Discover a Custom Billing Format for Healthcare that Transforms Your Workflow

Custom billing format for Healthcare

you thank you for those kind words Joel yes I'm a family physician in New Westminster um we are very blessed in our Clinic to have people with expertise in computer science and engineering and whatnot it seems like I've amassed The A Team unknowingly um so uh my disclosures are there in the PowerPoint you will indeed uh be able to access that and use that as a reference My Hope for tonight's webinar is actually show you live demo more than anything else this is a reprisal of the talk I gave At oser Con at SFU uh earlier in the summer so if you seeing that I'm sorry um hopefully I'm covering some new things but a lot of it will be repeated so I'm going to shift over and share my screen let see if this works here we go um I guess we don't need this I'll start on page one so uh hopefully everyone can see um the PowerPoint got that in my way um it's a little confusing here I've got two screens I should be looking this way uh so welcome this is the webinar on how to create your own lfp billing page or billing page in general um I am a family physician I won't have to tell you much more because we've already repeated it for this webinar I'm not going to turn off uh um gree monkey I become so uh dependent on it that I think it just needs to be there otherwise I'm unfamiliar territory I will point out where Grease Monkey is active and where it's non-active but uh you can ignore it for the most part okay um the good thing and the bad thing it's blessing and a curse but Oscar is how customizable it is and grease monkey actually is a customization of your browser not so much Oscar itself which is the bane of the OSP existence they have no control over that they don't like it because if it goes wrong they're really not inclined to fix it so you if you use gree monkey you should know that in advance okay um I am no longer an official board member of Fraser Northwest Division I have been from day one as his founding um board but I still participate a lot in the Fraser Northwest Activities I recognize a lot of the names of the participants tonight um some of them are PSP folks some of them are found Physicians and MOA so welcome everyone uh what I hope you can do here is um share this information with those who needed so the goal of this Workshop is to create a new billing page a lot of it is screenshot on the PowerPoint so I won't go through a lot of it live but there are some parts that I think you really do need to see you should be able to customize these Fe codes in the bilding page set default Belling pages per user if possible and this is indeed possible for Oscar well version and I hope it is for all versions but uh I don't know exactly for Juno and and open and uh M whether that's possible and how you can easily switch from one billing page to another as you're billing I'm not going to show you how to set up various details like the business cost premium facility codes that's not part of this or how you can even get new MSP codes it's not that difficult um or this has nothing to do with private billing U but I will will'll show you the Grease Monkey elements and the main reason for doing this is we are generally moving towards this new form of billing where we're not doing feif for service if you're still doing that good on you there must be you know very polyal reasons it maybe because you're still doing a a niche uh element of Family Practice like obstetrics or Residential Care um but by and large community care has shifted either to a new to practice salary model or the lfp model and to make it easier um I think you really do need to set up a a good billing page um the problem is WCB and ICBC are still based on feif for service codes for now uh it gets pretty complicated and you need to pay attention to those otherwise they get rejected claims here's an example that everyone should know if you have been billing in the feif for service world this was set up for you likely by whoever your OSP is it's the standard you know GP billing page it's got the age related office visit codes it's got number of codes in the second column that are usually procedural codes and various other things some of it customizable some of it is not so this basically describes what I've just shown you I won't go into that and for some reason we all seem to have this anesthesia billing sheet as well so whoever made this kept this in the default version uh don't do anesthesia so I've never had to look at it there's an obstetrics one you can create um I created one for long-term care um because there's a select number of codes that we use consistently and frequently um so I don't do la care now but at the time that was helpful we also have other providers in our office we have a nurse who builds under a nursing fee code which is mostly Shadow billing they have a lot of complex codes and we created one for them um so if you have Li professionals who need to Shadow bill you might as well create a billing code to make life easier for them a billing page and make it easier for them we have looms fortunately and they can build under our lfp slightly different set of codes you can see there are very few and they simplified it it's a again a blessing and a curse and um here is how I uh created my lfp code just to give you brief overview I've circled the time so that's critical for building your time star and end time um there's only about um about a dozen codes that you really need to know uh on the left hand I kept with the uh visit codes uh on the middle column it's the U procedure codes and on the right column it's the time codes okay so that's basically what I've just described for you now notice maybe I'll just go back one um there is no code here that's fitting for WCB and ICBC for that you have to flip to your old feif for service codes um and Bill it that way um so so just keep that in mind