5 Keys to Improving Participant Outcomes in Retirement Plans

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Capital Ideas Retirement

“I am constantly fielding questions about what improvements, beyond investment performance, can be made to a retirement plan. The attached article, provided by Capital Group, provides insight on a few simple action items that will create drastic results. While this is not an exhaustive list, it’s a terrific primer for a true retirement plan consultation.

I look forward to being a resource.”

Joshua C. Harper, CFP®, CLU®, ChFC®

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A Look Forward Into 2018 – A Contractor’s Perspective

Categories: Articles

construction contractorsThrough the years I have learned that future projections typically do not come true, so this article is not about projections for 2018 but about possible trends for the construction industry.

The New Year will bring challenges in hiring quality personnel as well as retaining current staff. As commercial workloads increase, so will the need for skilled labor. Construction companies will have to pay more to attract workers to the construction industry, provide on-the-job training and encourage workers to accept responsibilities of supervision. Our more seasoned personnel will be required to train the younger employees and those employees that are willing to learn new skills. Because construction tasks require manual labor, hourly rates will have to increase above hourly rates which do not require as much manual labor. My thoughts are the difference will be about $2.00 per hour.

As labor costs increase, there will be more opportunities for prefabrication and automation. Commercial construction still has a way to go before automation reaches to job sites, but equipment is currently being developed to help reduce manpower. There will come a point when much of commercial construction projects will be built in a factory and those parts will be shipped and then assembled on the job site.

As we move farther into 2018, we should see less demand for repair and replacement in Texas and Florida due to the hurricanes of 2017. Hurricanes Harvey and Irma hit in August of 2017 and damage has been estimated to be in $200 billion-dollar range by Bloomberg. As the demand for materials and labor for repairs continues to decline in these two areas, material delivery lead times should normalize, and skilled laborers will hopefully redistribute from the hurricane damaged areas.

The events of December provide strong indications that business investment may be on the rise. Record Christmas season sales and a pro-business tax bill establish a solid foundation. Companies may be more willing to invest in new buildings to house people and product, therefore increasing commercial construction demand.

All looks positive for commercial construction in 2018. Only time will tell.

By: Eric A. Schoppman

Practice Manager of the Month

Categories: Practice Manager of the Month

Kristy Lockert

Kristy Lockert
Practice Administrator, Sandy Springs Pediatrics and Adolescent Medicine, P.C.

Kristy Lockert is the Practice Administrator at Sandy Springs Pediatrics and Adolescent Medicine, P.C. located in Sandy Springs, Georgia. The practice has a dual specialty with focus on general pediatrics and a few of the doctors focus on infectious diseases. The practice started in October 1999 and has changed and grown through the years. Currently there are seven doctors in the practice with a total of 20 people on staff. Prior to working at Sandy Springs Pediatrics, Kristy worked in Dallas at several medical offices of various surgery types and also worked nine years in a national home health agency.

Kristy enjoys being in pediatrics. She finds the doctors to be more laid back and have fun compared to the surgery doctors, and she enjoys having kids around. Kristy has been in healthcare since 1986. She thrives on the ever-changing environment. To keep a healthy work environment, Kristy focuses on improving office satisfaction through frequent communication. She recognizes the importance of staff meetings to share information and openly discuss what is working and what is not. She also knows that it’s important to have more casual one-off conversations with each staff member where she can get different responses than the full staff meetings.

Another of Kristy’s tips to practice managers is to stay on top of changes by being proactive and thinking outside of the box. She accomplishes this by reading various industry newsletters from MGMA, Pediatrics Associations, and other physician practice newsletters. She also receives information from their EMR vendor. By staying informed, she is able to talk to the doctors about changes and steps to take to keep it a viable practice. Healthcare can be cyclical, especially with practices being bought out by hospitals and then returning to independent. Although pediatrics is not bought out as much as other specialties, Sandy Springs Pediatrics desires to stay independent. To succeed, they need to stay on top of changes and implement changes as necessary to keep patients and parents happy.

