike express appreciation for the convenience of this type of encounter. One major challenge, however, has been payment. While CPT had developed a code for non-face-to-face visits, many plans would not pay for them. Recently, several plans have recognized the value in the service. In fact, since the beginning of 2008, Aetna Inc., the county's largest insurer, and Cigna, have agreed to pay physicians for online visits. Experts expected other large health plans to follow suit. More... [http://rs6.net/tn.jsp?e=001HrCR4Bq4MGhC7dIkVIslgBmcl6XIfq8ULCZb-LEDf2cw1qBSB7dKVHFA7bn7g4GbVfh-5yDGLuZEJf3Fz75JQaQvpHDJ1kXNL3grkrPf8slgnFDe9xWX2yH5siIXvJmvL3-kBNqC5XlqSXTFfUaLbnYEKdweVMPK7m0QTFeGZJfRmrIzUGg3ag==] ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Cost Control Controlling Personnel Costs in Slower Markets Some practices are experiencing reduced revenues, because of reduced patient scheduling. The temptation is to consider staff cuts, but that may be more expensive in the long run. When business picks up again, it means that you will need to recruit, train, and deal with the front-end costs of the new hires. There are other options to consider first: More... [http://rs6.net/tn.jsp?e=001HrCR4Bq4MGjFS3IWPUqYoJBPrYnXRBiOMi7S89QYkJtAtUWAk5-T3a76hcqE_eabzYx9KLgIBXw1jkI_frKq6u53mAC-yQcaDKyMkQ_7vt0q0jh5wuldLjDWeHuLQnFAga8pLU-s09VQph5rr30wHOWSCIJHwM2acdGYI38S-GpK3wpjEo3t_Q==] ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Management Dealing with Change Medical practices are in a constant sea of change. Witness the transition to managed care, followed by the merger mania of the 1990s and the current challenges from lowered reimbursements as well as investigating, investing in and converting to Electronic Medical Records. Honda Motors has faced analogous changes. The entry into U.S. and European markets with the small car. The later upgrade to the Acura line followed by the luxury-class Infiniti. And now, the transition to the fuel-efficient hybrids. More... [http://rs6.net/tn.jsp?e=001HrCR4Bq4MGiti3SCa4WcteDCPEcOeZztkeZPn2n3brQud0v90sZocVMle_kzNKonEzss3oeX6Dw4jhB15ooGEB6wo8xA8FUsULo-wqL4TNhNR2anez_4vdx933pR1LWtOOXAxQCq__z83NGxf3f8EUwltnveG_jdKEqtHnjj_tr4Ya4cVeZn6w==] ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Management Five Tips for Managing Well Tim Finchen is the Chief Executive of the PGA Tours. In an interview with the Wall Street Journal he enunciated his simple but effective "5 Tips for Managing Well." More... [http://rs6.net/tn.jsp?e=001HrCR4Bq4MGhesWPeRLLHoYL8ThZ1QHoJ1gKEQQaYNMe8vUDen2v_o257BTQ_LkyQp79d5aD1UV6fcLT_AdoiYn2GUrhoZ2KKOtBRVwgHBI1qgdhkMqSQDT3KFYzpEPPzui3B83ZxEADKlUtyC58xH59JsXdHgyEgGDqcfa7nG8c16RpKVvFhQA==] ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Management Confirming Agreement on a Decision Made at a Meeting Once an agreement on a decision has been reached, ensure commitment to a decision on a critical matter by checking with each worker by name: "Anne, can you live with it?" "Jack, do you agree that this is the best solution right now?" Source: Meeting Excellence ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Electronic Medical Records When Your Patients May Want to Have Their Own Electronic Medical Record At some point in the future, your practice's EMR system will likely allow your patients to have access to your system, with options such as: * Patient education on chronic problems, pre-op instructions, etc. * Requests for refills and reminders on patient medicationsMore... [http://rs6.net/tn.jsp?e=001HrCR4Bq4MGj3iZXKXYzwKDciFQRMjjMVo61gSPmMxMFGbxDbRDzFznkJZ_aApQzE2KPWDig-m5dpOkvQ3AlNybSzPoWWpq5Cq9eJ7rJk9f_g_SZpg6Owwibt8bzKNsGLf_E0jGoQBd6rwiv099cfvaBXRDmI5DLGpmVvc1M5Q52MAN-uM58kWw==] ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Patient Management Health Clinics Slow Expansion CVS Pharmacy's Minute Clinics have cut back their growth plans. With over 500 Minute Clinics opened, CVS will open 100 clinics in 2008, a cutback from the original plans for 200. Check-Ups closed 23 clinics it operated inside Wal-Mart locations. However, Walgreen's, with 162 TakeCare clinics, will be adding 240 locations by the end of 2008. Reports indicate that initial projections were to reach the break-even point in 6 months, when it is now realized that it takes form 18-24 months to get there. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Patient Management Young Adults Most Likely Group to Be Uninsured Those between ages 18 and 34 account for 25% of the population, but 41% of those without insurance. Source: Census Bureau ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Personnel Management Tips to Tame Talkaholics Use these strategies to hold your own in conversation with a compulsive talker who doesn't seem to know how to listen or take turns: * Establish a time frame. As you begin the conversation, explain that you do not have unlimited time for discussion: "I have only five minutes before I need to..."More... [http://rs6.net/tn.jsp?e=001HrCR4Bq4MGj-3_jYWgr49LU27l1VWT-A5sswi2iDhWSw0KhPxh1tTSBKaPncMKTu1xo3e1-wfxc5lJQq4OAcYr1iVtYvEPQKrIHwoJyro-NnfmebWFR_XZEl8beoUfK6HqECcAqAW6NP8s2IIhs1fqsX8cha9VkFQTpATbB_nNG2YZ7_4IvMqA==] ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Personnel Management Employers Downsizing Maternity Leave Employers are cutting back on post-childbirth pay for mothers and offering shorter leaves, on average, for both moms and dads, compared with a decade ago. More... [http://rs6.net/tn.jsp?e=001HrCR4Bq4MGh3a2JYX2VudP33sWks_EMDY8nIiBWyuvNGexRR4bplnauM0kXi9bCJZdBRsQiCCa_HJeBtOgHk-W7WFUCDZF-q7qAWINgCJv9LwH7CuzYtsDDA7-Wi1_A6dHMVt4WX9Enb75YMoulCCvrW2GrtxVTrqCrPVe3_4k43f0UPbFBZcA==] ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Medicare New e-Rx Standards to Take Effect April 2009 The CMS issued a set of final regulations that establish new electronic-prescribing standards under Medicare Part D that the agency says will save money for beneficiaries and improve their healthcare. The regulations set standards for four types of information: More... [http://rs6.net/tn.jsp?e=001HrCR4Bq4MGjSFRaYsOPCm-E39e18V_gLkXhhUzXrOhjYDDiI1hvC2dhiSLC4Hcm5B6dNxMbmzHDsJLVBJiTDGYYr4v2Z5atUZ9_A0NKxSRFayUOjW-u-ni4LmdqiSf1OILczBdcHF4hK9LDyodtFUUGloG0juLSYLIeanKCkCyPbXqVs_pOKdw==] ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Forward email http://ui.constantcontact.com/sa/fwtf.jsp?m=1102390195137&ea=rscoby2@mac.com&a=1102402628131 This email was sent to rscoby2@mac.com by scobyr@conomikes.com. Update Profile/Email Address http://visitor.constantcontact.com/d.jsp?v=001Vzv-UqW3G57RI3Dful0_-VQj6t6SCPsqfJcT42mBnInxMjYR4ksZwg%3D%3D&p=oo Instant removal with SafeUnsubscribe(TM) http://visitor.constantcontact.com/d.jsp?v=001Vzv-UqW3G57RI3Dful0_-VQj6t6SCPsqfJcT42mBnInxMjYR4ksZwg%3D%3D&p=un Privacy Policy: http://ui.constantcontact.com/roving/CCPrivacyPolicy.jsp Email Marketing by Constant Contact(R) www.constantcontact.com Conomikes Associates, Inc. | 990 Highland Avenue | Suite 320 | (800) 421-6512 | San Diego | CA | 92075 ------=_Part_32113_888419572.1232053311798 Content-Type: text/html; charset=iso-8859-1 Content-Transfer-Encoding: quoted-printable
= 3D"CR
=20
January 15, 2009
In This Issue
Front-Desk Collection Challenges
Economic Blues Trickle Down
Good News for the Virtual Office Visit
Controlling Personnel Costs
Dealing with Change
Five Tips for Managing Well.
