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Serving Over 20,000 US Medical Transcriptionists

Outsourcing Costs Versus Quality Reports

Posted By: AnotherOldTimerMT on 2007-06-12
In Reply to: how many docs know? - Janine

Sorry to burst your bubble but doctors know when/why they're being outsourced and go along with it, but only for the ones who really care about quality, these individuals then become "appalled."  In the 1990s when medical malpractice suits were at their highest and attorneys saw what a lucrative field this could be, I learned at a monthly transcription meeting that it might become law that not only the doctor but the MT (under homeowner's insurance if based at home) could be sued for "inaccuracies" in a medical report.  That, however, quickly and quietly went away but don't think, for one moment, this still isn't being talked about!  That's why I have always had a hard time trying to figure out how hospital/clinic boards keep on authorizing overseas outsourcing (well it's obvious about the cost savings!) and then crying about all the inaccuracies in sometimes complex medicolegal reports, while still padding their own pockets with bonuses, etc.  If someone has an answer to that, I'd surely like to hear it!              


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Other related messages found in our database

Pay versus quality
I understand that experience warrants more pay - however, if working means I take a lower rate, and work up to a higher rate - than I take it - it does not mean I give less of myself - Being a Transcriptionist I take pride in my work and work hard at whatever the rate. Too many jobs going over seas for a much much lower rate than 7 cents a line - if we want to get it back, and / or continue working than you do what you have to for the time being. I have companies that pay me 7.5 and clients that pay me between 7 and 14 - and thank goodness I am busy enough to make a decent living. I am not a prima dona who picks and chooses - I have a responsibility to my family to make money, and a desire to work and maintain a household.

However, I will not work for someone who does not pay at all, bounces checks or disrespects me in any way - but my quality never wans for any reason - that is my reputation on the line not any one else's.

So, yes we should make more money - but if this is what is out there, I will take it.
Offshoring versus outsourcing

Remember this is a difference between offshoring and outsourcing.  Offshoring is sending transcription overseas.  Outsourcing is what hospitals do to give their transcription to us to transcribe.


When you write your senator be sure to make it clear that OFFSHORING is the problem, not outsourcing.


quality versus production
I would say they are keeping you hostage with this 99% stuff. You should be reading as you go, then spell checking and move on. Try making some more $ that way, then if your quality dips slow down. We all make mistakes, we arenot machines. It sounds like you are afraid to have amistake and itis tying up your hands. Don't you love how these companies work??? They get you one way or the other.
Quantity versus quality
I did an internship recently at a local hospital in Michigan.  I kept hearing the  supervisor say to the transcriptionists to type faster, type faster.  I could not believe the mistakes in the reports.  When I brought this up to the manager, she would look at the mistakes, and say go on to the next report.  The mistakes were never even fixed.  The worst part was that the manager of the transcription department was the QA, and she wasn't even a medical transcriptionist!!!
Quantity versus quality

If the company wants shoddy work, let them keep outsourcing to foreign countries.  If they get sued, they deserve it.  The office where I work will shortly be sending our work to India and doing away with us.  I saw a few reports from India, and they can't even spell our doctors' names correctly.  Their grammar is awful, not to mention the terminology.   Quality no longer counts, and I no longer want to work for companies that don't care about quality  They can take transcription and India and shove it!


 


 


FYI - I produce high quality reports because I
take the extra time to make sense of garbage that is dictated.  I'm saying that I will not do it from now on.  It averages about $10 to $11/hr to make "high quality."  It has gotten to this point because people like you let MTSOs walk all over them because you feel it's "your job." ---  Ya know what ---- Keep your job, I'm outta here ---
Beware of ink replacement costs. The more inexpensive the printer, the more the ink costs.
s
Hahah!a! Funny typo: not quality 'scAre', quality 'scOre'. LMAO!...nm
nm
I think that depends on the quality. Do you honestly think there is good quality just throwing every
MT on any account like they are. I also think QA has been told to not waste a lot of time on blanks so I think the hospitals are getting a lot more blanks. I certainly have more when I get in a hospital I dont know and they talk 100 miles an hour.
I thought quality was a given. Speed and quality are not mutually exclusive. sm

I maintain 99% accuracy above on my reports.  However, the original question was regarding personal preference, and I have stated mine, and I respect your opinion as well.  :-)    I do think if I was working in an office or hospital setting, the setup you mentioned might be more profitable in the long run.  There are too many interruptions and such when you have other people running in and out, phones ringing, etc. 


I doubt that anyone but me really cares about the lines per hour it takes for me to do a report.  They just want an accurate report in a timely manner.  I take pride in my work, and would never just slop something out for the sake of the almighty buck.   And, as an added incentive, I work for 2 companies, and one of them has my name on each report.  I don't have a problem with it, but I did think it was a bit unusual at first.