Kristy has had many mentors through the years including her mother, grandparents, and previous bosses. The key advice that she holds dear is to stay true to herself, serve, be fair, honest, and loyal, and most importantly to not forget where you came from. To be successful as a manager, "you need to remember the previous jobs you held and wear other hats to see different angles and viewpoints." She keeps this all to heart at Sandy Springs Pediatrics and is best expressed by John G. Long, MD, "One of the things that sets Kristy apart from other office managers that I have worked with is her energy and constant planning for the future. She has the ability to guide our group of fairly conservative MD’s into important projects that change and update our business. She is a dynamic leader who has guided us through adding new physicians, adopting an electronic medical record system, and twice moving the practice to new spaces, most recently last year when we relocated to our current offices in Sandy Springs. She is always able to carry out these projects with consensus building, good humor and ultimate agreement by all that progress has been made."

When Kristy is not working, she is an avid bowler. She bowls on several leagues. She also enjoys reading, hiking, and riding motorcycles.
Kristy Lockert was nominated by Chris Jann of Medicus IT. She speaks highly of Chris and all of the people she has worked with at Medicus. In 2013, the practice started using an EMR systems. Prior to that, Kristy was the IT person. She knew it was time to have full IT support to help handle everything from installs, updates, HIPAA compliance, and keeping everything secure. She wouldn’t want to do it without them.

Five Things To Remember When You Have A Lease Coming Up For Renewal

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  1. Give yourself enough TIME prior to expiration.
  2. Consider several ALTERNATIVES to your current space.
  3. THINK LONG TERM as well as short term.
  4. REVIEW the LEASE DOCUMENT even if you renew.
  5. Use the renewal or relocation as a time to RETHINK OFFICE OPERATION.



Make sure that you start the process early enough so that you will have enough time to properly evaluate alternatives. Don’t short change your practice by allowing too little time. As with anything else it is always better to have more time. If you start too early you can always slow down but if you start too late the advantage goes to the Landlord which you don’t want to do. What is enough time? To figure this out in your particular situation estimate how much time each component of the process from the initial search for alternatives, to lease negotiation and finally buildout will take. In the case of a 5,000 sf lease space you should figure on 30 days to determine what options are available. It is a good idea to find five or six options which might work. Figure another 30 days to work thru those options which would included doing test fits on the top two or three options. Efficiencies differ between different buildings and floorplates.


Take the time or hire a professional medical office broker to find a reasonable number of alternatives. After identifying five or six possibilities tour the buildings paying particular attention to such thing as visual appeal of the building ingress and egress to and from the building, the total number of parking spaces available in the building (4 spaces per 1,000 square feet of leased area is a minimum however ideally you would like 5 or 5 per 1,000. Parking is the silent killer of a practice. If there aren’t enough spaces patients will be late for their appointment, they will be upset at having to drive around looking for a space and upset because they were harassed by staff for being late to the appointment. Many times they won’t complain but just not come back. Once you have toured the options and made notes send out a request for proposal (RFP) to each option telling them what information you want. The idea behind an RFP is to get identical information from each option so that you can make an apples to apples comparison. Buildings will naturally try to give you information in a way that makes their property look good but if they are successful that makes the job of comparing them much more difficult. Once you receive the proposals from the options you will want to put the competing buildings on a spreadsheet and compare them both in terms of their economics and the more subjective issues such as appearance, ingress/egress and parking.


Concurrently with the RFPs you will want to do test fits with the best two or three options. This will tell you how each option actually lays out and how efficient they are relative to one another. In doing a test fit and looking at a long-term design for your space you will certainly want to think about the things which currently work in your space and those things that don’t. Do you have the right number of exam rooms? Does the reception area have enough seating?  Does the office still flow efficiently? What worked well for the practice five or ten years ago may not work now. Offices are generally designed along one of two ways. The “pod concept” where the exam rooms serving a particular doctor, the doctor’s office and the doctors nurse or nurses are all bunched together in a pod. The other concept “non grouped” which seems to be regaining favor in the current changing medical environment is to have all of the exams together with the nurses station and have the doctors all together apart from the exams, using charting stations interspersed among the exam rooms. This concept allows more flexibility in assigning different numbers of exam rooms to different providers which may be a function of the patient load or how a particular provider works.


