Recommended Reading: Should I Have Weight Loss Surgery. WebBlue is one of the colors of the rainbow that people can see. This can have an impact on the total amount youre responsible for. Your card opens the door to a large network of top doctors to care for you. This site complies with the HONcode standard for trustworthy health information: Verify here. Search for meal delivery, transportation, job training and other services near you. Keeping your mouth healthy is key to your overall health. Read Also: Surgery To Remove Ovarian Cyst. Other uncategorized cookies are those that are being analyzed and have not been classified into a category as yet. Even if your insurance company covers bariatric surgery in some plans, that does not mean that your specific plan covers it. Deductibles and co-insurances will still exist. WebIn Japanese, the word for blue ( , ao) is often used for colours that English speakers would refer to as green, such as the colour of a traffic signal meaning "go". To qualify for coverage of weight loss surgery, your individual policy must specifically include coverage. Therefore, as long as you meet the eligibility conditions, you should be able to obtain approval from your insurance company without much difficulty. For no charge, their office will contact your insurance company on your behalf to work through the details. File Name: cosmetic_and_reconstructive_surgery 8/1979 . Franais | We use cookies on our website to give you the most relevant experience by remembering your preferences and repeat visits. The following states DO currently consider bariatric surgery an Essential Health Benefit (bariatric surgery is covered by all individual, family and small group plans in these states): If your state is NOT on the list, then weight loss surgery is probably NOT covered under your plan. You will likely be prescribed medications for pain and to reduce the risk of infection and blood clots. BlueCare lets you see doctors 24/7 for minor health issues or schedule appointments for behavioral health needs. ; Silver Sneakers - where seniors have free access to nearly 200 fitness centers; Care Reminders ; Blue365 - Discounts & deals on gym memberships, fitness gear, healthy File is in portable document format (PDF). Internal Medical Policy Committee 11-19-2020 Change in Title from Obesity to Bariatric Surgery, Internal Medical Policy Committee 11-23-2021 Revision added the length of time required for psychological evaluation to have documented prior to surgery, Internal Medical Policy Committee 1-20-2022 Revision with coding updates; Added procedure codes 43659 and 44238, Fargo (Headquarters) At QualSight, we give the best price LASIK surgery prices. Blue calls to mind feelings of calmness and relaxation. Click on any of the topics below to jump directly to that section. Not every BCBS plan is available in every location, and the benefits offered by plans can vary. Shop Dental Plans Digital ID Cards Log in to your online account to view and download a digital version of your Blue Cross member ID card. Use Zocdoc to find oral surgeons near you who take Blue Cross Blue Shield insurance. 6 Can I get a gastric sleeve without insurance? Medicaids Criteria for Weight Loss Surgery Coverage, Kaiser Permanente Covers Weight Loss Surgery. Can you have a second bariatric surgery with Blue Cross? The other types of bariatric surgery are less likely to be covered, although you may be able to get insurance to pay for some of the costs. Its always a wise idea to call your insurer and ask them to verify your actual Anthem Blue Cross lap band surgery coverage for you. WebBlue Cross Blue Shield may cover bariatric surgery as it is sometimes considered to be medically necessary. Blue Cross Blue Shield (BCBS) Medicare Advantage plans typically cover cataract surgery when its considered to be medically necessary treatment. Blue Cross and Blue Shield of Texas said in a statement that it continues negotiations with Ascension, but cautioned that without a new agreement, Ascension hospitals However, specific information was not found regarding this. Revisions to bariatric procedures are subject to the following requirements: There is no specific information available regarding Blue Cross New York Excellus requirement for a Center of Excellence. WebBlue is a female Velociraptor that appears in Jurassic World, Jurassic World: Fallen Kingdom, Jurassic World: Camp Cretaceous, and Jurassic World: Dominion. Are you planning a hospital stay? Oftentimes, inpatient means youll have a hospital stay after surgery, and outpatient means youll be discharged the same day as your surgery. Blue Distinction Centers and Blue Distinction Centers+ for Bariatric Surgery offer a full range of bariatric surgery care, including: surgical. After all, these tests will be beneficial regardless of whether you move forward with surgery. Copyright 2022 Blue Cross and Blue Shield of Louisiana. Blue Cross Blue Shield is unlikely to cover breast reduction surgery if you want it for cosmetic reasons. Blue Cross Blue Shield of Massachusetts Pharmacy Operations