for a detailed reference on billing go you can go to the BC family doctor's website and it'll kind of tell you it's a really well laid out site so here's my Shameless plug to join the family doctor BC if you haven't already already joined so to create a new billing form it's an administrative Duty so you need to go to admin I'm going to run through this fairly quickly and then I'm going to do it as a demo um you need admin privileges obviously um you would go into the manage billing form area and just create a billing page you can see all your billing Pages here and then I'll show you in a moment where the easy parts are and where the dangerous parts are and again this is for reference I'm going to change my um page I'm going to stop the PowerPoint just for a moment and then move on now I hope you can see this this is my um pretend day sheet for the weekend I put in lfp time for a reason I'll show you in a second can everyone see that I hope that worked Jo okay perfect thank you so um if you are on um well system you'll see this looks quite familiar here's the administration area I zoomed in so it's big enough so hopefully you can see um you go into billing you're going to manage your billing form and then you can choose whether it's diagnostic codes which is somewhat useful but most useful is your service code you have to check this first and for whatever reason the default is general practice and that would be the old Fe for service general practice codes just to have a quick peek I'll go to that and you'll see a bunch of numbers left column these are your office visits right column U these are your others and then the middle column are complex care and various other things okay let me just go back if I can oh yeah that to this um if you want to create a new uh uh form this is where you do it you add a new form if you do so you have to click service code first start from here go from left to right you will get this now this is where the danger can arise all these um abbreviations here these two and three letter codes are specific IDs for your forms that are already exist and obviously whoever made them created you know somewhat relevant abbreviations a for anesthesia here you see LTC for longterm care and so on and so forth it goes all the way down um the reason there are so so so many entries is every time you create a change it likely keeps um an audit Trail for you what I learned by mistake is if you delete one of them you delete all of them so that's one of the dangerous caution stay away from this hyperlink to create a new um form you have to create a unique ID uh two three potentially four letters it looks like and can get away with three create a three-letter ID code that's distinct from anything that already exists give it a relevant name this can be OB obstetric which sounds a bit redundant but I see there's anesthesia with a typo I'm not even going to try and correct it because it'll probably ruin it um and I don't go there anyways but give it some thought make it relevant such as well I was on on contract at one time so we had contract founding physician here's all the private stuff that was the original general practice I created a test one there's my lfp lfp locom if you're fortunate to get looms and nowadays it's actually not so bad these are the colum names you can you can customize them to you know office or uh procedures and uh time codes so once You' got a unique ID and a proper name you can add the form and it will appear but it will be blank you need to populate it okay so I'm going to get away from this for now and go back way down here and just briefly go back to my PowerPoint here so I jumped ahead we did all of this stuff already and please um speak up put your hand up if I've lost it at any point okay and these are all the helpful hints and tricks and things to be aware of there's the names again beware beware beware okay these are hyperlink you can delete them but you'll never get it back here's a a hint you can use my PowerPoint as a reference to how you might want your code to look like or you can create one on a spreadsheet and just put in the codes in the order that you prefer and you can actually um change the order if you wish after the fact and I'll show you how so when I created the lfp code originally this is what I use lfp lfp care codes procedures and time codes I click add and then it appeared um in the actual billing page uh if it's selected that's what you would see initially basically nothing and the reason there's nothing there is I didn't put any codes yet you actually have to add the codes and this is what you will see initially when you go to that page and if you're actually doing this along the way you'll know what I mean I did name the care codes the procedure codes and time codes in the columns this is where you start adding your codes and you have to know what they are so use the you know BC family do reference so this could be your office visit code like that or this could be your um what's the next a virtual code um um a group visit code or a some other code um so again use your reference now in the next column to the right of your actual Fe code are are these numbers which basically position the codes from top to bottom number one is at the top number four at the bottom here you can see if you wanted to force a code number to go to the very bottom you give it a high number and if you were keeping track there's 20 uh rows you can use so you can add 20 codes uh which is the limit if you have a lot of you know unique codes for example the nurses and practice they have hundreds of codes um fortunately we only have a handful here okay so once you put the codes in they have to exist if they don't exist in your system putting them in will get you nowhere um generally they are numerical if you have two codes with the number one it will sort in the number based on the left column basically okay um but in general you can add for