A year before your lease comes up it is a good idea to get out your lease and review it to refresh your memory on what the sequence of events will be regarding the renewal of your lease. Are there any renewal options specified in the lease? This will usually be spelled out in the Special Stipulations section of the lease. If there are options how long before renewal do you need to give notice of your intent to renew. What in addition to the ability to renew does the renewal option describe such as a specific renewal rate or other items which are specified and have been pre-negotiated. An option only grants your practice the right to renew not the obligation. You will want to look at the market to determine if the renewal option is advantageous for your practice. If the renewal option is clearly advantageous then it may make sense to look at alternative spaces and begin the process of negotiating between the options to determine the best avenue for the practice.


During the process of considering a renewal it is a good idea to take a global look at the operation of the practice, and not just as it relates to the office space. Since a renewal may not involve additional square footage many practices just sign the renewal amendment and move on. However, a renewal marks three, five or even ten years since you have seriously looked at provisions in your lease. As you know there have been significant changes in the healthcare system which have had an effect on how your practice operates and possibly how your office space should function. Also with a renewal or relocation you should not just look how things effect your practice today but rather you should be looking at your needs 2, 3 or 5 years down the road.

In considering your long term needs you should consider such things as whether your phone system continues to be adequate for the operation of the practice. You might consider whether your computer system adequate for the demands of the practice in 2017 and beyond. There will be a range of issues which will be specific to your practice.

The bottom line on how to address an upcoming renewal is that you should begin early, take a careful look at whether your current space is adequate for your needs today thru the end of the renewal term, and use the anniversary to consider things that relate to your office space and maybe a few larger issues that relate to the practice. Good luck. If you don’t have the time to do an adequate job, consider hiring a real estate professional to take on some of the time consuming aspects.

FGI’s 2018 health care facility guidelines open for public comment

Categories: Articles

Revisions to the guidelines include new standards for emergency preparedness, operating rooms and more

The Facility Guidelines Institute has released its proposed additions, changes and deletions for its 2018 editions, which include three books this year; Guidelines for Design and Construction of HospitalsGuidelines for Design and Construction of Outpatient Facilities, and Guidelines for Design and Construction of Residential Health, Care, and Support Facilities.

FGI’s documents, which are updated every four years to keep up with changes in the field, have provided fundamental standards for the design and construction of various health care facilities since the 1940s. Some of the major changes to this year’s books include:

  • New guidance on design of telemedicine spaces
  • New design requirements for accommodations for care of patients of size (formerly bariatric accommodations)
  • Imaging room design requirements using a classification system based on procedures performed and patient acuity
  • Identical requirements for operating rooms in outpatient surgery facilities and hospitals
  • More flexible pre- and post-procedure patient care area guidance (allowing provision of one, two or three spaces, depending on operations)
  • Two options for sterile processing area design
  • Expanded sustainability requirements regarding waste minimization, potable water and energy efficiency

The organization’s multidisciplinary 100-member Health Guidelines Revision Committee (HGRC) has also proposed revisions for its Provisions for Disaster chapter within the Guidelines for Design and Construction of Hospitals. HGRC has proposed retitling the chapter as Emergency Preparedness and Management. Proposed changes within the chapter mainly focus on hospital resiliency, or the ability to “absorb and recover from adverse events,” such as a hospital’s ability to: adapt to changing conditions, recover from disruptions, resist probable deliberate attacks, improve technical and organization capabilities, focus on reducing damage and disruptions to public health and safety.

The proposed emergency preparedness changes also touch on allocating hospital space to act as a shelter where patients, staff and visitors can go for safety, as well as having space for emergency supplies and resources.

The revisions echo some of the major points included in the Centers for Medicare & Medicaid Service’s (CMS’s) recently released emergency preparedness requirement, which has three key goals: safeguarding human resources, maintaining business continuity and protecting physical resources.

“In light of the new CMS rule, we’d like to make sure we aren’t conflicting with that,” says Douglas Erickson FASHE, CHFM, CHC, HFDP, chair of the 2018 HGRC. “So we absolutely want people to take a look at that rule and our new draft guidelines and give us feedback on the proposed changes.”

The 2018 Guidelines revision cycle will yield three documents, one for hospitals, one for outpatient facilities and another for residential health, care and support facilities. FGI developed an electronic comment system for each book, and the organization says the public can access the drafts at its website. FGI specifically is asking commenters to weigh in on the costs and benefits of any changes to the draft text, which will be reviewed by its Cost/Benefit Committee.

The public comment period closes Dec. 12 and comments are restricted to proposed changes, including deletions, revisions and new material.