Confirming Agreement on a Decision
When Your Patients May Want to Have Their Own Electronic Medic= al Record
Health Clinics Slow Expansion
Young Adults Most Likely Group to Be Uninsured =
Tips to Tame Talkaholics
Employers Downsizing Maternity Leave
New e-Rx Standards to Take Effect April 2009
=20 =20 =20
Quick Links
=20 =20
Dear Richard Scoby,
Welcome to our new, improved electronic editio= n of Conomikes Reports. You will= be getting more from us, twice as much as in the past. We hope you enjoy o= ur new format which also allows you the ability to easily pass along import= ant articles to others at your practice. I welcome any of your comments and= suggestions to help us bring you what you need to face the challenges at y= our practice.
Sincerely,
Geor= ge Conomikes, Editor and Publisher
=20 =20
<= span style=3D"font-weight: bold;">Billing & Collections
Front-Desk Collection Challenges Increase in 2009
It is reported that, for private insurance pla= ns, the average deductible is jumping from $500 to $1,000 for 2009. This me= ans that your practice front-desk is going to have more explaining and work= to do with those patients.
More...
=20
<= span style=3D"font-weight: bold;">Billing & Collections
Economic Blues Trickle Down to Some= Physicians
Some physicians are feeling the repercuss= ions of the recession that began in December 2007 and deepened during the f= inancial crisis in the fall of 2008.
    <= li>Fifty-six percent of hospi= tals told the American Hospital Association in November that physicians wer= e seeking more financial support, ranging from reimbursement for on-call du= ty to outright employment.
  • Roughly 1 in 2 physicians plan = to attend fewer continuing medical education conferences in 2009 that requi= re overnight travel, according to a September survey by the publication Med= ical Meetings.
  • Some physicians received fewer holiday gift= s, a sure sign of belt-tightening among patients.
More.= ..
<= span style=3D"font-weight: bold;">Coding
Good News for the Virtual Office Visit
Web-based doctor visits are increasing in popu= larity, and patients and providers alike express appreciation for the conve= nience of this type of encounter. One major challenge, however, has been pa= yment. While CPT had developed a code for non-face-to-face visits, many pla= ns would not pay for them. Recently, several plans have recognized the valu= e in the service. In fact, since the beginning of 2008, Aetna Inc., the cou= nty's largest insurer, and Cigna, have agreed to pay physicians for online = visits. Experts expected other large health plans to follow suit.
<= a track=3D"on" href=3D"http://rs6.net/tn.jsp?e=3D001HrCR4Bq4MGhC7dIkVIslgBm= cl6XIfq8ULCZb-LEDf2cw1qBSB7dKVHFA7bn7g4GbVfh-5yDGLuZEJf3Fz75JQaQvpHDJ1kXNL3= grkrPf8slgnFDe9xWX2yH5siIXvJmvL3-kBNqC5XlqSXTFfUaLbnYEKdweVMPK7m0QTFeGZJfRm= rIzUGg3ag=3D=3D" linktype=3D"link" target=3D"_blank">More...
<= span style=3D"font-weight: bold;">Cost Control
Controlling Personnel Costs in Slower Market= s
Some practices are experiencing reduced revenu= es, because of reduced patient scheduling. The temptation is to consider st= aff cuts, but that may be more expensive in the long run. When business pic= ks up again, it means that you will need to recruit, train, and deal with t= he front-end costs of the new hires. There are other options to consider fi= rst:
More...<= /a>
<= span style=3D"font-weight: bold;">Management
Dealing with Change
=
Medical practices are in a constant sea of cha= nge. Witness the transition to managed care, followed by the merger mania o= f the 1990s and the current challenges from lowered reimbursements as well = as investigating, investing in and converting to Electronic Medical Records= .

