Health Insurance, How to Charge No Show, Do You Need Another LLC, and Questions About Killin’It Camp | PoP 352

Health Insurance, How to Charge No Show, Do You Need Another LLC, and Questions About Killin'It Camp

Ever wondered about working for yourself but not sure whether it would be worth losing your benefits from your full time job? Are you looking to venture into consulting but don’t know if you need to have a second business registered? How do you charge no shows?

In this podcast episode, Joe Sanok addresses some questions about health insurance, how to charge no shows, whether you need an LLC and some questions about Killin’It Camp.

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In This Podcast

Summary

In this podcast episode, Joe Sanok does a Q&A and answers some of our listeners questions.

Question 1

I just started an online private practice and I also work full time. In an ideal world I would double my salary, hit the 6 figure mark and be able to work from home 3 days a week. I have 3 auto immune diseases so I do need to take my health into consideration when planning my future. Having more flexibility and fewer hours would be better for me in the long run, but I worry about medical and disability insurance. Is it safer for me to stay with my employer or eventually break off fully on my own?

Answer

In most cases if you’re growing a practice, you can write off the health insurance as a business expense. You do have to dig deeper into this though with your own accountant/attorney. For life insurance you also typically want to look at term life insurance.

Question 2

How do you charge no shows?

Answer

There does have to be some flexibility, within reason. If someone however is cancelling all the time you will pick up on this and then of course you can charge them. For me, what I do is that I charge my full fee rate for no shows and late cancellations, I don’t keep a card on file. But in the next session someone needs to pay for that previous session as well as their current session. If they don’t do this then they don’t get to reschedule.

Question 3

Do I need to start a separate business from my counseling business? I am also wondering about liability insurance and specialized training when providing consulting to new counselors.

Answer

Firstly you should definitely consult with you attorney and accountant. But in my experience I have not had to set up a separate business. You will however need to consider certain things with your liability – I have my liability insurance with HPSO, they have an add on for consulting. This costs around $25 a year. You should also have a good idea of how much money is coming in, to be able to know the ROI with your consulting VS your practice so that you can identify the potential.

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Killin’It Camp

Read more about this Killin’It Camp here and Register here to attend!

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Meet Joe Sanok

private practice consultant

Joe Sanok helps counselors to create thriving practices that are the envy of other counselors. He has helped counselors to grow their businesses by 50-500% and is proud of all the private practice owners that are growing their income, influence, and impact on the world. Click here to explore consulting with Joe.