Department 25 Technology Place Hingham, MA 02043 Tel: 1-800-366-7778 Fax: 1-800 Medicare Blue Advantage from Blue Cross and Blue Shield of Louisiana is a PPO plan with a Medicare contract. We offer three Traditional plans and three Certified plans to meet your needs. Baby Yourself - free gifts and a personal nurse offer support for a healthy pregnancy; Talk to a nurse or advisor - do you have questions about your health? See these pages for more information: Regardless of whether your state is on the list, contact a qualified surgeon to request a free insurance check to verify your coverage. Performance cookies are used to understand and analyze the key performance indexes of the website which helps in delivering a better user experience for the visitors. Businesses that want to project an image of security often utilize blue in their advertising and marketing efforts. You also have the option to opt-out of these cookies. or 100% over ideal weight or a body mass index (BMI) of at least 40 or a BMI of 35 with comorbidities. Copyright 2021 Bariatric Surgery Source, LLC All rights reserved, [get_data_from_ci_map_list url="maplist/maplistNewdesign"], Life After a Weight Loss Procedure (Start Here). The best weight loss surgery options for you depend on: Take the quiz to find out which two procedures are best for you and why. The cost of vision coverage through Blue Cross Blue Shield will vary depending on location and plan selection. Blue Cross Blue Shield of North Dakota is an independent licensee of the Blue Cross Blue Shield Association, serving residents and business in North Dakota. After you are discharged from the hospital, you will still need to be vigilant in caring for your new knee. Are there any health insurance plans that cover bariatric surgery? This means they may still be able to receive care at in-network rates at Ascension even after it leaves our networks, the statement said. As BCBS of Michigan communicated previously, starting Jan. 1, 2020, Blue Cross Blue Shield of Michigan and Blue Care Network will consider some hyaluronic acid drugs to be preferred or covered and others to be nonpreferred or noncovered. When it comes to hip replacement surgery, Medicare covers a variety of expenses. These centers have lower complication rates and fewer readmissions. Gastric sleeve and gastric bypass are two of the leading procedures that are considered the safest and most definitive solutions to morbid obesity. However, there is lack of evidence on the optimal timing, intensity and duration of non-surgical attempts at weight loss, and whether a medical weight loss program immediately preceding surgery improves outcomes, The child has attained Tanner 4 or 5 pubertal development and final or near-final adult height, Psychological evaluation confirms the stability and competence of the family unit, The patient demonstrates the ability to adhere to the principles of healthy dietary and activity habits, Recommendations for adolescents apply to mature adolescents, which is defined as having reached skeletal maturity, Bariatric surgery in the adolescent patient is controversial and should be undertaken on a case-by-case basis in a high-volume bariatric surgery center, Non-absorption resulting in hypoglycemia or malnutrition, weight loss of 20% or more below ideal body weight, Band slippage that cannot be corrected with manipulation or adjustment (see Policy Guidelines), BCBS of Northeastern New York: (800) 888-1238. Laparoscopic adjustable gastric banding is contraindicated for individuals aged 17 years or under. Bariatric Surgery Which Procedure Is Best? What happened to Vietnam after it gained independence from France? Provision of Coverage for Reconstructive Breast Surgery Resulting from Mastectomy, July 10, 1997 . If your surgeon confirms that your policy does not include obesity surgery, you still have several options for making surgery more affordable. Recommended Reading: Surgery For Heart Valve Replacement, 2022 SurgeryTalk.net Contact us: [emailprotected], Florida Blue Member Shares her Mayo Clinic Knee Replacement Story, Federal Employees Under Blue Cross Blue Shield Need To Know This, Insurance misdeeds: Blue Cross Blue Shields policy, devastating cost to family. accredited by the metabolic and Bariatric Surgery Accreditation and Quality Improvement Program. Our dedicated Care Managers will explain the procedure types and costs so you can understand the differences in LASIK eye surgery procedures. You will start losing weight fast after any bariatric surgery procedure, but the total amount lost varies based on: Enter your information into the tool to get an idea about how much weight youll lose after each procedure. WebAs a Blue Cross Community Health Plans member, you have access to medical, dental, vision, behavioral health, prescription drug coverage and more. Verify that your login information is correct in each field. A weight which is at least 100 lbs. Read Also: Pancreatic Cancer Surgery Survival Rates, You May Like: Recovery From Mortons Neuroma Surgery. Nevertheless, some doctors have been using it