Choosing a medical transcription company and getting top transcription service from it is a two-way street.
The company has to meet certain standards. At the same time, the office has to do its part to make it possible for the company to succeed, says Alisha Harris, owner of Precision Transcription in Albany, NY. And to achieve both, the manager needs to be aware of five elements.
What’s the real cost?
There’s more to the quoted price than many managers realize, Harris says.
The most common pricing is by the line. The number of lines is derived by counting total number of characters in the document and dividing by 65. Find out what divisor the company uses, because it can be less and sometimes even more than 65, and that will affect the price. A price of 12 cents a line may be a better buy than 10 cents a line.
Another common pricing approach is a dollar amount per minute of dictation. The average rate of speaking is eight to 12 lines per minute, and the price is often quoted in the middle at 10 lines per minute.
Pricing can be also done by page of transcription.
And it can be determined by the number of keystrokes, though that number usually includes capitalizations, bolding, italics, and so on and has to be tracked by computer.
Turnaround time will also affect the price.
But the price may not end there, Harris says. Ask if there are other charges. There may be electronic fees. Or there may be charges for corrections. Or the office may have to use the company’s platform, which can create an additional expense.
What’s the quality of service?
“The last thing a manager should have to worry about is whether the transcription is getting done on time and whether it suits the doctors,” Harris says. A good service should satisfy “both the physicians and the practice as a whole.”
If a physician has special preferences, the manager should be able to say, “Dr. A is really picky on this” and the company should meet that requirement.
Best quality comes when the company assigns one transcriptionist to each physician, Harris says. After about 60 days, the transcriptionist fully understands that doctor’s individual preferences.
Is HIPAA compliance assured?
The office has to have confidence in the company’s HIPAA compliance.
The business associate agreement covers that, but when the company is located overseas, “here’s a gray area of how much HIPAA compliance can be assured, particularly if the company uses subcontractors.
The greater the separation between office and service, the less control the office has on HIPAA compliance and the greater the risk of violations that will ultimately be the office’s responsibility.
Is the office doing its part?
Managers also need to be aware of their own responsibilities, Harris says. Many seemingly minor things can affect both efficiency and price. She makes several recommendations.
One is to send the patient schedule at the start of the day so the company can complete each job without having to interrupt it for lack of data. Her advice is to send the schedule at the beginning of the day even if there are going to be add-on appointments. Then send the completed schedule at the end of the day so the company can pick up that extra information.
Another recommendation is to “ask the doctors to slow down for the first two weeks” when the office starts using a new company.
Another is to explain to the physicians that they should edit their transcription as little as possible. “Some doctors edit constantly,” she says, and the office winds up with slower service, extra costs, and loss of the doctors’ productivity.
And here are yet two more recommendations.
First, set a turnaround time that will allow for the level of accuracy the office wants. With a 48-hour turnaround, everything should be accurate, she says. But when the customer needs the transcription in just a few hours, the accuracy rate will be lower.
And second, be clear about the format the office needs so the company can set up a template that meets those requirements exactly.
What’s the accuracy rate?
What sort of accuracy should the office expect?
Accuracy can be measured a number of ways. Most often, it’s by the percentage of errors per number of lines or per number of files.
But don’t get tied to calculations, Harris says. Put equal weight on whether the company corrects whatever errors the office flags and doesn’t repeat them.
And be sure to flag the errors. “In our line of business, no news is good news,” Harris says. Unless the company hears otherwise, it assumes all is well.
Errors differ in seriousness. The Association for Healthcare Documentation Integrity headquartered in Modesto, CA, puts them into four categories:
Critical errors. These affect patient safety – medical word misuse, incorrect drug or dosage, incorrect lab values and test names, omitted dictation, and patient identification error.
Major errors. These affect document integrity – misspellings, transcription that’s different from the dictation, failure to flag a document for clarification, leaving a term blank instead of researching it, and failure to follow the office’s preferences.
Minor errors. These are typos as well as errors in grammar, punctuation, and formatting.
Dictation Flaws. These vary and can be critical, major, or minor.
Errors in medical words aren’t easy to avoid, Harris says, because terms are often spelled more than one way and also because there’s a constant stream of new medication products. What’s more, the doctor may mispronounce a product name or may dictate an incorrect spelling that the patient has written down.
For best accuracy, the company should flag just about all medicines as well as allergies for physician review. And along with that, the physicians should spell out anything that could cause confusion.
