Use this medical bills guide to build a clear demand letter for Phoenix.
Navigating Medical Bills in Phoenix: Know Your Rights and Demand Effective Resolution
Living in the vibrant and expansive Phoenix Metropolitan Area comes with its own set of challenges, and for many residents, unexpected medical expenses can be one of the most significant. Whether you've received a bill for a routine check-up, an emergency room visit, or a complex procedure, understanding your rights as a consumer in Phoenix regarding medical bills is paramount. This comprehensive guide is designed to empower Phoenix residents by demystifying the often-confusing world of medical billing, focusing specifically on the legal framework and practical steps you can take to address disputes and incorrect charges. Arizona, and by extension Phoenix, has specific laws and regulations in place to protect consumers from predatory billing practices and to ensure fairness in healthcare transactions. However, navigating these regulations without clear guidance can be daunting. This resource aims to provide you with the knowledge and tools necessary to effectively communicate with healthcare providers and collection agencies, understand your legal standing, and ultimately, achieve a fair resolution for your medical bills. We will delve into Arizona's specific statutes, outline a step-by-step process for crafting a powerful demand letter, and equip you with information on crucial deadlines and common pitfalls to avoid. By understanding your rights and utilizing the strategies outlined herein, you can take control of your medical finances and ensure you are not unfairly burdened by erroneous or excessive healthcare charges within our dynamic city and the broader state of Arizona. This guide is tailored to the unique legal landscape of Arizona and the practical realities faced by individuals in Phoenix, ensuring you have the most relevant and actionable information at your fingertips.
Arizona and Phoenix Medical Bills Laws: Protecting Your Consumer Rights
Arizona's legal framework provides several layers of protection for consumers dealing with medical bills. At the state level, various statutes govern debt collection practices, contract disputes, and consumer protection, all of which are applicable to medical bills within Phoenix. A cornerstone of consumer protection in Arizona is the Arizona Consumer Protection Act, which prohibits deceptive or unfair acts or practices in the conduct of any trade or commerce. While not exclusively focused on medical bills, this broad statute can be invoked if a healthcare provider or collection agency engages in misleading or unfair tactics regarding your outstanding balances. Arizona Revised Statutes (A.R.S.) § 44-1521 et seq. outlines these protections and provides avenues for redress.
Furthermore, specific statutes address debt collection. The Fair Debt Collection Practices Act (FDCPA) is a federal law, but Arizona has also enacted its own version, A.R.S. § 33-1601 et seq., which mirrors many of the FDCPA's provisions and offers additional protections. These laws prohibit debt collectors, including those attempting to collect medical debt, from using abusive, deceptive, or unfair practices. This includes harassment, misrepresentation of the amount owed, and attempting to collect debts that are not legally owed. For medical bills, this means collection agencies cannot threaten legal action they cannot take or misrepresent the legal status of your debt. It's crucial for Phoenix residents to understand that these protections extend to all forms of debt collection, including those stemming from healthcare services.
When it comes to the healthcare provider themselves, Arizona law also has provisions related to billing transparency and dispute resolution. While there isn't a single statute solely dedicated to medical bill disputes, the principles of contract law and good faith dealings apply. When you receive medical services, there is an implied agreement for reasonable compensation. If the billed amount is significantly outside the realm of reasonable charges for the services rendered, or if there are demonstrable errors in coding or documentation, you have grounds to dispute the bill. Arizona courts generally uphold the principle that contracts must be based on mutual understanding and fair consideration. Therefore, a medical bill that is demonstrably inaccurate or inflated can be challenged.
Phoenix, as a major city within Arizona, operates under these state laws. While there may not be extensive local Phoenix ordinances specifically detailing medical bill dispute procedures, the Maricopa County Superior Court handles civil matters, including those involving contract disputes and debt collection. Understanding the jurisdiction and procedures of this court is vital if a dispute escalates beyond a demand letter and requires legal action. The Arizona Attorney General's Office, Consumer Protection and Advocacy Section, is a key state-level resource that can provide guidance and investigate complaints against businesses, including healthcare providers and collection agencies, that violate consumer protection laws. They are a critical point of contact for Phoenix residents seeking assistance.