“Although we are only in the middle of revising the FGI Guidelines documents, HGRC members have been putting forth a yeoman’s effort to verify the need for existing requirements and validate newly proposed language,” Erickson says. “Now we need users of the Guidelines to review the draft documents and provide comments, supportive or constructive, for consideration by the HGRC during the final stages of developing the 2018 documents.”

September 29, 2016
Jamie Morgan

The Healthcare Industry Faces Ongoing Communication Challenges

Categories: Articles

Healthcare professionals themselves are up on the latest technology. A recent study by Spyglass Consulting Group found that 96 percent of licensed physicians in the U.S. regularly use smartphones as their primary device to communicate, manage their personal and professional workflows, get news and information, and browse the Internet for medical-related information.

Healthcare facilities, however, are not. Spyglass also found that fully one-third of the 950,000 licensed physicians in the U.S. are still required to use legacy alpha-numeric pagers for work-related communication. Even worse, that especially applies to those involved in critical and rapidly-evolving specialties such as emergency/trauma, critical care, surgery and radiology.

It’s not that anybody wants to use pagers, but at least they’re secure. According to an article in InformationWeek, Atlantic Health System found that over half its clinicians were using insecure SMS text messaging despite repeated warnings from the IT staff.

“We are blue in the face telling our clinicians and nurses, ‘You can’t do this. SMS is not safe,’” said Linda Reed, CIO at Atlantic Health. But, she added, “At the end of the day, not doing it is not practical.”

And that’s only half the problem. Nurses are often overlooked when it comes to analyzing healthcare communications. A Kansas University Medical School survey revealed that 92 percent of nurses said their most common forms of communications at work were face-to-face and telephone conversations.

This is a situation that has to change. Even as modes of treatment have undergone dramatic technological improvements, healthcare institutions have vastly under-funded upgrades to their communications technology.

That’s a costly oversight. The Joint Commission, which accredits and certifies U.S. healthcare organizations, has found that ineffective communications were the primary cause of more than 70 percent of treatment delays and unexpected deaths or injuries.

A study by the Ponemon Institute found that clinicians lost more than 45 minutes per day by relying on pagers and other outdated communications technology. The decline in efficiency cost the U.S. healthcare industry more than $5.1 billion annually, according to Ponemon.

Further, the healthcare profession is under more pressure than ever before to increase efficiency. There are some 75 million baby boomers to care for, and they are starting to reach retirement age, requiring more complex medical care from more specialists. The Affordable Care Act also adds new regulations that beg for more efficiency. Medicare and Medicaid may reduce payments to hospitals with too many patients readmitted within 30 days. There are also pay-for-performance incentives and new patient-centered care models that would benefit from better communication between patient and care provider.

Clearly, 21st Century medicine has a critical need for 21st Century communications technology.

Paul Mancini
Fall 2017

Practice Manager of the Month

Categories: Practice Manager of the Month

pmm_loribazzaniLori Bazzani

Practice Administrator, Rockdale Family Practice

Lori Bazzani is the Practice Administrator at Rockdale Family Practice in Conyers, Georgia.  The practice was started by Dr. Mary-Jane Kassam (Dr. MJ) and Dr. Mohamed Kassam (Dr. Sam) back in 1991.  Lori joined the practice in 2010 and started off in the billing department.  As the practice grew so did Lori’s role.  Dr. MJ started a weight loss program and expanded her role within the practice, and later expanded Lori’s role again to become the Practice Administrator.  Rockdale Family Practice has grown and now has five doctors and two physician assistants, for a total staff of 30. Prior to Rockdale Family Practice, Lori previously worked eight years for an allergy practice.

Lori knows that if the staff are happy, then they will enjoy coming to work.  By maintaining a good work environment, the staff work more efficiently and take better care of the patients. Lori has an open door policy to talk about personal issues or other things that may come up while at work.  By talking it through and giving them care and attention, her colleagues feel valued and better throughout the day.  She is the liaison between the staff and doctors, so she knows her role is important to keep everything running smoothly.  Lori is extremely proud to have happy staff.

The two tips that Lori offers as suggestions to other practice administrators support this mantra.  She recommends to be a good listener and to be compassionate to both staff and patients.  A lot of things come up during the day that you don’t anticipate.  So it’s important to be prepared to be hit with things and be ready to respond.  Lori wears a lot of hats in the practice administrator role and often needs to think outside the box for the solution.