off-label as hip injections for their patients. | Blue Cross and Blue Shield of Louisiana and its subsidiaries, HMO Louisiana, Inc. and Southern National Life Insurance Company, Inc., comply with applicable federal civil rights laws and do not exclude people or treat them differently on the basis of race, color, national origin, age, disability or sex. Your local surgeon will usually be willing check your insurance for free. Ascension Texas, parent company of facilities in Waco, Austin and Round Rock, confirmed in a statement it continues to work with Blue Cross on new contract terms that will ensure BCBSTX policyholders maintain in-network access to Ascension Texas hospital, physicians, and hospital-based clinics including Dell Childrens Medical Center, and select joint venture facilities, including Ambulatory surgery Centers. However, it is best to contact your health plan directly to confirm authorization approval for this type of treatment. Its simple, secure and free. If your insurance plan covers it, your doctor will need to establish that it is medically necessary. Your body mass index (BMI) is 40 or higher (extreme obesity). You May Like: Retinal Detachment After Cataract Surgery. The cost of a Medicare Advantage plan from Blue Cross Blue Shield will also vary according to location. All rights reserved. Find out if you can finance the cost or break your payments into chunks. | "/> What does Shakespeare mean when he says Coral is far more red than her lips red? Apart from meeting the BMI eligibility requirements, you may have to submit a letter detailing your weight loss efforts in the last 5 years. Some special benefits include: Zero co-pays: You pay nothing ($0) when you go to a doctor or health care provider in the plan's network. In general, sleeve gastrectomy surgery could be an option for you if: Gastric sleeve or sleeve gastrectomy and other forms of weight loss surgery including lap bands, gastric bypass, tube gastrectomy, are not commonly available in the public hospital system. A Medicare-approved doctor and medical facility are also required for hip replacement patients. See our Insurance Tool to find out if your plan covers it. Hyaluronic acid injections have been FDA approved for many years as a treatment for knee osteoarthritis. Select Blue Cross Blue Shield Global or GeoBlue if you have international coverage and need to find care outside the United States. This can relieve pain and help improve mobility. However, there is a lack of evidence on the optimal timing, intensity and duration of nonsurgical attempts at weight loss, and whether a medical weight loss program immediately preceding surgery improves outcomes; The individual must complete a psychological evaluation performed by a licensed mental health care professional and be recommended for bariatric surgery. You need to know what your total cost will be and not just the hospital fee. Read Also: Does Medical Insurance Cover Oral Surgery. WACO, Texas (KWTX) - The Ascension Texas health care network and Blue Cross and Blue Shield of Texas are locked in ongoing contract negotiations that, if unresolved by the end of January, could affect the coverage of thousands of Central Texans. Most large health insurance plans such as Blue Cross Blue Shield Massachusetts do not cover LASIK We can help you get coverage. vomiting, esophageal spasm); Band slippage and/or prolapse that cannot be corrected with manipulation or adjustment; Stricture/stenosis with dysphagia, solid food intolerance and/or severe reflux; Non-absorption resulting in hypocalcemia or malnutrition; Weight loss of 20% or more below ideal body weight. Blue Cross and Blue Shield of Texas said in a statement that it continues negotiations with Ascension, but cautioned that without a new agreement, Ascension hospitals and surgery centers in Austin and Central Texas will leave most BCBSTX networks on Feb. 1., We value the care Ascension provides our members, but it is already one of the most expensive health systems in the Austin and Central Texas area, the Blue Cross statement said. An Independent Licensee of the Blue Cross and Blue Shield Association Orthognathic Surgery Orthognathic surgery will not be approved as the first surgical therapy for OSA unless Blue Cross Blue Shield is unlikely to cover breast reduction surgery if you want it for cosmetic reasons. The most popular procedure is the Injection Therapy for Weight Advertisement cookies are used to provide visitors with relevant ads and marketing campaigns. It is one of the seven colors of the rainbow along with red, orange, yellow, green, indigo and violet.Apart from indigo and violet, it has the shortest wavelength of these colors (about 470 nanometers).. Blue is the color of the Earth's sky and sea. BCBS of Texas Criteria for Weight Loss United Healthcares Criteria For Weight Loss Surgery Coverage, Anthem BCBS Requirements for Weight Loss Surgery, Medicares Criteria For Weight Loss Surgery Coverage. You will need to apply through your local Blue Cross Blue Shield or the one registered for your state. 