Moreover, Arizona law emphasizes the importance of clear communication and good faith negotiations. When disputing a medical bill, you are essentially entering into a negotiation with the provider or collection agency. Both parties are expected to act in good faith. This means you should present your dispute clearly and with supporting evidence, and the provider or agency should respond reasonably and investigate your claims. Failure to do so can be construed as an unfair or deceptive practice under the Arizona Consumer Protection Act. The spirit of Arizona law encourages fair resolution of disputes, and by understanding these legal underpinnings, Phoenix residents can approach their medical bill challenges with greater confidence and a solid legal foundation.
Step-by-Step Guide to Crafting an Effective Medical Bills Demand Letter in Phoenix
Before you begin writing, clearly identify the exact medical bill you wish to dispute. Note the patient's name, date of service, the name of the healthcare provider (hospital, clinic, physician group), the account number, and the total amount of the bill. Having this precise information readily available will ensure your demand letter is focused and professional.
Pinpoint the exact reason(s) why you are disputing the bill. Common reasons include billing errors (e.g., incorrect codes, duplicate charges), services not rendered, insurance coverage issues, unexpected charges not discussed beforehand, or excessive charges compared to standard rates. Be specific about what you believe is wrong with the bill. For instance, instead of saying 'the bill is wrong,' state 'I was billed for a consultation on [date] which I did not attend' or 'the CPT code [code number] billed does not accurately reflect the service provided, which was a simple blood draw.'
Collect every piece of evidence supporting your dispute. This includes copies of the original bill, Explanation of Benefits (EOB) from your insurance company, medical records related to the service, any pre-authorization documents, notes from conversations with the provider or insurance company, and any correspondence you've already had regarding the bill. The more comprehensive your documentation, the stronger your case will be. Refer to the 'Essential Evidence' section for a detailed list.
Determine whether you should send the demand letter to the healthcare provider directly or to the collection agency if the bill has been sent to collections. If you're disputing an original bill, address it to the billing department of the healthcare facility. If a collection agency is involved, address it to their legal department or designated consumer relations department. Using the correct recipient ensures your letter reaches the appropriate decision-makers.
Begin your demand letter with a clear statement of your intent. For example: 'This letter serves as a formal demand for the correction of an erroneous medical bill and a dispute of the outstanding balance for services rendered to [Patient Name] on [Date of Service], account number [Account Number].' Maintain a respectful and professional tone throughout the letter, even if you are frustrated.
Clearly outline each specific charge you are disputing and explain precisely why. Refer to your gathered documentation to support each point. For instance, if a charge is for a service you believe was covered by insurance, state: 'According to the EOB from [Insurance Company] dated [Date], the service with CPT code [code number] was billed at $[Amount] and was covered under my plan. However, I have been billed by your facility for this same service at $[Amount]. Please correct this discrepancy.'
While not always necessary for a first demand letter, referencing relevant Arizona statutes or federal laws can strengthen your position, especially if the provider or agency has been unresponsive or uncooperative. For example, you might mention the Arizona Consumer Protection Act (A.R.S. § 44-1521 et seq.) or the Fair Debt Collection Practices Act (FDCPA) if you believe their collection practices are violating these laws. You could state, 'I am aware of my rights under Arizona's consumer protection laws, including the prohibition of unfair or deceptive practices, and expect this matter to be resolved promptly and fairly.'
Clearly state what you want the recipient to do to resolve the dispute. This could be to remove the incorrect charges, re-bill the corrected amount, provide proof of the debt, or adjust the balance to a mutually agreeable figure. For example: 'I demand that the incorrect charge of $[Amount] for [Service] be removed from my account, and that a corrected bill reflecting the accurate balance of $[Corrected Amount] be issued. Alternatively, I propose a settlement of $[Settlement Amount] to resolve this matter amicably.' Be realistic with your proposed resolution.
Specify a reasonable timeframe within which you expect a response. For medical bills in Arizona, 15 to 30 days is generally considered reasonable. State this clearly: 'I expect a written response to this demand letter within 30 days of the date of this letter.' This creates a sense of urgency and establishes a timeline for further action.
Politely inform the recipient of the actions you will take if a satisfactory resolution is not reached by the deadline. This could include filing a complaint with the Arizona Attorney General's Office, the Better Business Bureau, or seeking legal counsel to pursue further action in Maricopa County Superior Court, or even the Arizona Small Claims Court if the amount falls within its jurisdiction (currently $3,500 for claims filed on or after January 1, 2023). For example: 'If I do not receive a satisfactory response and resolution by [Date], I will be forced to explore all available legal avenues, including filing a formal complaint with relevant consumer protection agencies and potentially seeking legal recourse.'