The best advice that Lori has received is from the current doctors.  They told her to be confident in decisions and be a leader for the office.  She does this well as M.J. Kassam, M.D. stated, “Lori has an ability to brighten the whole place with her presence, her smile, her overall enthusiasm and genuine care for the practice and the individuals whose lives interact there, whether they be clients, vendors, business associates, staff members or a delivery person passing through.  Even on the more challenging days, Lori radiates positive energy and a sense of fairness that contribute greatly to good morale, cooperation and team building.”  Lori received high praise from Indira Asser, M.D., “There are several things that I love about working with Lori Bazzani. She handles the administrative part of the office so effectively, that I don’t recall the last time I had to be involved in ‘putting out a fire’, which involved a patient or an employee.  She is a very good listener, very conscientious, and adored by my fellow doctors and all other employees. Because of her, the minutiae is handled and I can focus on what I love doing, and that is, taking care of patients.”

Lori Bazzani was nominated by Chris Jann of Medicus IT.  She stated, Chris knows that she’s not big on knowing computer systems and feels good about leaving things in his team’s hands.  When Rockdale Family Practice got a new EMR system the prior year, the EMR group wanted to switch IT companies, but Lori talked to the doctors and wanted to keep Chris and the Medicus IT team.  Medicus IT was more than capable of working with the new EMR system and keep everything running smoothly.

What You Don’t Know CAN Hurt You. Is Your Practice Compliant?

Categories: Articles

201710_wydkchyiypcBy now, we know that discrimination is against the law. Or we should know that. As it turns out, many physician practices don’t know the compliance standards of ACA Section 1557, and that they are currently NONCOMPLIANT. And who can blame a busy practice administrator?? With so many rules & regulations about just about anything, this was easy to miss.

IF a practice knows about Section 1557, they may assume it doesn’t apply to them. So who does this regulation apply to? ANY provider receiving federal assistance from HHS. Those would include:

  • Medicaid
  • Medicare Parts A, C & D
  • Grants and Credits from HHS, such as Meaningful Use payments

So, what does a practice have to do to become compliant?

There are actually 7 required elements included in Section 1557. The elements include information regarding language assistance services being available at no charge to the patient, and how a patient can obtain auxiliary aids, free of charge. Also included is information regarding the grievance procedure for any action prohibited by Section 15574.

A non-discrimination notice that contains all 7 requirements must be posted in a number of places. One is a conspicuous physical location at the practice location, like the waiting room. In addition to the office, a link to the notice must be accessible from the practice’s website home page.

The official ruling can be found here:

We’ve tried to make the rules easy to understand, so we’ve created a whole page on our website. That can be found here:

Don’t allow your practice to be non-compliant. It’s an easy fix. Not knowing about the requirements seems to be the biggest issue.

Article written and submitted by Sheila Fox-Lovell, President of Shandy Creative Solutions.
Questions? Contact Sheila at 770.951.0305 or sheila@shandycreative.com

Why Use a Staffing Agency?

Categories: Articles

201710_wuasaMost businesses can use an extra set of hands to handle a big project or a new surge in business. But most are also reluctant to hire full-time staff. A staffing agency can provide temporary employees to help with a wide variety of business tasks. Working closely with the staffing agency, a hiring manager can ensure that temporary workers possess the needed skills, education and experience to meet the needs of the company.

Improve Productivity

Bringing in temporary workers to handle work overload can prevent employee burnout of full-time staff. When work schedules are overloaded, employees can quickly become unmotivated and overwhelmed. This can increase mistakes made as well as decrease productivity. Increased absenteeism is often a side effect when this occurs. By bringing in temporary staff to handle the extra work load, full-time employees can continue to focus on their main job tasks while maintaining their productivity.

Try Before You Buy

Temporary employees give the business a chance to try out an employee before making a permanent offer of employment. In some cases, a person may have the experience and education for a job but simply does not mesh well with the business environment. Having the opportunity to have the person work on a temporary basis first gives the business a chance to evaluate how the person will fit in with the corporate culture and other employees. It also provides time to identify any weaknesses that would not typically be evident in the interview process.