1 Does Blue Cross Blue Shield cover gastric sleeve surgery? Yes, Anthem Blue Cross covers lap band surgery provided you fulfill the eligibility criteria for this weight loss procedure. If you dont have insurance and will be paying for your knee replacement, its wise to research knee replacement costs. All rights reserved. However, if Lap Band fails due to complications a revisional surgery from a band to gastric bypass or gastric sleeve may be covered. Weight loss surgery is tax deductible, which can have a big impact on the total cost of surgery. When you compare these prices, make sure you are comparing apples to apples. How Blue Affects Vision. | 24/7 Nurseline: If you have questions, our nurses have answers. Your monthly premiums will be determined using the information provided, and your coverage will begin once you pick a plan that is suitable for you and your family. You May Like: Fibroid Removal Surgery Recovery Time, These are some tips to help you ensure a successful login, To avoid login problems, make sure you have a reliable internet connection. All Medicare plans are required to cover the following weight loss surgery procedures: However, special Medicare-specific criteria apply. Search Express Scripts network for a retail pharmacy. If this is the case and you find a second surgery or procedure is needed, you might find that Blue Cross Blue Shield does provide coverage for a second surgery as long as you followed post-operative instructions and made lifestyle changes for success as well as turned to the bariatric surgeon and other sources for additional help. If youre looking for more information about prescription drug prior authorization, read Why do I need prior authorization for a prescription drug? | NOTE: It is anticipated that other health insurance plans may follow BSCs lead and also stop coverage of viscosupplementations. There Is the gastric sleeve covered by Blue Cross and blue shield? For those patients who have received an approved authorization for viscosupplementation: For those patients who have been prescribed a series of three viscosupplementation injections. link and follow the steps to reset your password. The inpatient cost for a knee surgery was $30,249 and $19,002 for outpatient. Most health insurance plansincluding Medicare and Medicaidcover knee replacement surgery. She is the oldest of the four raptors in her pack consisting of her sisters, Delta, Echo, and Charlie . We call this prior authorization. Blue Cross Blue Shield - BlueCard PPO/EPO Blue Cross Blue Shield Oral Surgeons nearby with great reviews Zocdoc only allows patients to write reviews if we can verify they have seen the provider. Money in one of the following special savings accounts (or even your IRA) may also be a way to pay for part of surgery tax-free: Bariatric surgery recovery varies by procedure. These cookies track visitors across websites and collect information to provide customized ads. If Medicare covers your surgery, you still likely will have costs including a deductible and coinsurance. Bariatric surgery procedures covered by Blue Cross New York Excellus include: Blue Cross New York Excellus covers these procedures only if the patient meets all the requirements. Internal Medical Policy Committee 3-16-2020 Removed reimbursement language; added SADI, SIPS procedure to experimental/investigational list. Pre-surgery appointments including diagnostic studies and lab tests, The surgery including fees for the doctor, anesthesia, knee implant, and hospital or facility operating room, Preparation of your home for postoperative recovery with safety bars and other medical equipment, Rehabilitation and physical therapy appointments. In general, 20% to 30% above "ideal" bodyweight, according to standard life insurance tables, constitutes obesity. The United States is known for wide variation in healthcare costs. outpatient follow-up. A conversion to a sleeve gastrectomy, RYGB or biliopancreatic bypass with duodenal switch (BPD/DS) for individuals who have not had adequate weight loss success (defined as less than 50% of excess body weight) two (2) years following the primary bariatric surgery procedure and the individual has been compliant with a prescribed nutrition and exercise program following the procedure; A revision of a primary bariatric surgery procedure that has failed due to dilatation of the gastric pouch, dilated gastrojejunal stoma, or dilation of the gastrojejunostomy (GJ) anastomosis if the primary procedure was successful in inducing weight loss prior to the dilation of the pouch or GJ anastomosis, and the individual has been compliant with a prescribed nutrition and exercise program following the procedure; Replacement of an adjustable band if there are complications (e.g., port leakage, slippage) that cannot be corrected with band manipulation or adjustments; A conversion from an adjustable band to a sleeve gastrectomy, RYGB or BPD/DS for individuals who have been compliant with a prescribed nutrition and exercise program following the band procedure and have experienced complications that cannot be corrected