Ensure your letter is signed and dated. Include your full name, mailing address, phone number, and email address. This ensures they have your contact information for their response.
To ensure proof of delivery and receipt, send your demand letter via certified mail with return receipt requested. This provides you with a legal record that the letter was sent and received, which is crucial evidence if the dispute escalates. Keep a copy of the letter and the mailing receipt for your records. This is a critical step in demonstrating your earnest attempt at resolution and establishing a paper trail.
Essential Evidence for Phoenix Medical Bills Claims
When disputing medical bills in Phoenix, the strength of your claim hinges on the quality and comprehensiveness of your evidence. Arizona law, like most jurisdictions, requires consumers to substantiate their claims with credible proof. Gathering and organizing this evidence meticulously is the bedrock of a successful demand letter and any subsequent legal action. The more robust your documentation, the more persuasive your argument will be to the healthcare provider, collection agency, or legal body.
By systematically gathering and organizing these types of evidence, Phoenix consumers can build a compelling case to support their demand letter and achieve a more favorable resolution to their medical bill disputes.
Critical Deadlines for Medical Bills in Arizona: Navigating Time-Sensitive Requirements
Understanding and adhering to critical deadlines is crucial when dealing with medical bills and disputes in Arizona. Missing a deadline can significantly jeopardize your ability to resolve a dispute favorably or even to pursue legal recourse. Arizona law, along with federal regulations, imposes various time limitations that consumers must be aware of. For Phoenix residents, these deadlines are governed by state and federal statutes that apply across the state.
It is imperative for Phoenix consumers to prioritize these deadlines. When in doubt, it is always best to consult with a legal professional in Arizona. They can provide specific guidance based on the details of your case and ensure that you do not miss any critical timeframes. Proactive management of these deadlines is key to a successful resolution of your medical bill issues.
Common Mistakes to Avoid in Phoenix Medical Bills Claims
Navigating medical bill disputes in Phoenix, as elsewhere, can be a minefield of potential errors that can hinder resolution or even strengthen the provider's or collector's position. Being aware of these common pitfalls is crucial for any Phoenix resident seeking to effectively challenge an erroneous or unfair medical bill. By understanding what not to do, you can significantly improve your chances of a positive outcome.
1. **Ignoring the Bill Entirely:** This is perhaps the most detrimental mistake. Many individuals, overwhelmed or embarrassed by medical bills, choose to ignore them. However, an ignored bill can quickly escalate. It can be sent to collections, negatively impact your credit score, and eventually lead to legal action. In Arizona, ignoring a bill does not make it disappear; it only allows it to grow and potentially cause more damage.
2. **Failing to Read Bills Carefully:** Medical bills are often complex and can contain errors. A common mistake is not meticulously reviewing every line item, CPT code, and charge. You might be billed for services not rendered, duplicate charges, or services you never authorized. A thorough review is the first step in identifying potential disputes. This applies universally, but for Phoenix residents, it means scrutinizing bills from local hospitals and clinics with the same diligence.
3. **Not Understanding Your Insurance Coverage:** Many disputes arise from a misunderstanding of what your health insurance plan covers. Failing to verify coverage beforehand or misunderstanding your deductible, copay, or coinsurance responsibilities can lead to unexpected bills. Before or after receiving services, always confirm with your insurer what is covered and what your out-of-pocket costs will be. This is especially important in Arizona, where insurance plans can vary significantly.
4. **Not Communicating in Writing:** While phone calls can be helpful for initial inquiries, relying solely on verbal agreements or discussions is a significant mistake. Healthcare providers and collection agencies are more likely to honor written agreements. Always follow up phone calls with an email or letter summarizing the conversation and any agreements reached. This creates a crucial paper trail. For Phoenix disputes, this written record is vital evidence.
5. **Being Aggressive or Unprofessional:** While it's natural to be frustrated, an aggressive, rude, or emotional approach can be counterproductive. It can make the provider or collector less willing to cooperate or negotiate. Maintain a calm, professional, and assertive demeanor. Focus on facts and evidence, not on emotional accusations.
