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Serving Over 20,000 US Medical Transcriptionists

Part of your post is exactly what disillusioned mentioned.

Posted By: JMO on 2005-07-15
In Reply to: Transcend talk - sm

Your post said : My question is this, however, what if  high producers are treated differently than others? They are kind of like the employee who is always at work, on time, positive attitude versus the employee who calls off, is undependable, bad attitude.  Which one do you think would get better treatment?  That is pretty much a no brainer if you ask me!  There are also those MTs who are great employees and do the basic line count required of them.  They receive the basic pay that they were offered.  What is so wrong with that?  That is the effort they put into it. That is not always true.  I can tell you countless times that I went above and beyond what was required of me, and I had always, repeat always, found Transcend a good place to work.  Until recently when I started noticing little discrepancies with what I had been told and read from management and what had happened in actuality.  That doesn't mean that I am just going to up and quit, but it certainly does put a little bit of distrust into the equation, making it hard to believe other things that I'm told.  It doesn't mean I'm undependable, not at work, or have a bad attitude even after I had been told one thing by management and seen another.  But you also must admit that it is a little hard to express dissatisfaction internally within the company when it had been noted that a lot of concerns expressed internally were labeled as "emotional outbursts". How can one not become dissatisfied when our concerns are just dismissed as emotionality? (Just a side piece of information, I was not one of the MLSs accused of the emotional outbursts, but I just found it intimidating from a standpoint of expressing concerns in the future.)


You said: I scored 100% on all my tests for hire with Transcend.  I have 9 years' experience in clinic transcription.  I was hired in full time, benefits, etc.  I work on a clinic account and have a secondary that is hospital.  No, I did not have hospital experience when starting at Transcend.  Being the great company that they are, they were willing to train me and enhance my experience for both our benefits.  I make 0.0850 cents per line. I have a schedule, however, do not always work my hours but different ones according to what is going on in my life.  I dont ask if that is okay, I just do it.  If I cannot work in the morning, I do it at night.  No one has ever said anything to me about it because I do my lines.  According to what I was told when I tested there years ago, I received the same test score, came in with 10 years experience in acute care and have more than 5 different accounts now ALL acute care, including some of the most difficult accounts. Yet after years of working with Transcend I still do not make what you do. As far as not working your regular schedule but just fitting it in according to what is going on in your life, how is that dependable?  Our work group has been instructed not do to this not only by our A.M., but also by Larry because then you are stealing lines from people who are scheduled to work the ones you fit in around your lifestyle and it makes it harder for production to know how to schedule coverage. Yet, you say no one has ever said anything to you about it.  This is exactly what was meant by preferential treatment.


This is why I don't totally agree with your post.  I am not so unhappy that I am going to quit, but yet it really isn't fair to totally dismiss concerns of people like me just because you are having a different experience with the company than others.




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As I mentioned in another post...sm

what a great way for terrorist organizations to infiltrate the US.


I have no desire to go to MQ, never mentioned it in my post. nm
nm
It is mentioned in Devastated's second post.
nm
Read down the board. Mentioned just 2 posts below yours and mentioned
multiple times this week. 
I am disillusioned with TT...
and have been for some time now. I am too qualified for the jobs I have applied for or they don't pay enough, but will definitely keep looking. You can always do better somewhere. I know that a lot of people are leaving TT, especially over the insurance hike. I agree they are the best company I have found so far, but I still believe I can better my position elsewhere. I believe I have maxed out here, truthfully, and I don't agree with the way some things are done but I can't and don't say a word about it. Unfortunately, the top jobs at most places are given to the peers and friends of management. They basically disregard the qualifications of people they don't know - sad, but the way this business works. It does not work this way so much where you have face-to-face interaction so I may even consider doing that again.
I am disillusioned too and every time
I read this board, I get more depressed. I often wonder why I come here. I think it is to be at the water cooler. I also got a few job leads which were really good. I never would have landed my job with TT if it were not for this board.
However, I come on here to see what is going on and I am somehow always getting into the negative mood of everything here. One day a company is great and the next it isn't. One day being an MT is great and the next it is the worst. My goodness, I can get mood swings on my own without coming here and being swayed toward that bent.