Decrease Costs

Temporary staff persons are employed by the staffing agency, not the business that is using their services. This can decrease the overall costs of the employee as the business does not have to provide benefits to a temporary staff member. In addition, bringing in temporary staff may reduce other overhead costs such as overtime for regular, full-time employees. While the per-hour cost may be more than the per-hour cost of a full-time employee, temporary staff can be used as needed without a commitment of a 40-hour workweek regardless of if the work exists to support it.

Avoid Unemployment Claims

Because the temporary staff person is an employee of the staffing agency and not the business, there is no concern about the person filing for unemployment when their services are no longer needed by the business. This can also reduce overall operating costs for the business as the unemployment claims rate of the business will not be raised due to letting go of temporary staff. Human resources costs may also decrease as managers will not be spending multiple hours dealing with unemployment claims and the Department of Labor.

Increase Flexibility

Temporary employees allow businesses to use staff as needed. Temporary employees can be brought in to cover the vacation of an employee or maternity leave. Many staffing agencies can provide employees in a wide variety of disciplines to meet all of the needs of the business. The business then has the flexibility to use the services of the temporary staff as needed, whether it is a few hours a week or on a full-time basis. Using a staffing agency can avoid the permanent commitment that a full-time employee requires, saving both time and money.

The Avery Difference

At Avery Partners, we are different in that we take all the risk. We meet each of our candidates face to face for the interview to make sure they are the best fit for the job. These candidates are also OUR employees. We manage all their paperwork, applications, check references, federal verification and tax forms, background checks, drug screenings, pay-records, taxes, etc. This takes the hassle off your company and staff so that you can do what you do best.

Please contact Jennifer Hall for more information at the office (770) 642-6100 x237 or email Jennifer.Hall@AveryPartners.com

Main article taken from: smallbusiness.chron.com/use-staffing-agency-2513.html

Should your business consider near field communication?

Categories: Articles

201710_sybcnfcNear field communication, NFC, is a short-range, wireless data transfer between two enabled electronic devices.  In the payment processing world that means it allows two devices, like a smartphone and a payment terminal, to talk to each other when they are within range (usually about two inches) to complete a transaction.  Sometimes near field communication is referred to as contactless payments or the wireless version of EMV (Europay, Mastercard, and Visa or chip card payments.)

NFC is another payment method option and does not interfere with magnetic stripe or EMV chip card transactions.  It allows the business to meet the customer’s payment preference by offering another option. Similar to chip card transactions, there is increased security with the transaction as NFC includes dynamic encryption for each transaction.

How does it work?

Both the customer and the business need to have technology in place to allow NFC payment transactions.  For the customer, they need to utilize a mobile wallet on their phone.  The phone may have one included or they can download a mobile wallet app such as Apple Pay, Android Pay, or several others.  The customer loads their credit or debit card information to the app.  The technology within the app and phone provides an effective barrier against fraud.  NFC mobile payments are dynamically encrypted to prevent hacking, and the phone has additional security of fingerprint technology or PIN entry.  The customer may also ‘turn off’ their mobile wallet card at any time. For the business, they need to have an NFC enabled point-of-sale terminal.  With the implementation of EMV at the end of 2015, most credit card terminals also included NFC capability. Businesses can check with their merchant services processor to confirm functionality.

The credit card terminal initiates the transaction as the cashier enters the transaction amount then the terminal awaits payment information.  If NFC is enabled, the customer opens the mobile wallet app on their smartphone or device, selects the particular card, then taps, holds, or waves the device over the NFC enabled terminal reader until payment is accepted.  The transaction usually completes faster than an EMV chip card transaction.

Why allow NFC payments?

NFC payment transactions are secure, fast, and convenient.  The dynamic encryption and short communication distance between devices provide security for the transaction similar to EMV chip cards. Additionally, the customer’s card is never out of their hands. The transaction runs faster than EMV transactions which may speed up lines and improve customer satisfaction.  Today’s customer is fast moving and often carrying their smartphones and may not always carry their purse or wallet.  By enabling NFC payments, the business appears tech savvy and doesn’t miss the opportunity for a sale. Mobile wallets have increased in popularity over the last three years.

Jennifer Autian is the founder of TCA Business Solutions and an independent representative of merchant services.  To learn more about NFC technology or explore other payment processing options, connect with her at 678-523-8760 or by email at Jennifer@tcabiz.com.

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