6. **Missing Deadlines (Statute of Limitations, Response Times):** As detailed in the 'Timeline Deadlines' section, Arizona has specific statutes of limitations for debt collection and contract disputes. Missing these deadlines can mean losing your right to sue or defend yourself. Similarly, ignoring response deadlines for debt validation requests or legal summons can lead to default judgments. Proactive engagement and awareness of timelines are key.
7. **Paying Without Verification or Dispute:** Do not pay a bill you believe is incorrect or unjustified without first attempting to dispute it. Many people pay a bill out of fear or confusion, only to realize later that they overpaid or paid for something they shouldn't have. Always dispute first, then negotiate or pay what is rightfully owed.
8. **Not Sending Demand Letters Via Certified Mail:** When sending a formal demand letter, using certified mail with return receipt requested is not just a suggestion; it's a necessity. Failing to do so means you lack proof that the letter was sent and received, which can be critical evidence if the dispute escalates to legal proceedings. This is a standard legal practice in Arizona.
9. **Failing to Keep Copies of Everything:** This is a cardinal rule in any dispute. Make and keep copies of *all* documents related to the medical bill and your dispute: bills, EOBs, medical records, correspondence, payment receipts, demand letters, and mailing receipts. Without these, you cannot effectively present your case.
10. **Not Seeking Professional Help When Necessary:** While this guide provides comprehensive information, some medical bill disputes are complex and may require the expertise of an attorney, a medical billing advocate, or a consumer protection agency. Trying to handle a complicated case entirely on your own can be a mistake if you lack the legal knowledge or negotiation skills. For significant bills or persistent issues, consulting with Arizona-based legal professionals or relevant agencies is a wise step.
By diligently avoiding these common mistakes, Phoenix residents can significantly enhance their ability to resolve medical bill disputes efficiently and favorably, protecting their financial well-being.
Frequently Asked Questions About Medical Bills in Phoenix
In Arizona, the statute of limitations for medical bills, often treated as contract disputes, is generally six years for written contracts (A.R.S. § 12-506) and two years for oral contracts (A.R.S. § 12-505). This means a healthcare provider or collection agency has this period to sue you for an unpaid bill. It's essential to be aware of these deadlines to avoid potential legal action or to know your rights if you need to dispute a bill that is past its statute of limitations.
Yes, if a healthcare provider or collection agency obtains a court judgment against you for an unpaid medical bill, they may be able to garnish your wages in Arizona. However, they must first go through the legal process of suing you and winning a judgment. There are also limits on how much of your wages can be garnished under Arizona law to ensure you have sufficient funds for basic living expenses.
For claims filed on or after January 1, 2023, Arizona's Small Claims Court has a monetary limit of $3,500. If your medical bill dispute falls within this amount, you can file a case in small claims court, which offers a more streamlined and less formal process. For amounts exceeding $3,500, you would typically need to file in the Maricopa County Superior Court.
To dispute a medical bill with a Phoenix hospital, first, review the bill carefully. Gather all relevant documentation like your insurance EOB and medical records. Then, write a formal demand letter to the hospital's billing department, clearly stating the errors and what resolution you seek. Send it via certified mail with return receipt requested. If the hospital is unresponsive, consider contacting the Arizona Attorney General's Office or seeking legal advice.
Generally, no. In Arizona, healthcare providers are required to obtain informed consent for most medical procedures and treatments. If you were billed for services you did not consent to, and there was no emergency situation, you have strong grounds to dispute the bill. You should clearly state this in your demand letter and provide any evidence you have, such as lack of a signed consent form.
In Phoenix, you can contact the Arizona Attorney General's Office, Consumer Protection and Advocacy Section, for assistance with consumer protection issues related to medical bills. The Better Business Bureau (BBB) of the Grand Canyon State can also be a resource for filing complaints and seeking mediation. Additionally, local legal aid societies may offer assistance for low-income individuals.
Yes, a hospital can send a disputed medical bill to collections, especially if you do not formally dispute it or fail to reach a resolution. However, if you have a legitimate dispute with proper documentation and have followed the steps outlined in your demand letter, you can also dispute the debt with the collection agency and potentially with credit bureaus if it impacts your credit report. It is crucial to formally dispute the debt and provide evidence to both the provider and the collection agency.