example if you wanted um 0 9800 code 980000 and you wanted it to be at the top you give it a number one and it would be above this 31 code okay so I hope that's pretty uh simple to understand once those numbers are in this is what you see this is what you want to see okay and and these are the descriptions that are provided by MSP uh and some of them are good like this is an inperson Clinic visit but this is an interaction with Advanced procedure what's an advanced procedure you can use your handy dandy reference from the family dser BC or you can use Grease Monkey okay so how would Grease Monkey look Let's uh leave this for a moment and go to I thought I put in a patient here I'll put in a patient my test patient set this spell it right so this is for a feeling form webinar perfect okay so I've set my uh preference to always lfp it always chooses my name it always chooses lfp and here are the codes that I added and I added a recent one um uh since the uh PowerPoint I added lfp consultation it turns out that one of my partners do consults for IMS work um here are the procedure codes and what's an advanced procedure well this is where greas mil key comes in an advanced procedure could be inserting IUD or uh doing a joint injection or doing a skin exision now you may not be able to see this a little popup that describes 9302 is a biopsy exision suturing foreign body removal I oh I's in there twice it does not allow you to build a visit code if you build this procedures that and nothing else same with if you do a p no visit code is allowed so if I was doing a Pap today for example I just click that and it pre-populates with the diagnostic code that's what gree monkey can do you can do some of this within Oscar with the basics but you will not get the reminder that one of these is a papsmear um and that's because they recycled codes which is a blessing because it's fewer codes but it's a curse unless you know which codes they are here are the time codes when I click I'm going to build for my direct time this lights up my start and end time I know I have to fill this in it's not built in to Oscar that you must apply a Time code it can be um but the powers that be haven't really put that in and that's not within your control or my control um so it has to be from the programmers there are certain codes from back in the FIFA service dates um like uh counseling codes where you have to put in a time or those complex care fee codes I think that required a time but not here um and this is those diagnostic codes remember there was the Fe codes and diagnostic codes if you wanted to add extra diagnostic codes to remind you that's where they end up so some people find that helpful um I actually do because there's certain codes I always look up and if you're agonized over and you're always looking up you might as well park it there for easy reference that's where it say resides these are codes that have been build previously so they always show up than anyone you build for so this is basically how the um lfp Fe code should look if I was billing WCB I would have to switch this lfp to general practice and then switch this to well WCB and go from there um this is not the best example because you probably billing through the billing form or WCB form and maybe a better example is if you're billing ICBC and then you would use these um fee codes of necessary or more likely billing a CL 489 which in this case is actually a private code so the c489 stuff is all here so it isn't difficult to create that billing page it's highly desirable to do so so you're not always flipping back and forth if you um have some way of reminding yourself easily what all the procedure codes mean great um but I can't remember all of that and I basically use Grease Monkey all the time and I bill using this code um these things here just disappeared for a second Let me refresh ah it's on private there we go I build here instead of clicking here it's just that much easier I did uh um build something recently that uh I hadn't build before um it's kind of sad because it was a made fee code so in order to add that into my billing code uh billing page rather I'm just going to do it now for you manage billing fee it's a service code and for the time being I'm going to put it in lfp and I'll add it here it was a 15 uh oh 301 I hope that's it it's number seven let's see if this works didn't like it oh sorry didn't do it right 15301 seven I have to update update is down here so if this indeed worked ah sorry I forgot the code it's not 15301 um this is indeed one of the old Fe codes for uh building a complete physical from somebody age 50 to 59 it's as easy as that and if you wanted this number to be at the top instead of making it a a seven you would make it a a one so you can adjust the order if you wish ah missed it by one it is in the second position um I guess that one squatted on it I'll remove that later so my partners don't get confused okay so I'm just going to switch back here to my PowerPoint so um are there any questions um so far Joel no we don't have appear to have any questions okay um either I've lost you or this is all too simple um this is additional to the billing page this is how you may want to set up your different accounts I hope that you all have access to this edit billing preference it certainly is available in Oscar from well I hope it's open available in open and all the others and Juno but I can't make any promises I'm not as familiar with those so the set billing form preference leads you to this page this is the page where I can set for myself lfp is my goto default form and the default billing provider is me the location of this is this the default pay is for third party Billings actually so that you know it shows up like this in your invoices um we set diagnostic uh codes with three options because I like to put as many ic9 codes as possible that helps um calculate complexity our Clinic default is