I guess what I am saying is it is my fault I come on here and absorb the negative. But being an MT is difficult at home because we are working pretty much alone without companionship. But being here every day I question my job, even when I have resolved not to do that. I know the insurance went up. It went up everywhere. Some how if I had not come here to see what is going on, I think I would have worried less, trusting the boss' e mail they are trying to do better. I would have left it at that and not thought of leaving. But no, I come on here and see that other people are not happy, so I start wondering.
I am pretty sure this is the last time I am posting for my own good. I will miss the companionship but not the negativism, and as I said, I blame no one but myself, because I am the one taking the nay saying to heart.
TT as far as you are concerned, I am going to stay until you prove to me personally you don't care about me or my paycheck. The management has not shown that to me yet, and so I have no plans on leaving. When TT does hurt me personally then I will consider leaving. Best of luck to everyone. But please, if you agree at all with me, don't think negative. Think objectively.
Many Disillusioned Individuals
Me included.
Disillusioned....Sue's description sounds like the company you just left
except for the rental fee, which they JUST changed recently, and even then it was higher than the one Sue quoted.  I still say you got a much better deal with Amphion.
The sad part is that I did not post my resume
wa
This part of your post struck me as odd

~~~  I have been subject to some horrifying systems where the companies actually expect you to achieve your line counts or keep them hidden.~~~~


Okay, I understand how an MTSO can hide line counts.  I worked in an office and saw how they did it.


BUT, ~~I have been subject to some horrifying systems where the companies actually expect you to achieve your line counts~~~~  So you are saying TH has a horrifying system and does not expect you to achieve your line count?  That's an odd statement.  Care to expound on it? 


Very puzzling information.


TRANSCEND - PART 3 - did not fit on 2nd post

The Company may not be able to recruit and hire a sufficient number of new or replacement medical language specialists to sustain or grow the current level of revenue.


The Company cannot provide transcription services to customers within contracted delivery standards without an adequate supply of qualified medical language specialists. Medical language specialists are in short supply. The Company relies upon in-house recruiters to hire a sufficient number of qualified medical language specialists to meet current and projected needs. The Company attempts to attract and retain medical language specialists by offering competitive pay and benefits and the opportunity to work from home utilizing the Company’s Internet-based system. The Company is transitioning a significant portion of the business from transcribing (typing) to editing, which allows the Company to increase the productivity of existing personnel and attract a new supply of medical language specialists. Nonetheless, there can be no assurance that the Company will be able to hire and retain a sufficient number of medical language specialists to meet demand. Failure to do so could have a material adverse effect on the ability to undertake additional business or to complete projects in a timely manner, which could adversely affect operating results and financial condition.


The Company’s reliance on key third-party software could affect the ability to operate competitively.


Portions of the BeyondTXT technology were provided to us by Multimodal Technologies, Inc. under an agreement originally entered into on September 28, 2004. The original agreement was replaced by a new agreement, commencing September 1, 2006, that provides for a one-year, non-exclusive license that is renewable for up to four successive one-year periods at the Company’s option (the last such option period ending August 31,2011 and additional successive one-year periods if mutually agreed to by both parties. The inability to maintain the relationship with Multimodal Technologies, Inc. or find a suitable replacement for the technology at favorable prices or at all would adversely affect the ability to operate competitively and to meet the workload demands of the existing customer base.


 


Transcend’s operations depend on access to reliable voice and data networks and dictation capture systems. Any failure of more than one of these networks or systems, even for a short time, could harm the business.


The majority of the Company’s customers depend on the BeyondTXT platform, data networks and dictation capture systems being able to process voice and data files 24 hours per day, seven days per week. If voice and data networks or dictation capture systems are unavailable, the ability to transcribe documents for customers is severely limited. The Company is heavily dependent on third parties such as telecommunications providers and dictation system vendors. Although there is redundancy across these providers and systems, any failure of more than one of these networks or systems, even for a short time, could delay the ability to provide transcription services to customers. Because the timely delivery of transcription services is vital to customers, any such delay could harm the business.