If your insurance denied a claim, you should first understand the reason for the denial by reviewing the EOB. You have the right to appeal the insurance company's decision. If you believe the denial was incorrect, you can file an internal appeal with your insurer. If the internal appeal is unsuccessful, you may have further appeal rights, including external review. Concurrently, you should address any billing discrepancies with the provider, especially if the denial was due to a billing error by the provider.
What to Expect When Settling Medical Bills Disputes in Phoenix
When you embark on the process of disputing a medical bill in Phoenix, it's essential to have realistic expectations regarding potential settlements. The goal of a demand letter and subsequent negotiations is to reach a mutually agreeable resolution, which may not always be a complete dismissal of the bill, but rather a reduction or adjustment. Understanding the typical outcomes and negotiation strategies can help you approach these discussions more effectively.
Firstly, be aware that many medical bill disputes are resolved through negotiation rather than outright dismissal. Healthcare providers and collection agencies are often willing to negotiate a lower payoff amount, especially if you can demonstrate a clear error in billing or a genuine inability to pay the full amount. A settlement often involves a compromise where you pay a reduced lump sum, or agree to a more manageable payment plan, in exchange for the provider writing off the remaining balance. For Phoenix residents, this could mean negotiating a settlement that fits within your budget for the Phoenix metropolitan area's cost of living.
Secondly, the success of your negotiation often hinges on the strength of your evidence and your communication. A well-crafted demand letter, backed by solid documentation (as outlined previously), significantly increases your leverage. If you can clearly show that the bill contains errors, or that your insurance should have covered more, the provider is more likely to offer a concession. Conversely, if your dispute is based on a misunderstanding of your insurance benefits or a general inability to pay without substantial proof, your negotiating power may be limited. Arizona law encourages good faith negotiations, meaning both parties should be willing to engage and find common ground.
Thirdly, be prepared for a back-and-forth process. Settlements rarely happen with the first offer. You may receive a counter-offer that is still higher than what you wish to pay. This is where negotiation skills come into play. You might need to politely reiterate your position, highlight specific points of your evidence, and perhaps make a slightly increased offer. If you are dealing with a collection agency, they are often empowered to settle for a percentage of the total debt, as their goal is to recover some amount rather than nothing.
Fourthly, understand that a settlement agreement should always be in writing. Once you reach an agreement, ensure it is documented clearly and signed by both parties. This document should explicitly state the agreed-upon settlement amount, confirm that this amount is accepted as full and final payment of the debt, and stipulate that the provider or collection agency will cease all further collection efforts. This written agreement serves as your protection against future demands or negative reporting to credit bureaus. For Phoenix residents, having this written confirmation is vital for their financial records.
Finally, if direct negotiation fails, consider alternative dispute resolution methods. Mediation services, sometimes offered through consumer protection agencies or private mediators in the Phoenix area, can help facilitate a conversation between you and the provider or collection agency with the help of a neutral third party. If the dispute is within the small claims court limit in Arizona, filing a case can sometimes prompt the other party to settle to avoid the legal process. However, always weigh the potential costs and benefits of further action against the proposed settlement.
Phoenix Medical Bills Resources and Contacts
Navigating medical bill disputes can be complex, but Phoenix residents have access to several valuable resources and agencies that can offer assistance, guidance, and support. These local and state-level entities are designed to protect consumers and help resolve issues with healthcare billing and debt collection.
1. **Arizona Attorney General's Office, Consumer Protection and Advocacy Section:** This is a primary resource for any consumer dispute in Arizona, including medical bills. They investigate complaints of deceptive or unfair business practices, mediate disputes, and can take legal action against companies violating consumer protection laws. They offer guidance and can often intervene on behalf of consumers.
* **Website:** [https://www.azag.gov/](https://www.azag.gov/)
* **Phone:** (602) 542-3784
2. **Better Business Bureau (BBB) of the Grand Canyon State:** The BBB serves as a trusted intermediary between consumers and businesses. You can file a complaint against a healthcare provider or collection agency, and the BBB will attempt to mediate a resolution. While not a legal enforcement agency, their involvement can often prompt a business to address a complaint.