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Podcast Transcription

Joe Sanok: Everyone loves payday, but loving a payroll provider? That’s a little weird. Still, private practices across the country love running payroll with Gusto. Gusto automatically files and pays your taxes. It’s super easy to use and you can add benefits and HR support to help you take care of your team and make your private practice safe. It’s loyal, it’s modern. You might fall in love yourself. Listeners get three months free when they run their first payroll. Try a demo and test it out over at gusto.com/Joe. That’s gusto.com/Joe. This is the Practice of the Practice podcast with Joe Sanok. Session number 352. Welcome to the Practice of the Practice podcast. I am so glad you’re here. We’ve got so many things that are going on. No matter what your phase of practice is, you know, we just launched our, was it seventh, eighth cohort of Next Level Practice, which got, so I think 40 or 50 people joined that. So, they’re kicking things off and we’ve got some surprises. We’re going to be mailing them and it’s so fun. We started doing this thing in Zoom called What’s Working where everybody comes together. So, we have 20 or 30 people that come and then I can break them up into small groups. And so, they’ll break up into groups of three or four and I’ll kind of float between the groups and we’ll talk about marketing, we’ll talk about private practice, we’ll talk about what’s working with launching. And it’s been so fun to kind of have this small group connections, and in each time I do it, it’s like random. And so, they don’t know who they’re going to be with and it’s just really fun to watch and this group’s going to be getting their logo pretty soon and people are just getting more clients and feel like they’re really growing their practices, which is really fun. And I also just launched these mastermind groups specifically for people that are growing big ideas, so podcasts and, you know, like e-courses and public speaking and consulting, those things that it’s like, you know, you’re in a counseling practice and you’re talking to someone, you’re like, “Man, the world should hear this.” And so, those things are things that are just lots of fun to be launching into hearing people’s big ideas. If you do want to be in the next cohort for Next Level Practice, head on over to practiceofthepractice.com/invite. And if you want to apply for one of the eight spots for the big ideas … but the big idea is when you can read more about it and see a video that I did over a practiceofthepractice.com/ideas. As you might hear my voice feeling not so great, my wife Christina, she went down to Florida for a long weekend with friends. So, last weekend I was with the girls. I’m actually recording this just a couple of days before this goes live. Was on daddy duty and batch-recorded all of January before I left on vacation but haven’t been able to get to do the podcast. Kind of playing a little catch up here. But it was on daddy duty and my wife came home sick from Florida and I got sick from something else. I hope we don’t swap the sickness between us, but yeah. All right. So, that’s where we’re at. Today I’m super excited about this episode. It’s a little different than normal. I get emails all the time from people with questions and, one question hit me recently and I asked the person if I could ask you on air and I’m not going to give her full name because of kind of the sensitivity of it. But then a couple of people have also left voicemails. And so, if you ever have a question that you want me to air on the podcast, I would love to do more of these kinds of Q & A questions on the podcast. You can go to practiceofthepractice.com/voicemail. And all you need is a microphone, your headphones, you could just use your regular phone. Just say your name, where you’re at, and your question. We use a thing called SpeakPipe to do that and then it sends me an MP3 and then I can just drop that right in here. So, we’re going to have a couple of those questions that I’m going to answer as well. And yeah, it’s going to be a little Q & A. I’m also going to share about Killin’It Camp with you, and kind of what that looks like. And we’re launching those tickets right now and we’re going to be doing a Q & A. Actually, this goes live on Tuesday. Tomorrow we’re going to have a Q & A all about Killin’It Camp. It’s on the main page of Practice of the Practice. If you’re just wondering about it after you hear kind of what I have to say about Killin’It Camp and you’re like, “Maybe I want to go, maybe I don’t ask some questions.” We’d love for you to come to that meeting and it’s going to be online, it’s going to be awesome. So, let me read this first question to you. So, Alyssa says, “I met LMHC in Florida and I just started an online private practice in August. I’m thinking about my future and what I would like in my career. I also work full time as a school counselor his time and enjoy my fulltime job. In an ideal world though, I would make double my salary and hit the six-figure mark and be able to work from home three days a week. I have three autoimmune diseases and I’m 28 years old. Although I have been relatively healthy in the past year or so, I became very sick in 2016. So, I do need to take my health into consideration when planning my future. Having more flexibility and fewer work hours were probably be healthier for me in the long run. On the other hand, I worry about medical insurance and disability insurance. I have medical insurance as totally paid for from my employer right now, but I should be able to jump on my husband’s plan if I was fully self-employed. Have you ever considered doing a podcast or webinar for clinicians that details how medical disability, life insurance work comes into private practice or have you already done one? I’d really appreciate your input on this matter. I’m