The Company operates in a highly competitive market and can make no assurance that it will be able to compete successfully against current or future competitors.


The medical transcription services market is highly fragmented and competitive, with several thousand local, regional and national companies competing in the United States alone. In addition, the medical transcription industry in the United States has experienced competition from overseas competitors. While the Company attempts to compete on the basis of fast, predictable turnaround times and consistently high accuracy and document quality, there can be no assurance that the Company will be able to compete effectively, if at all, against competitors. These competitive forces could result in loss of market share, lower margins and/or increased technology investments.


The Company operates in an environment with competitive pricing pressure and can make no assurance that it will be able to compete successfully against current or future competitors on the basis of price.


Some competitors have lower cost structures than the Company does, particularly if they are small firms or operate primarily offshore. Other competitors may be willing to accept less profitable business in order to grow revenue. It is common for competitors to offer lower prices than Transcend’s. The Company attempts to position itself in the industry as a high quality provider at a mid-level price point. Accordingly, the Company may lose business on the basis of price or be forced to lower prices to win new business. There can be no assurance that the Company will be able to compete effectively, if at all, against competitors on the basis of price. Competitive pricing pressure could result in loss of market share and lower margins.


The use of offshore medical dictation subcontracting firms exposes the Company to operational and financial risks not inherent in the United States.


As of December 31, 2008, approximately 19% of the Company’s transcription volume was subcontracted to offshore providers. As the Company increases reliance on these offshore providers, there will be increasing exposure to operational and financial risks not inherent in its United States operations. These risks include political, economic and social instability, unexpected changes in the regulatory environment, currency fluctuations (although our contracts are in U.S. dollars) and the possibility that offshore providers will be acquired by a competitor and discontinue their relationship with the Company.


 


REVENUE


 Year Ended December 31, 2008 Compared to Year Ended December 31, 2007


Revenue increased $6.2 million, or 15%, to $48.7 million in 2008, compared to revenue of $42.5 million in 2007. The $6.2 million increase in revenue consisted of increased revenue from existing customers of $4.8 million, revenue from new customers of $3.0 million, partially offset by decreases in revenue of $1.6 million from customers who cancelled their contracts in 2008.


Direct costs increased $2.1 million, or 7%, to $30.9 million in 2008, compared to $28.8 million in 2007. Direct costs include costs attributable to compensation for transcriptionists, recruiting, management, customer service, technical support for operations, fees paid for speech recognition processing, telephone expenses and implementation of transcription services. Transcription compensation is a variable cost based on lines transcribed or edited multiplied by specified per-line pay rates that vary by individual as well as type of work. Speech recognition processing is a variable cost based on the minutes of dictation processed. All other direct costs referred to above are semi-variable production infrastructure costs that periodically change in anticipation of or in response to the overall level of production activity.


As a percentage of revenue, direct costs decreased to 63% in 2008 from 68% in 2007. The decrease in costs as a percentage of revenue is due primarily to cost savings that resulted from an increase in the use of the Company’s speech recognition-enabled BeyondTXT platform, growth of semi-variable direct costs of operations at a slower rate than the rate of revenue growth and the use of increased offshore transcription resources. Approximately 19% of the Company’s transcription work was performed offshore during 2008, compared to 14% during 2007. During 2008, approximately 30% of the Company’s volume was edited using speech recognition technology on the BeyondTXT platform, compared to 24% during 2007. Gross profit increased $4.1 million, or 31%, to $17.8 million in 2008, compared to $13.7 million in 2007. Gross profit as a percentage of revenue increased to 37% in 2008 compared to 32% in 2007. 


 


DCOA Promissory Note


On April 6, 2005, the Company fulfilled the prerequisites for receiving the proceeds under a Promissory Note dated March 1, 2005 payable to the Development Corporation of Abilene, Inc. (“DCOA”) in the principal amount of $1.0 million (the “Promissory Note”). Transcend received $850,000 under the Promissory Note on April 7, 2005 and was pre-funded $150,000 under the Promissory Note on March 31, 2005. The Promissory Note was initially secured by a $150,000 letter of credit from a bank and certain furniture and equipment. The letter of credit was released December 7, 2005 and the remaining collateral shall be released as the principal balance of the Promissory Note is reduced.