* **Website:** [https://www.bbb.org/arizona](https://www.bbb.org/arizona)
* **Phone:** (602) 264-1721
3. **Maricopa County Superior Court - Small Claims Division:** For medical bill disputes under $3,500 (as of Jan 1, 2023), the Small Claims Division of the Maricopa County Superior Court is an accessible venue for legal resolution. The process is designed to be simpler and less formal. Their website provides information on filing procedures, forms, and court dates.
* **Website:** [https://www.superiorcourt.maricopa.gov/](https://www.superiorcourt.maricopa.gov/) (Navigate to Civil Division -> Small Claims)
* **Phone:** (602) 372-6300
4. **Legal Aid Societies in Phoenix:** If you have limited income and cannot afford an attorney, Legal Aid societies can provide free or low-cost legal assistance for certain civil matters, including consumer debt issues. They can offer advice, representation, or referrals.
* **Community Legal Services (CLS):** Serves low-income individuals in Maricopa County.
* **Website:** [https://clsaz.org/](https://clsaz.org/)
* **Phone:** (602) 252-3937
* **Arizona Legal Aid:** Another provider of legal services for those who qualify.
* **Website:** [https://www.azlegalaid.org/](https://www.azlegalaid.org/)
5. **National Consumer Law Center (NCLC):** While not a direct service provider, the NCLC is a non-profit organization that advocates for consumers and provides extensive resources, research, and publications on consumer law, including debt collection and medical debt. Their website can be a valuable source of information for understanding your rights.
* **Website:** [https://www.consumerlaw.org/](https://www.consumerlaw.org/)
6. **Arizona Department of Insurance and Financial Institutions (DIFI):** While primarily focused on insurance, DIFI can be a resource if your medical bill dispute involves complex insurance coverage issues or if you suspect unfair practices by an insurance company related to a medical claim.
* **Website:** [https://difi.az.gov/](https://difi.az.gov/)
* **Phone:** (602) 542-1539
7. **Medical Billing Advocates or Consumer Attorneys:** For more complex or high-value disputes, consider consulting with private professionals. Medical billing advocates specialize in reviewing and negotiating medical bills. Consumer protection attorneys can provide legal advice and representation if litigation becomes necessary.
* *Search online directories for 'medical billing advocates Phoenix' or 'consumer protection attorneys Phoenix'.*
By leveraging these resources, Phoenix residents can gain the knowledge, support, and legal recourse necessary to effectively manage and resolve their medical bill disputes.
The Medical Bill Battle Plan
Get the Itemized Bill
Not a summary - the full itemized bill with procedure codes. Errors hide in the details.
Compare to Your EOB
Explanation of Benefits from your insurer. What did they pay? What did they deny?
Research Fair Prices
Use Healthcare Bluebook or FAIR Health to find what procedures should actually cost.
Medical Billing Laws Protect You
The No Surprises Act limits surprise billing. State laws add more protections. Insurance denials can be appealed.
Arizona Medical Bills Laws
Applicable Laws
- No Surprises Act (Federal)
- Arizona Balance Billing Law
- A.R.S. § 20-2803
Small Claims Limit
$3,500
Notice Period
30 days
Consumer Protection Agency
Arizona Department of Insurance
Medical Bill FAQ
What if the bill is in collections?
You can still dispute. Send a validation letter to the collector and dispute with the provider simultaneously.
How do I know if I was overcharged?
Compare your itemized bill to fair market prices. Look for duplicate charges, upcoding, and services you didn't receive.
Can I negotiate the bill?
Absolutely. Many hospitals will reduce bills by 20-50% if you ask, especially for uninsured patients or prompt payment.
What is balance billing?
When an out-of-network provider bills you for the difference between their charge and insurance payment. The No Surprises Act now limits this.
Should I pay while disputing?
Ask for the billing to be paused during the dispute. Make partial payments if needed to prevent collections, but document your dispute.
Can I request an audit?
Yes. Request an itemized bill audit from the provider's billing department or hire a medical billing advocate.
What about charity care?
Many hospitals have financial assistance programs. Ask about charity care, sliding scale fees, or payment plans based on income.
About FreeDemandLetter
FreeDemandLetter provides free, AI-powered demand letter generation with location-specific legal citations. Our content is reviewed by subject matter specialists and regularly updated to reflect current laws. We help thousands of people resolve disputes effectively—but we're not lawyers, and this isn't legal advice. For complex situations, consult a licensed attorney in your jurisdiction.
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