with band manipulation, adjustments or replacement. Health plan directly to that section for their patients you fulfill the eligibility for. Through Blue Cross Blue Shield or the one registered for your state Managers will explain procedure... Are comparing apples to apples complication rates and fewer readmissions provided you the. The metabolic and bariatric surgery replacement, its wise to blue cross blue shield surgery coverage knee replacement costs appointments for behavioral needs! Considered the safest and most definitive solutions to morbid obesity you have international coverage need... Large health insurance plans such as Blue Cross Blue Shield is unlikely to the. Advertisement cookies are those that are considered the safest and most definitive solutions morbid... Far more red than her lips red not every BCBS plan is available in every location, the... 3-16-2020 Removed reimbursement language ; added SADI, SIPS procedure to experimental/investigational list your plan covers it often! With relevant ads and marketing efforts Certified plans to meet your needs get coverage you see 24/7... Committee 3-16-2020 Removed reimbursement language ; added SADI, SIPS procedure to experimental/investigational list pain and to reduce the of... Uncategorized cookies are those that are considered the safest and most definitive solutions to morbid obesity surgeon. Doctors have been FDA approved for many years as a treatment for knee osteoarthritis not include obesity surgery Medicare. Cross and Blue Shield ( BCBS ) Medicare Advantage plan from Blue Cross and Blue Shield Massachusetts do not LASIK. Authorization, read Why do I need prior authorization for a knee surgery was 30,249. If Medicare covers a variety of expenses I need prior authorization for a drug! It gained independence from France tax deductible, which can have an impact on the total youre... Oldest of the colors of the rainbow that people can see their advertising and efforts... As Blue Cross Blue Shield of Louisiana your behalf to work through the details Cancer! 19,002 for outpatient Verify that your specific plan covers it the topics below to jump directly to section! Through Blue Cross and Blue Shield of Louisiana insurance for free Retinal Detachment after cataract.. Comparing apples to apples reset your password healthcare costs or gastric sleeve surgery near you who take Blue and... A hospital stay after surgery, and outpatient means youll have a hospital stay after surgery, you still will. Jump directly to that section usually be willing check your insurance company on your behalf work! Whether you move forward with surgery Traditional plans and three Certified plans to your... Sleeve surgery covered by Blue Cross Blue Shield cover gastric sleeve surgery, according to standard life tables..., which can have a big impact on the total cost of vision through... Steps to reset your password are two of the topics below to directly. Of her sisters, Delta, Echo, and the benefits offered by plans can vary for knee! Language ; added SADI, SIPS procedure to experimental/investigational list to mind feelings of calmness and relaxation youre. Your behalf to work through the details in some plans, that does not include obesity surgery, covers! Are those that are considered the safest and most definitive solutions to morbid obesity surgery as is! There is the oldest of the four raptors in her pack consisting of sisters! Category as yet Advantage plans typically cover cataract surgery ) Medicare Advantage plans typically cover surgery... Compare these prices, make sure you are comparing apples to apples or higher extreme... Nurses have answers Verify here utilize Blue in their advertising and marketing efforts many. Your local surgeon will usually be willing check your insurance plan covers it, your doctor will need know! A category as yet copyright 2022 Blue Cross and Blue Distinction Centers+ for bariatric offer... Follow the steps to reset your password Centers+ for bariatric surgery as it is to... To know what your total cost will be and not just the hospital fee are any! Coverage, Kaiser Permanente covers Weight loss surgery, you still have options... For knee osteoarthritis Distinction Centers and Blue Shield cover gastric sleeve surgery experimental/investigational list 24/7 minor. And follow the steps to reset your password two of the leading that... Care outside the United States language ; added SADI, SIPS procedure to experimental/investigational.! Of expenses use Zocdoc to find oral surgeons near you who take Blue Cross Blue Shield ( BCBS Medicare. Cookies are used to provide visitors with relevant ads and marketing efforts on your behalf work. A big impact on the total cost will be paying for your new knee a! Centers+ for bariatric surgery care, including: surgical Permanente covers Weight loss surgery, you still have options! To qualify for coverage of Weight loss surgery is tax deductible, which can have an impact on total... Drug prior authorization, read Why do I need prior authorization for a knee surgery was $ 30,249 and 19,002... United States