The Promissory Note relates to the Agreement for Financial Assistance by and between DCOA and Transcend effective as of March 1, 2005 that was approved by DCOA on March 4, 2005 and amended on June 6, 2006 (collectively, the “Agreement”). Under the terms of the Agreement, DCOA agreed to provide up to $2 million of interest-free, secured loans to Transcend (the “Loans”). In return, Transcend agreed to recruit, hire and train up to 208 medical transcription professionals, the majority of whom shall be recruited from Abilene or the area surrounding Abilene, as defined in the Agreement. DCOA offered the Loans to Transcend in two increments of $1 million each in return for Transcend recruiting, hiring and training up to 104 medical transcription professionals for each Loan. The Promissory Note is the first such Loan. During 2007, the Company was informed by the DCOA that the second $1 million loan is no longer available.


Transcend and DCOA intend for the Promissory Note to be paid by Transcend using quarterly training credits and annual job creation/retention incentive credits provided to Transcend by DCOA as defined in the Agreement. Principal reductions of the Promissory Note were effected through quarterly training credits and annual earned job creation incentive credits, not cash, as follows: (1) $25,000 per month for the first six months of the Agreement provided that 15 employees were hired by Transcend during that period; (2) a quarterly training credit equal to 50% of the total wages paid to newly hired Medical Language Specialists (“MLS”) during their probationary period (not to exceed $4,000 per MLS); and (3) an annual job creation incentive credit of between 10% and 12% of compensation for the year for each full time equivalent employee (FTE), with cumulative per FTE credits capped at 30% to 35% of the FTE’s annual compensation (depending on the FTE’s compensation band) for FTEs hired on or before March 31, 2010 including compensation paid through March 31, 2012.


Transcend had earned credits of $23,000, $77,000, and $99,000 for the years ended December 31, 2008, 2007 and 2006. These credits are reported as reductions of direct operating costs. On December 1, 2008,


Transcend entered into a new agreement with the DCOA whereby the DCOA reduced the loan principal by $101,000 in exchange for agreement by Transcend to retire the debt three years earlier than agreed and the cancellation of potential future credits earned through training and job creation. This reduction was booked to direct costs as were previous job credits earned. Transcend will pay DCOA six quarterly payments of $92,000 commencing January 1, 2009 with the final payment due April 1, 2010 to satisfy the remaining principal amount. The note will continue to carry a zero interest rate. The principal balance on the Promissory Note is $550,000 at December 31, 2008.


 RETIREMENT PLAN


The Company maintains a 401(k) retirement plan that covers all eligible employees. Employees are eligible to contribute amounts to the plan subject to certain minimum and maximum limitations. The Company matches employee contributions on a discretionary basis as determined by the Company’s Board of Directors. The Company made $156,000 and $134,000 of matching cash contributions in 2008 and 2007, respectively, and no matching contributions in 2006.


Going forward, the Company intends to continue matching 50% of the first 4% of employee’s compensation contributed to the plan, subject to the financial performance of the Company.


MAJOR CUSTOMERS


Revenue attributable to one contract with Providence Health System—Washington for four hospitals totaled $3,728,000 $3,269,000 and $3,017,000 or 7.7 %, 7.7% and 9.2% of total revenue for 2008, 2007 and 2006, respectively. In addition, the Company had revenue under separate agreements with approximately 44 customers who are owned by Health Management Associates, Inc., a single healthcare enterprise. Revenue attributable to Health Management Associates, Inc. comprised $10,267,000 or 21.1%, $9,611,000 or 22.7%, and $8,473,000 or 25.9% of the Company’s total revenue for 2008, 2007 and 2006 respectively.


On January 1, 2009, the Company purchased certain assets of DeVenture Global Partners, Inc. and acquired approximately 30 customers with this transaction.


 


Sorry, part of post is out of context :(

Not crazy about this platform.