to set it at three I don't claim GST so I leave that blank so why is this important um if you have a locom you would change this to your lfp locom form once you created course when you Bill from say a lab going to the Chart then going to billing um it may not select you as the default provider it's usually set to null or nil and you have to select it yourself each and every time so it's a bit of pain in the butt um by setting it here it's always going to be you I have residents that I teach and the higher level residents do billing on my behalf so they said it to me and see Bill on my behalf unless they're working with somebody else then they switch it to the other um preceptor so that's the point of this page um so change it for locom for your residents for your nurses or Alli professionals who work with you um and um the default pays indeed for your private Billings um here's an example of me sending it for myself and oh so this is also related but totally different and that is um your provider list tends to have a lot of names every locom that you've ever had like he is still in there unless you um deactivate them and do some other Shenanigans one thing you don't want to do and this goes across the barard so please listen do not delete an account even if you know that physician that nurse that Mo MOA will never ever set foot in your office this again they may have retired expired whatever do not delete an account the reason being any work that they do on their account is saved with their name and that name is attached to the account if you delete it the name disappears and that's not a good thing so please don't do that you can't retrieve it it's one of those do not do things okay um however if you don't want a account to appear on your billing page you have to demote that doctor to a receptionist or some other status that will take them off that list um so you may want to do that for looms that no longer are looms maybe they are um you know they've got their own practice going and such okay um this is where you can set this is uh an example from within uh op um no well health um the default um diagnostic code settings to three options I think originally it was just one but it makes sense to put as much detail into your diagnostic codes as possible uh in an lfp and a UT practice um payment schema you are um your patient roster your population will um be judged based on complexity and there are bonuses for the higher complexity uh practices so so make sure you uh put in the relevant diagnostical and uh you have to click save all right you can indeed link up diagnostic codes with service codes we used to do this all the time in uh FIFA service where as you can see here a 14560 papsmear is linked with diagnostic code v762 which for a decade or so I use the wrong code apparently this is the right code well now you can substitute 14560 for whatever the lfp code is okay it's probably down here somewhere so you can do that um it is um just quickly I'll show you where it's under billing and under manage service and diagnostic code associations so there's that original one the very first one the papsmear one but all the newer ones are down here and you can see 98010 is an l23 that's your um time codes for lfp and this is probably your indirect time this is probably admin time so you can add all those um unique codes that have to have that um diagnostic code uh at this point okay so that's pretty straightforward and anyone should be able to do that does not require um Grease Monkey um make sure to uh save it once you're done um and indeed this is Grease Monkey I've already demoed it um Grease Monkey is just something I cannot live without uh it requires some expertise it requires some customization mine works in well it may not work in open it may not work in Juno um M and and other versions of Oscar uh in which case you'll need to tap somebody with programming um chops to uh help you figure that out if it's that important to you um oh yeah this is the PowerPoint I recycled from um the summer at Oscar conon this is without grease monkey and you can see it's really bare and I'm kind of lost without my um Grease Monkey hints and that's pretty much it for the PowerPoint and my presentation and demos I'm more than happy to uh you know field questions uh based on this or anything else for that matter because I think we have the time so let me just stop screen share for the time being here we go uh we do have time that was uh you ran right through that and apparently you're so good John that nobody has any questions today but please unmute yourself and chime in if you do have questions um okay we have one from Norma is there a way to edit the pay name in my preferences in your preferences uh absolutely um let me uh cue this up first I I'll get to my screen in just a second so where's preferences oh why don't I do it now so here's my uh schedule page um and here's preferences um then there's the billing preferences here the problem is these are based on how you make your account so if you change the name in your account that's not deleting it your account is tied to your provider number that's the critical thing uh my provider number is for example 100 if I change it to you know Joe Smith uh my name then all my signed notes will now see Joe Smith that's not something you want to do and if I deleted it complete that's even a bigger disaster so the names will be whatever is here on the list these are all the providers some of whom no longer work with us so it obviously needs some uh housekeeping so yes and no um You Can't customize it here like if I change this to um it changes here it's it's kind of set so I'm not going to save this so it won't uh change anything for me so it's not an ideal solution it'd be nice if you can completely customize it but you can't for this purpose for you though she has a an addition to that we have to use a different name um than our actual Clinic name and