scared about this, but also, and about it if it’s safer for me to stay with my employer or eventually break off fully on my own and do my private practice. With benefits, my salary now is about $53,000. And without benefits, just salary, it’s about 43. I’m a loyal listener of your podcast and love all your materials. Thank you so much for the work you’re doing in our field. Wow. You know, I think one thing that this brings up for me is just how when people say that they want to make money, there’s always a story behind it. There’s always a why. That is awesome, you know, to be dealing with this sort of stuff. It’s tough, you know. It’s tough and it’s a big decision. And I remember in 2012, and some of you may know this about me, that’s when I was working full time at the community college here, great counseling position, one of the higher paid kind of positions. I want to say I was making 50 or $60,000 a year, had my private practice on the side and the evenings and had just launched Practice of the Practice, sort of as an idea of, you know, maybe this thing could take off. Maybe this could be my primary income someday. I was really inspired by Pat Flynn and other online people that were doing really ethical but good marketing work. But that year 2012, that’s when my daughter had heart surgery. I had cancer that year. My wife had a miscarriage, one of our friends had breast cancer. My mom was recovering from cancer. So, it was just like a year from hell. And at that time, I was just like, you know, I have to have this insurance. I have to have it. And you know, in retrospect, I did need health insurance, but I didn’t have to have it through there. And I’m glad that I took my time and leaving. I felt really good about when I did leave, but I do think I could have done it sooner. Right now, the way health insurance is in the United States for someone that doesn’t have, you know, a husband like, you know, our question has, if you don’t have the option, when you really look at it for yourself or for your family, you’re going to pay probably somewhere between 500 and a thousand dollars. If you don’t qualify for any deductions or any kind of assistance. And who knows how that will change in the future, who knows how that will change with the next presidents and all of that, whether that will be taken away or preexisting conditions or all of those kinds of things. We just don’t know and so, in some sense it’s safer for that $10,000 a year that you’re getting in benefits. But when you really break it down, so, if we use the calculator and actually like break that down. So, let’s say $10,000 per year, and we’re going to divide that by 48 weeks of work. And we’re going to divide that by, well, let’s say you do 15 sessions a week, so you’re not even full time. That’s going to be about $13.89 cents per session that needs to go towards your health insurance to reimburse yourself for that now. And that’s working 15 hours a week. So, in most cases, if you’re growing a practice, that health insurance side that you can then write off as a business expense also. It hardly even touches the overall budget. When I think about the potential for a practice, I mean, let’s just say you’re at 22 sessions a week and you’re just charging like a hundred bucks a session. You work 48 weeks a year, you’re at $105,000. And so, if we multiply that, maybe let’s take out, you know, all of your expenses, your taxes. So, let’s say we see your take home is 60% of that. All right? We’re $63,000 per year, and you’re working less. And so, and also you have scalability with your practice. So, back to the question really, what is it like in regards to medical disability, life insurance? There’s a couple of things that I’ve picked up on from, whether it’s Dave Ramsey or other people’s work, my own insurance person. You really want to do your own kind of work around these different benefits, in regards to just kind of learning about them. But here’s what I’ve learned. Talk to your own attorney, your own accountant. But in regards to retirement planning, what I’ve picked up on is that having a Roth IRA, maxing that out with my wife and myself is really important. That’s a great tax deduction and then that money’s growing. When you use a savings calculator to see how fast that money compounds, it’s really important to be putting money in early. And Tony Robbins, he actually has a podcast called Unshakable. That’s, I think a seven- or eight-part podcast talking all about how many fees are often taken out. And so, if you want to go with a low-cost kind of fund, Vanguard’s a great one. Of course, consult your own financial adviser and such. But Tony Robbins in that podcast talks about how for every percent that you lose, on like, you know, fees that’s about 10 years of income when you retire. You know, life insurance, typically you want to have term life insurance and so term is going to stay so for the next, you know, 20, 30 years, while I’m an adult or not an adult, I hope I’m an adult after that, while I am a parent, you know, to just protect my kids during that time, that if something happens that there’ll be the finances for their caregivers to take care of them if I pass. All right. And then with medical, I always kind of run all those numbers to see if it’s better to do a high deductible or a low deductible. And for me and for our family, usually a high deductible plan that’s less per month, but then ends up being a lot more when you’re paying out of pocket. So, that’s how I would answer that question. All right, let’s listen to another question. Katie Ziskind: Hi Nate. This is Katie Ziskind from Wisdom Within Counseling. I’m in Niantic, Connecticut so, we could say a beachy town. I have a question. You can totally use this. You’re welcome to use my name. I have a private practice. Do you see, middle schoolers, high schoolers, I do a lot with like our yoga and music