Honda Motors has faced analogous changes. The entry into U.S. = and European markets with the small car. The later upgrade to the Acura lin= e followed by the luxury-class Infiniti. And now, the transition to the fue= l-efficient hybrids.
More...
<= span style=3D"font-weight: bold;">Management
<= font size=3D"2">Five Tips for Managing= Well
Tim Finchen is the Chief Executive of the PGA = Tours. In an interview with the Wall Street Journal he enunciated his simpl= e but effective "5 Tips for Managing Well."
More...
<= span style=3D"font-weight: bold;">Management
<= font size=3D"2">Confirming Agreement o= n a Decision
Made at a Meeting
Once an agreement on a decision has been reach= ed, ensure commitment to a decision on a critical matter by checking with e= ach worker by name: "Anne, can you live with it?" "Jack, do you agree that = this is the best solution right now?"

Source: Meeting Excellence
<= span style=3D"font-weight: bold;">Electronic Medical Records<= br />When Y= our Patients May Want to Have Their Own Electronic Medical Record
At some point in the future, your practice's E= MR system will likely allow your patients to have access to your system, wi= th options such as:
  • Patient education on chronic problems, pre= -op instructions, etc.
  • Requests for refills and reminders = on patient medications
More...
<= span style=3D"font-weight: bold;">Patient Management
Health Clinics= Slow Expansion
CVS Pharmacy's Minute Clinics have cut back th= eir growth plans. With over 500 Minute Clinics opened, CVS will open 100 cl= inics in 2008, a cutback from the original plans for 200. Check-Ups closed = 23 clinics it operated inside Wal-Mart locations. However, Walgreen's, with= 162 TakeCare clinics, will be adding 240 locations by the end of 2008. Rep= orts indicate that initial projections were to reach the break-even point i= n 6 months, when it is now realized that it takes form 18-24 months to get = there.
<= span style=3D"font-weight: bold;">Patient Management
Young Adults M= ost Likely Group to Be Uninsured
Those between ages 18 and 34 account for 25% o= f the population, but 41% of those without insurance.

Source: Census Bureau
<= span style=3D"font-weight: bold;">Personnel Management
<= font style=3D"color: rgb(0, 0, 153);" size=3D"3">Tips to Tame= Talkaholics
Use these strategies to hold your own in conve= rsation with a compulsive talker who doesn't seem to know how to listen or = take turns:
  • Establish a time frame. As you begin the conversat= ion, explain that you do not have unlimited time for discussion: "I have on= ly five minutes before I need to..."
More...
<= span style=3D"font-weight: bold;">Personnel Management
<= font style=3D"color: rgb(0, 0, 153);" size=3D"3">Employers Do= wnsizing Maternity Leave
Employers are cutting back on post-childbirth = pay for mothers and offering shorter leaves, on average, for both moms and = dads, compared with a decade ago.
More...
<= span style=3D"font-weight: bold;">Medicare
<= font size=3D"2">New e-Rx Standards to = Take Effect April 2009
The CMS issued a set of final regulations that= establish new electronic-prescribing standards under Medicare Part D that = the agency says will save money for beneficiaries and improve their healthc= are. The regulations set standards for four types of information:
<= a track=3D"on" href=3D"http://rs6.net/tn.jsp?e=3D001HrCR4Bq4MGjSFRaYsOPCm-E= 39e18V_gLkXhhUzXrOhjYDDiI1hvC2dhiSLC4Hcm5B6dNxMbmzHDsJLVBJiTDGYYr4v2Z5atUZ9= _A0NKxSRFayUOjW-u-ni4LmdqiSf1OILczBdcHF4hK9LDyodtFUUGloG0juLSYLIeanKCkCyPbX= qVs_pOKdw=3D=3D" linktype=3D"link" target=3D"_blank">More...
=20
=20
3D"Safe
This email was sent to rscoby2@mac.com by scoby= r@conomikes.com.
Conomikes Associate= s, Inc. | 990 Highland Avenue | Suite 320 | (800) 421-6512 | San Diego | CA= | 92075
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