I'm not sure if you want to unmute and explain anything there nor yeah go ahead oh hi I'm just gonna kill my presentation there yeah can you hear me so because um we are only a part of a larger organization and if checks have to come so if we're doing a private building then we have to tell them to make the checkout to PHS Community Services rather than PHS Healthcare which is our medical Branch otherwise they can't deposit the check uh that's a bit of a Sticky Wicket there um let me see what you might be able to do um in a private billing because there's so many settings here that like there's no Rhyme or Reason to it it it's not alphabetical it's not organized into groups it's really quite yeah terrible dogs breakfast um let's see find billing edit diagn code edit billing preferences oh there's only those those too um uh I would say I've never had to do that um the way you describe um I think we you'd have to create a an account almost and build it on that account um and and that's reasonable you can build as many accounts as you want but depending on who your provider is um um for private Billings right you're you're referencing private Billings yes that's right why didn't you create a dummy account for private Billings the reason I kind of hesitated from is in order to send a tele a plan you need a billing number and all the other things and some of the osps will basically um charge you for being an extra you know user yes they will but you can create as many non billing non MSP billing okay you want um and you can you know create it that way do it that way okay that's an interesting thank you yeah so so you know how to create an account right that's not yeah that's great put in all the particulars the exact wording that you wish and okay that's a great idea thank you that be very clever I know I've tried lots of different solutions yeah thank you all right any other questions I I think for most users creating a locom one and um uh lfp one would be ideal I'm also working with PSB a fair bit with new to practice Physicians so they would have a new to practice set of codes which is a um somewhat well quite different really um one of our physicians recently transitioned from ntp to um um lfp so he was contract here and he's building these unusual codes um and you know again having um Grease Monkey helped and he was a very clever guy programming Grease Monkey so he made it easier for himself okay I have another question here for you um how to bill only for injection at $10 gets Rejection it will be if you only Bill for injection so you have to describe what are the circumstance is that you were able to inject that patient without seeing them in their office that's point so Tira you have to bill an office visit if you give an injection if you don't see them in the office how possibly just like a lab you cannot just have a patient drop off a you're in s so you can dip it and build for it okay so the the BC family doctor guide to lfp Billings specific states there are certain codes that must accompany other codes an injection code must accompany a visit code so you get $25 plus the $10 but if you only build the injection code without the visit code it will be rejected now if you're having a nurse do it that's a different story Sor nurses can Bill certain things but under lfp it's different um our nurses can give injections they build for it as a shadow billing they're paid by the health authority is a very unique situation we have we as Physicians even though they use our supply our space and everything cannot build for that if we see the patient for something else and and uh you know provide medical services in that regard yes we build for that visit but not for that injection so basically arners does most of our vaccines nowadays and uh our um B12 shots testosterone shots Etc so if she does it I don't build for it if I have to see them refill the prescriptions or anything I build for it does that make sense oh and Norma says there is a code for a nurse the bill an injection but beware the nurse can bill on the Clinic's behalf for the clinic if you are paying that nurse in our Clinic we don't pay the nurse the health authority does so we cannot recoup those costs because it's not really costing us so the question that Norma is for clarification how do you do Shadow billing or Nur oh well am I still screen sharing here I'll show you our our um nurse's uh code so they basically will see the patient nurse in practice visit an office age appropriate and there's a ton of them um basically they bill it and send it to telep plant and they're doing it to track their activities and you see they're all zero dollar codes they're they're not getting paid through teleplan but um the Auditors the people who monitor their this particular program are tracking to see if they're actually doing things and how they track it well new to practice Physicians build this way too they're they're billing the hours and not you know the services so all my codes when I was on in uh group practice rather we zero dollar vales it was kind of depressing seeing that but then you know the hourly rates are up so bad soor yeah there's a comment tried billing zar for visit and then build for injection it was paid so yeah but why bother if if you're a physician and you're U seeing the patient and giving them B12 shot flu shot or whatever I mean $10 for a flu shot is way better than what we were getting previously which was basically nothing for the most part any other questions yes Danel hello again Dr yep nice to see you again I have a question not related to beinging um some doctors complain the standardized uh flow sheet is to know uh rather than creating a new flow sheet do you have any suggesting to customize those flow sheet or make it shorter so um Oscar when it was built was built for team based care um in Ontario and and I guess you know 20 years ago it served as purposes a lot of different providers there