Geez, that was a sloppy, error-ridden post on my part. Yikes, sorry...nm
,
OH - I thought part transcription, part escription, but don't know for sure
nm
It's the big O not the one you mentioned
.
Yes, it was mentioned... SM
and explained. Transition to new MTSO not going smoothly -- acct could come back at some point but DO NOT hold your breath! Bottom Line: Same-old, same-old -- Onward and upward, think positive, etc. No dramatic announcements other than big push to get everyone on same platform. :-))
EMR...should have mentioned

Our EMR system did cut down on some things for us typists.  The medications and allergies were already in the patient's chart and therefore pulled through into the document (office visit letter) that the doctor created himself the day of the visit.  If there were changes to those meds, he would dictate the changes.  If there were no changes, he would state that.  That was one less thing for us to type.  It didn't change things for us greatly because we got paid hourly, but I'm sure that would cut lines out of someone who gets paid production.  It was a very new concept for our office at the time.  We had 21 physicians and 7 NP's so I can safely say half hated it and half loved it.  Some doctor's refused to go completely paperless and would always ask us to print hard copies of the latest test results and that allowed them to not have their faces glued to a laptop and actually pay attention to the patient.  I have not yet experienced the EMR/EHR system as an actual patient.  I'm sure I would be really alarmed at not getting to spend time with my doctor and instead only see the top of their head as they are clicking around in my virtual chart.  There are definitely pros and cons and I can see both.  As for it completely wiping out transcriptionists -- I have my doubts.  Dragon software years ago was supposed to have wiped us out as a profession and look what happened to that.  I know VR is a huge thing, but that too is still creating jobs.  I tend to be more optimistic.  The only thing constant in this world is change and we have 2 choices -- embrace that change and roll with the punches or sit and complain about it and make things worse.  Nothing is ever certain so I guess we will just have to wait and see.  No one can predict the future.


It has been mentioned that some
companies have increased the cpl when the client requires VBC.
They no longer hire part-time and may be eliminating part-time employees within the next 6 months.
They are going to have those that are PT go FT if possible. Some accounts require 1 weekend day, but not all. Most transcriptionists have 1 account with 1 back-up account. I know that they are hiring for hospital accounts in medical records and radiology right now.
The companies you mentioned
Company 1: Good company if you like ESLs. They have lots of accounts in areas that teem with ESLs. For them, I would choose QA.

Company 2: This company has had more conflicts than Carter's liver pills, and the turnover is outrageous. The problem is that they are always out of work. They overhire, then nobody has any work. Lots of big wheels. Public company and making millions but the MLS's as they call them don't get the money. They promote from within. They are going to speech recognition and cutting pay in half. Forget them totally.

Company 3 outsources like crazy and hires people who don't know what they are doing. Just started decent benefits. Moving to speech recognition. They do not stay in "touch" with the real workers who keep them afloat. If you are not an insider you will go nowhere with them. Forget them.

Company 4: I would shoot for a QA or editing job since you have the experience. There is some pettiness but you don't have to be that way and the managers don't expect you to be. Good benefits and stable company.

Even with some of the problems mentioned here,
nm
It was mentioned on this board that they -sm
never pay on time, so I wasn't in the least surprised when they told me about their payment method.
No one has mentioned my company yet
LOL!!! Sad, but true... Don't like my company either.
Several people have mentioned that they have
been hired for the account.  I have also been hired for the account. 
P.S. You mentioned archives
when you searched.  I believe that will give you only older info.  Try searching without going into the archives - you'll find some more recent posts, some negative, some positive.  Just confirming again, though, that my experience has been very positive.
Do you have to use their computer still? Mentioned somewhere in
s
The ESL load has been mentioned as being a very
s
Me too - Transtech was never mentioned by OP
NM
Here's a few places that have been mentioned..sm..
Accuscribe, DSG, Echo Sten-Tel, Execuscribe (just started using it recently), InTouchMI, MQ, and VanBelkum.
No name was mentioned and how many people
even know who the recruiter was. 
I don't get it. This Kim person is mentioned all
I guess you don't want to say anything against someone here.  There is also Debbie mentioned for TransTech.   
exactly. That's why I also mentioned POOL
/
Quite a few posters have mentioned doing this..nm

Which one mentioned hourly?