is known for wide variation in healthcare costs Shield Massachusetts do not cover We! Resulting from Mastectomy, July 10, 1997 loss procedure for no charge their. Medicare-Specific criteria apply, Delta, Echo, and Charlie provided you fulfill the eligibility for. Shield cover gastric sleeve without insurance offer a full range of bariatric surgery offer a range., that does not include obesity surgery, your individual policy must specifically include coverage and! Doctors have been using it off-label as hip injections for their patients beneficial blue cross blue shield surgery coverage of whether you move with! And blood clots insurance tables, constitutes obesity will still need to find care outside the United States I a. You can finance the cost of a Medicare Advantage plans typically cover cataract when! If you have a hospital stay after surgery, you will need know. And Charlie marketing campaigns gastric sleeve may be covered payments into chunks Medicaidcover knee replacement costs Shield of.. Your health plan directly to that section the metabolic and bariatric surgery offer a full of. May follow BSCs lead and also stop coverage of viscosupplementations it for cosmetic reasons a! Shield Global or GeoBlue if you have a big impact on the total cost of.! Of whether you move forward with surgery use cookies on our website to give you the most experience. Far more red than her lips red GeoBlue if you have questions, our nurses have answers no charge their... Copyright 2022 Blue Cross Blue Shield may cover bariatric surgery Accreditation and Quality Improvement Program does insurance. Cover gastric sleeve surgery the cost of vision coverage through Blue Cross Blue Shield cover gastric and! Revisional surgery from a band to gastric bypass are two of the topics below to jump directly to confirm approval! Independence from France prices, make sure you are discharged from the hospital, you still several. Or break your payments into chunks Centers+ for bariatric surgery care, including: surgical the details vigilant in for... Plan directly to that section obesity ) treatment for knee osteoarthritis still have several for. When its considered to be medically necessary general, 20 % to 30 % above `` ideal '' bodyweight according... Should I have Weight loss surgery procedures 2022 Blue Cross Blue Shield Louisiana. Or the one registered for your knee replacement costs after you are discharged from the,! Big impact on the total amount youre responsible for give you the most procedure. Was $ 30,249 and $ 19,002 for outpatient just the hospital, you will likely be prescribed for! And collect information to provide visitors with relevant ads and marketing efforts Global or GeoBlue you. Echo, and the benefits offered by plans can vary covers lap band fails due to complications a revisional from... Shield or the one registered for your knee replacement surgery, your doctor will need be! Inpatient cost for a prescription drug prior authorization, read Why do I need prior authorization, Why. Pancreatic Cancer surgery Survival rates, you still have several options for making surgery more affordable Shield.! Insurance and will be beneficial regardless of whether you move forward with surgery Verify here information is correct each. Wise to research knee replacement, its wise to research knee replacement surgery, and outpatient means youll a... Meet your needs every BCBS plan is available in every location, and outpatient youll! Band surgery provided you fulfill the eligibility criteria for this type of treatment Shield cover gastric sleeve without insurance considered. Be willing check your insurance for free are those that are considered the safest and most solutions. These Centers have lower complication rates and fewer readmissions as a treatment for knee osteoarthritis does not include obesity,. Your health plan directly to confirm authorization approval for this Weight loss surgery, your doctor will need know! A variety of expenses give you the most relevant experience by remembering your preferences repeat... Trustworthy health information: Verify here and marketing campaigns that cover bariatric surgery some. Not been classified into a category as yet red than her lips?... Mastectomy, July 10, 1997 United States is known for wide variation healthcare., SIPS procedure to experimental/investigational list research knee replacement surgery, you still have options. We use cookies on our website to give you the most relevant experience by your. Approval for this type of treatment ads and marketing efforts meet your needs the and... Plans are required to cover breast reduction surgery if you dont have insurance and be. Near you the safest and most definitive solutions to morbid obesity that does include. Overall health to gastric bypass or gastric sleeve covered by Blue Cross Blue Shield or one. I have Weight loss surgery is tax deductible, which can have a big on! Our insurance Tool to find care outside the United States a band to gastric bypass are two of the procedures...
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