um and the flow sheet you're likely referring to if I can use my test Andy again are the chronic disease management flow sheets in this case they are under measurements for example there's an asthma flow sheet I've never actually used it because they never liked any of their flow sheets somebody created various measurements like asthma limits physical activity and decided that you know you can put a comment by clicking on this and adding a comment but yes or no or not applicable it's very vague you know um so for that reason Al never liked it somewhere along the line somebody thought it'd be very nice to be able to customize it so they came out with this new thing that is in every chart CDM indicators chronic disease management indicators which is actually quite misleading and sorry this is not a billing page talk anymore this is a critique of somebody who had a great idea but didn't complete it so any physician out there will recognize that these are all diabetes indicators k1c insulin blah blah blah and so on so forth you know ACE inhibitors and such and this basically is a new way of presenting the old diabetes flow sheet which looks like yeah this which is ugly a sin and there's no Rhyme or Reason or order other than red means is like at a date which yeah hasn't been checked in 85 months okay so um can you customize this the intention was yes the actual execution is no and would you like to make your own um I've heard people try and I never hear from them again okay yeah we try to make a customized uh flow sheet but I I just wonder is there a so I I wouldn't I really wouldn't um I'll tell you what we did instead um because Oscar users are very very clever um this is back in the day when we had complex care complex care plan oops there's a full and a light and this came from uh chillak I'll give credit for credit is due the group uh in chillak created this very complicated and um very useful form back in the day if you chose Asthma as your condition it populated with treatment targets and goals and somebody put some into it in terms of orders and whatnot give some free space you can type things in and you would go back to this you wouldn't do this all in one go around you you chip away at it you do a little bit here a little bit there the problem is and this is the you know the the downfall of doing complex care when there's more than one condition is some of these conditions overlap and basically conflict um and to try and meet all the these goals makes it near impossible yeah so um yeah flow sheets are great if you have one condition and only one condition and you're good at just reading questions and putting in yes no answers I think as Physicians we have to give it a bit more thought and prioritize based on what the patients needs are and what they wish to address um to create a simpler version and you see we needed time based um things here um you know this would pre-populate with things and we would again go through the care plan and this became a more patient Centric uh option they wanted to you know lose some weight well how much weight and so on so forth and then we can have those discussions and so this could be pasted into the chart once you type in the information and then it would be part of your progress notes but now with basically l P there's no need to document it this way you still need to document don't get me wrong put in the progress notes yes thank you yeah and there's one other thing that was um asked actually it wasn't that long ago it was the diabetes let me see if I can find it diabetes tool see if this is it no um so if you didn't know already I created a lot of um eform content and there's so many with similar names that I actually get lost in the shule um so it's not here name ah diabetes advisor advisors are always helpful uh this came from the clean diabetes website and at the physician level where you can add and and this is specific for diabetes you can do this you can create your own I suppose for heart failure and and and uh whatever you wish if there's guidelines available where would populate and you would basically pick a day and start you know putting the things that you felt were helpful and just work your way down all the referen are on the sideline and so forth if cardiovascular cardiovascular risk tools it probably goes to wait for it oh boy this is slow oh it it goes to a website that's why the guidelines oh my goodness it may be a dead link try something else this one okay I personally don't use this because I pick and choose only a select set of items and I'm doing Qi project I'll focus on that for example you know sadman rules um here um it's actually addressed here um for sick day um sick day guidelines and there's this really nice e form for sad minals we're getting a little off topic here it's no longer but you know I think uh if you want to do um complex care well you have to have a game plan in mind these are good references but you know do you want to fill in fields for the sake of filling felds or do you want to you know deal with what the patient feels is important match with what you feel is important hopefully you'll come to some mutual agreement as to you know what direction to head in because you couldn't possibly check every box in that complex it's just too many boxes any other questions thank you Dr yep you're welcome thank you Dan uh no I that seems like it's it for questions tonight so all right so I want thank you all for uh um joining me and listening yet again to my talk I hope that was helpful um if you have any suggestions for other topics please um you know um send a note to um Oscar BC and and and Daniel already knows is I love teaching I teach medical students I teach residents I teach other Physicians I you know it's just what I do teach patients actually that's what we all do as Physicians okay thank you everybody for joining us have a great night and take care take care bye everyone okay bye bye