therapy. So, I consider myself an experiential therapist. My question is regarding a late cancellation fee or no-show fee. So, I know it’s important to set boundaries, and my time’s valuable and part of it is me believing that and really upholding that boundary. But do you ever, what is your hour late show fee? Do you automatically hold a card on file and charge that or do you kind of discuss that with them the next session? How many late no-shows do allow, like do you allow two and then you’ll just totally discharge them and don’t give them another chance or like how, what is your type of, if you could talk to like, how long do you work with a parent like with their teenager in therapy? Like, you know, I don’t want to get too sucked into the cycle, but I also want to uphold like, I was thinking a $60 fee, but like do you ever not charge that if someone has a baby or like their parent dies? Like when do you do that? Joe: Oh my gosh, I love this question because I feel like no-show and late cancellation fees represent so much more about how someone thinks about their time and thinks about their business and also pushes back on a lot of what we learned in grad school. You know, in grad school you hear, yeah, you should charge, you know, a $30 cancellation fee or something like that. But here’s what I recommend. And ultimately, it’s your business. You can do what you want, what you feel good about. I first start with the fact that, you know, I’m a parent. I’m someone that has things come up, so we do need to have some flexibility with it. So, for example, if someone gets in a car accident or if they find out their kid’s sick or they’re sick, like I don’t want you to come into my office if you had the flu because you want to save the money. So, there does need to be some element of being reasonable with us. With that said, you know, if you see someone that’s perpetually, you know, not showing up, “I’m sick again,” you’re going to pick up on that. So, what’s the format that I use? Well, I charge my full fee rate for no-shows and late cancellations. That’s why I have such a low no-show rate. But I do charge people for that. To the question, do I keep a card on file? I don’t, but someone needs to in the next session, they need to pay for that previous session as well as their current session. And if they don’t do that then they don’t get to reschedule with me. So, the idea that someone’s going to have two or three no-show rates that they haven’t paid for or two or three sessions at the end of every session people need to pay for their counseling or pay their deductible or you know if you’re taking insurance. And then if they no-show it’s great because then I’m making my hourly either way. You know I can do a blog post and feel like all right I made this or if it’s my last client I get to go home. I would just keep charging people for that. And if they’re paying, you know, I’ve had people that every other session they no-showed but they really needed it to be in counseling. So, the idea of me then deciding okay you need to leave counseling because you keep no-showing, you keep getting this mixed up, and we can’t figure out why your calendar won’t work. To me, they’re coming to counseling still. They’re getting benefits out of it and if they choose to pay twice as much because they no-show every other session, I’m not going to discharge them for that. But I think that when it comes in is when people are not following through on their no-show rate. I’ve had people that, I said to them, because they had no-shows so frequently that they actually had to prepay this session ahead of time in order to come in because, you know, I didn’t want to black out that spot. It was more of I didn’t want to give up the spot for someone that I knew for sure would come, more than I cared about the money. So, you can send a link to someone using PayPal. So, for example, like practiceofthepractice.com/payment. I have that, just go to a PayPal button where someone can enter the amount in and then it goes through and then it’s like, ‘Okay, there’s the money.’ And so, you can do these things so that people pay each time, they don’t kind of have a debt or a running debt and that there’s a 24-hour cancellation time. I mean, if it’s like 23 hours or you know, they thought they were going to be, you know, coming in at two and the day before they call it three. I mean, if it’s close, I really look at the intent. If it’s the day of, I say, you know, I could have filled this spot if I had known this yesterday. So, unfortunately, I do need to charge you. Or you know, I do need, for your son, to charge him for that late cancellation. And sometimes what happens then is, magically they make it work. Okay, well if I’m going to pay that $250 for that session or that $95. I’m going to rearrange things. So, then that crisis that happens inside of them of having to rearrange things because they didn’t want to drop that full fee, they then for one make therapy a priority. But two, they remember how much they had to scramble to find childcare. They remember what it was like to miss half a session when I called them, you know, 15 minutes, but they paid the full fee amount. Then they don’t, no-show or they remember to cancel within 24 hours. So, that’s what I would recommend. All right, let’s take this next question. Brianna Willie: Hi Joe, this is Brianna Willie. I am wondering, do I need to start a separate business from my counseling business? I’m also wondering about liability insurance and specialized training and providing consulting to new counselors. Thank you so much and thank you for everything you provide. Joe: Brianna, that’s such a great question. And, yeah, I love that you’re thinking through that because we want to set up our businesses correctly, want to reduce our liability. But let me start with it. I’m not an attorney, I’m not an accountant, so you definitely want to