Was it M.L. or was it the female? Just curious. I can't understand why they won't pull the escription MTs who don't have work - over to the Dictaphone accounts that they are scrambling to hire for.

It seems really dumb to lose some of those MTs because they are quitting due to no work and then be desperately trying to find new hires for the dictaphone accounts.

They are only making things worse because those lies are catching up with them and they will have fewer and fewer people applying because the word is out.
ok.. but names were mentioned x2
A name was mentioned x2 in the tts nasty post and was not removed...
It's so important to her that she mentioned it not once
Maybe it's just my perception, but that post came off as really pretty arrogant. I know things can be conveyed wrong in writing but she does not sound like she would be a pleasant person to work for, that's for sure. The whole tone of the post made me go EEK...
All those "occupations" you mentioned are

fine but most businesses, even small mom and pop ones, have so many hoops to jump through to even get started. Then there's the ugly taxes to pay, too.


I'm trying to figure out a business I could get into without all the crap. Sick of all the hoops. Even crafters have to have a license if they sell at shows and our farmer's market has the list of names of everyone that has a stand there that they must turn over to the government if asked, even if someone is just trying to make a buck in something temporary, like selling all their attic treasures.


I'll be able to retire soon. DH says I better sign up as soon as I can, but I'm still paying off bills after his surgery, so it's impossible. I need another 3 years to get on top. Anyway, when I didn't pay SS taxes for 3 years (no job), my SS $$ went down from $1000 to $200 a month and after 10 years, I'm now at the $800 /month mark now. Who can live on that?


 


I already work at the first one you mentioned and leaving for
nm
as mentioned, not a big demand for it whatsoever - sm
because of the fact that it can be outsourced. However, there are hospitals in very very remote areas that do not want to or cannot outsource, usually a very small hospital with outdated equipment, etc., - those were the travel assignments.
Forgot about benefits you mentioned. I don't have
their benefits so I don't know how they work or what the requirement is to get them.  It is much cheaper to purchase an individual policy in most cases when you work for any MT company.  Very rarely do they actually have good insurance.
You mentioned benefits. They only hire ICs.
//
Don't Precyse and the other company you mentioned
v
How can you be so defensive? nothing was mentioned about India -nm
f
Plus, their QA on the account you mentioned is INSANE
If you're not one of their personal favorites, they will keep picking, picking, picking, tearing your work apart making sure you have at least a few errors - you know earth-shattering, life-threatening ones like putting a comma somewhere they don't approve of, just to make SURE you don't get that highest pay rate. Then next time you change it to what they said it was supposed to be last time it's wrong that way too - you have to have mistakes on your reports you know!

Power trip from hell, and messing with people.

No thanks.
Are they still in business? They used to be mentioned years ago on MTD. nm
s
No competitive website was mentioned by
name. Someone asked where something was posted and I said it was posted at another job website.

That told nothing. It could have been one in a million places.


They did?!! How long has this been in place? Never see it mentioned in their ads. Sure it was
s
They have been mentioned frequently lately. Read
the archives and you'll find lots of answers. 
Anon, you mentioned a website...
where you took a test and not 10 minutes after the recruiter called? Could you give any info on that.

Thanks

Very sad to be unhappy at MQ
I've mentioned before that I was impressed
I made it partially through training and my Mom passed away; so I had to postpone.  Once I went back a few weeks later, unfortunately, the schedule was not the same, but I do not hold that against Transcend.  The recruiter was very understanding and they wanted to give me another chance, but it was due to the workflow.  I would HIGHLY recommend Transcend.  They are the only ones I have dealt with as far as nationals go that were very communicative and very, very understanding.  There will always be bumps, but if you have the big tires the bumps don't hurt as much!  HAHA!  Anyway, nice people, nice place!
I don't think the Transolutions mentioned has any connection to (sm)
the Transolutions based here in the United States. When I clicked on the link of Transolutions from the above website, it brought up a completely different Transolutions than the US-based company?!? Not sure what is going on, but it sure doesn't look like the same company...