consult with your own in your state to make sure there’s not any overlap. But in my experience in meeting with my accountant and meeting with my attorney, they have not had me set up a separate business because consulting is so close to counseling in a number of ways. And in Michigan, APLLC, it’s fine to do that under. So, a couple of things though that you want to consider with your liability. So, HPOS, that’s who I have my liability insurance through, they have an add on for consulting, it’s like $25 a year or something like that. It’s for teaching and consulting. So, if you’re doing any teaching or any consulting, I’d say it’s probably worth it to have it. Even if someone reads a social media post wrong, that you’re just covered for that. So, definitely sign up for that through your liability insurance. Also, you kind of want to have an idea of kind of how much money’s coming in. And so, to be able to know how much your consulting is bringing in versus your practice, to be able to look at the ROI for your time, so, if for every hour you do consulting, you’re making $500 an hour versus $94 an hour and you’re in your counseling, well that’s a big difference. And we’d want to be able to say, “Well, how do we amplify that?” Whereas if, you know, to put together a proposal or a speech or whatever it is you’re consulting on, you end up making $17 an hour. Yeah. There might be times when you say it’s worth that extra hustle. I have the time and I really see the potential here. And you know, early on in Practice of the Practice for me, I didn’t make a dime, but I saw the potential there. I saw that there something could really be grown that helps the private practice community. So, you want to kind of weigh all that out. And also, I’d look at how different is the consulting from counseling. So, if you’re consulting on something that you have expertise in, but it’s really, really different from counseling, then I’d say it might be worth really kind of considering separating that out. The other thing you might want to look at is if at any point do you think that you’re going to sell the practice, in the year or two before you would want to sell it, you definitely want to split apart the two LLCs so that the income from your consulting isn’t taken into account or assets from that business wouldn’t be part of a sale. So, if you’re going to sell your website and if you have a building or kind of the overall flow and Admin all that, that would be a part of the equation as well. Hopefully that helps. So, if you want this year to be amazing, to just rock it out, to totally kill it this year, I would love to hang out with you all in Estes Park Colorado. So, I’m launching this conference called Killin’It Camp. And Killin’It Camp is kind of addressing that problem that I’ve noticed that you go to a conference and just like a couple of the breakout sessions you connect with and the things you grabbed from those, it’s just not a big enough takeaway to warrant flying all the way somewhere getting a hotel, paying the conference fee that is just sort of like, come on. I’m like, there’s got to be a clear and more in-depth way to grow a practice. And so, I partnered with the YMCA of the Rockies, for a number of reasons. For one, the Rockies are amazing. We host Slow Down School here in northern Michigan and Trevor City where I live. You know, you can’t get here without at least transferring to one airport at least to like, Chicago or Detroit or New York or I think Minneapolis has direct flights. Pretty much everyone, unless you live in one of those four towns, you’re going to have to, kind of transfer. And the tickets aren’t always that cheap. Denver, however, you know, is, most places you can fly direct to Denver. And so, wanted to find some place kind of on the western side of the United States also wanted to find a place that it was really affordable. And so, the YMCA of the Rockies, you hear YMCA, and I never would have thought that YMCA would have like a hotel. It’s not like we’re in bunk beds. It’s not like we’re hanging out on a basketball court. The YMCA of the Rockies, and I would really encourage you to go over and check out their website. You can just type in YMCA of the Rockies. They have hotel style cabins and the one that we’re going to have, it’s awesome. I think it has 20 rooms and then the cabin next door can sleep a few hundred more people. So, you have your own individual room that has two queen size beds. So, our prices are based on sharing a room with somebody. So, you can pick who you share with or you can pay a little bit extra if you want your own room. So, it’s got its own bathroom, they provide all the food so, all the food is included. So, super easy where you don’t have to worry about cooking or cleaning or any of that. And then we’re bringing in tons of experts that I have trained, that I’ve got to know that some of them I haven’t trained, but people that really understand specific areas of growing your practice. And we’re going to hang out from October 20th to October 23rd and on the first night on that Sunday, we’re going to kick it off. We’re going to welcome you. We’re going to make sure that you have some quick friends. On Monday we’re going to really frame out your practice and look at what’s working. We’re going to kind of do some large group activities that I facilitate personally. And then we’re going to have some smaller group, kind of breakout speeches and talks, then drill into specific areas that you want to work on. Tuesday of that week, same sort of thing. We’re going to have some larger group things and really help you kind of focus on the future there. And then on Wednesday morning we’re going to really look at how do we plan for the next year? How do you have a quarter by quarter plan? Exactly what you need to do in the coming year so that when you leave you feel just like, “Oh, that’s exactly what I needed. I wanted a plan. I wanted to know I was doing it right. I want to be able to say no to things as much as I want to say yes to things.” And we’re going to have a lot of fun. We’ve got some amazing sponsors that are going to be doing some fun events that I’ll be telling you about. And the tickets, they just opened up for the early bird over killin’itcamp.com. That’s where you can watch our video, you can read more about it, you can see all the people that are speaking at it. The price we have kept, where we’ll be making just a little bit and it’s really our sponsors too that make it worth it for us to do this. But we really wanted to put on an event that you could afford to come to. So, the early bird tickets are $650. There’s a handful of volunteer tickets left. So, if you want to volunteer five hours of your time, so just help us keep things moving along to make sure our speakers have water to, and we’re going to have some swag that we’re going to sell, things like that. If you want to do that, it’s only $500. So, for 650 bucks, you’re going to get your lodging, you’re going to get your food, you’re going to get the conference. The only thing you have to pay for is getting to Estes Park. So, you can fly, you can drive out of Denver. There’s lots of buses that go from there for, I want to say 70 bucks or so round trip on that. They’ll take you right to the YMCA of the Rockies. It’s going to be an event that I am just so excited about. It’s right in the middle of the Rocky Mountains in the middle of when the colors are going to be changing. The elk will be out. Christina and I went out there to check it out in September of 2018. Breathtaking. There’s deer that just walk right up to you. It’s a gigantic campus … It’s just completely surrounded by the Rocky Mountains and we are going to be able to just take this place over. And in the future, what’s amazing is they can sleep thousands of people. So, our hope is that Killin’It Camp becomes the event of the year for people that are in private practice where we make friends, we reconnect with each other, we bring in the best experts that we can afford to bring in so that it really does change what it means to be in private practice. So, you feel supported that you feel like you have other people that think like you. If you’re like me, you know, small northern Michigan town here in Traverse City, there’s not a whole lot of people that have this entrepreneurial private practice mindset. People that are really going after big things and want to do podcasts and listen to things that can really help me grow the business. It can be lonely. And so, to bring people together, it’s just amazing how when you have the right people in the right room working in the right direction, how much can happen in a short period of time. So, if you want to hang out with us in Colorado, head on over to killin’itcamp.com, in fact, tomorrow. So, this goes live on a Tuesday. The next day I’m doing a Killin’It Camp Q & A. And so, you can register for that at Practice of the Practice. It’s right on the main page. If you have any questions at all, I would love for you to register for that because I know that your money, it matters. You could put that towards lots of different things. And if you’re going to fly to Colorado, you’re going to come to this conference, I want you to feel like it’s really going to be worth it, that you’re going to get enough out of it and connect with enough people that it makes your business get to a whole new level. So, come to that Q & A we’d love to talk with you. We’re also going to be doing a second Q & A, I believe in March. I have to look at the exact dates for that, but we’ll be emailing that out too. Would love for you to come to Killin’It Camp. Again, that’s killin’itcamp.com for more information and to sign up for tickets. And if you want to do that Q & A, it’s tomorrow, right after this goes live. Also, just want to thank our sponsor, Gusto, gusto.com/Joe. You can go there for three months free for your payroll needs. They’re amazing. They’re so streamlined. It’s what technology should be for this kind of thing. So, head over to gusto.com/Joe. They help support the podcasts. They keep this thing going. We couldn’t do it without our sponsors. It just financially would not be worth the time. But we have these amazing sponsors that help kind of make it worth the time for me and for the editing and for Sam with the promotion. So, go support them, go check them out. And we’ve got some amazing guests coming up next month and you’re going to be super excited about them. Let me just pull up who we have. We have Jon Vroman next week, on the 5th of February. That goes live. John is going to share with us what are the big things that we really need to do as a parent. That’s also a businessperson. John is in charge of the Front Row Dads, which, I’m part of that group and they say that we are men that are dads, they have a business, not businessmen that are dads. Oh, they have a witty little thing that he’ll share. I’m sure I’ll get it by next time. Feeling a little under the weather today. So, he’s going to be on. And then we have quite a few other awesome guests. We’re actually going to be doing two, four, six podcasts in February, so probably two per week, to really make sure that we get a whole bunch out to you. And so, that’s coming up and thanks for letting me into your ears and into your brain. Have an amazing day. See you. Special thanks to the band Silence as Sexy for your intro music. We like it a lot. And this podcast is designed to provide accurate, authoritative information in regard to the subject matter covered. It is given with the understanding that neither of the host, the guests or the publisher are rendering legal, accounting, clinical, or other professional information. If you want a professional, you should find one.

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