Oh well ... I must confess that what I'd TRULY like is to be paid lots of money to just sit and play Battle Phlinx on Pogo all day long, but as of yet, no such luck.  


65 character line versus gross lines versus pay by word

I am checking into other options for transcription.  Can anyone tell me how to compare all of these types of lines & also payment per word?  I know companies use different scales, so I wondered how they compare.  I have been paid on a 65 character line with spaces, but I may be making a change in the future - don't want to get burned.


Thank you in advance!


The MR reports were being filed. Referring physicians/medical care providers reports were not.
This is a hospital radiology department with in-house MTs and a clerk who is in charge of the report distribution.
Question versus gross lines versus 65-character lines....

I have always charged or been paid by 65 or 60 character lines or per letter or space typed, but have never been paid or charged per gross line.


What is the advantage of this?  If I were to charge 11 cents per 65-character line including spaces, what does this figure out to for an average line rate and how do you do this calculation? 


I'm wondering if it is financially beneficial for me to bill by gross line or to keep it the way I have it.  I do know some accounts will only pay per 65-character line, as this was the deal my first own account I recently acquired.  They were adamant on a 65-character line, but didn't specify with or without spaces and I personally would never not charge for spaces.


Thanks for explaining this.  I appreciate it and hope everyone has a speedy day.


The two sentence normal reports will balance out the 3 page reports.
I am Wendy too
costs
I also agree that the cost of vet care has gone way up in the last 10 years, having animal companions is expensive. I think as more and more people are coming to realize their companions are senient beings they are willing to do whatever is necessary for optimum care just as you would do for a human. That being said, it is extremely expensive and where I used to have 5 cats and 2 dogs, I now have 3 cats and 1 dog due to losing some to old age and illness. Although I would love to have more, I know I cannot afford it if one of them gets sick.
Can you tell us how much this costs?
Have the Martel catalogue but oddly it does not give price. Am hoping it is under $50.
Rx costs
I get 2 of my meds from Canada.  Can you get yours that way and save $?  Just do a search for cheap drugs or Canadian drugs.
MT Costs
I have been a working MT for 2+ years and I am still buying things.  I have a full library of books but there are only a few I use all the time.  Still there are days when I find I need the others.  I believe I have around 16 total.  The Book Of Style is an important one.  I would recommend that for sure along with any other specialty books for the type of account you plan on typing.  I had my computer prior to training but with books, the MT course, pedals, software (spell checker, expander) I spent over $2,500.  This doesn't include a desk, chair or the other things you'll need. I would suggest you buy some 3-ring binders to keep samples in for each account you type.  I have a binder for every doctor/client.  Every doctor you come to learn to type will have his/her own rules.  The binders are my Bibles.  At first I went through a ton of legal pads.  I always keep one at my desk to jot things down.  Now I only need one on occasion.  It will be a learning experience and slow going at first, but hang in there.  Like some other MTs mentioned, it is not as easy as it sounds, but I do enjoy it.  Welcome to the club!
It costs more than $10 believe me.
They take a percentage of what is sent to you - it's not a flat rate fee. The more you make the more they take.
My costs have actually gone down
This year my property taxes will go from over $2,300 to $800 a year, that is because I have turned that magical number of 65. That is good and yet if I were to die, then the taxes would go right back up for hubby as he is 10 years younger and has not gotten there yet. He better treat me right!
Yes, and that same jug of water costs how much after it's
been paid for with tax dollars, hauled in on trucks, and handed out by National Guardsmen and FEMA workers who are being paid and are away from their own families? That little jug of water costs more to the taxpayers than Perrier.
My son did too. It costs a lot and unless you're
a real people person who can SELL, you won't make any money and you'll spend a bundle. TURN AND RUN, don't walk away unless you're ready to LIVE IT! IT has to be all you think, talk, eat, use, buy, etc....and you won't make a bunch if you don't get people to sign up.
I cut my costs a year ago...
I have noticed very little difference. I get the same speed and the only things that inhibit that are the usual things such as when the ISP is doing an update etc. Everyone I know with different DSL companies have said the same. You can always go back up to the higher speed if it doesn't work well in your case. To me it was worth saving the extra $20/month
AT&T business costs
I pay 230 a month for three lines, unlimited long distance, and DSL on a business plan. The biggest difference is the DSL cost is higher, and they charge per jack on installation. As opposed to 20 per line, i pay a flat rate of 50 for the LD for all three lines.
hidden costs by being an IC

The taxes are more as an independent contractor.  period.


you pay the matching that the employer would pay.


Normally your benefits pkg from the hospital or employer of sick days, holidays, insurance, etc is worth about $10,000.  Somehow you have to absorb that with what you charge.  In addition to losing the matching the employer is paying.  Otherwise the company you are contracting with is making out like a bandit -- and you truly are coming out on the short end of the stick -- they know this -- and they are laughing up their sleeve until we wake up out here and start charging so they won't be coming out the winner in this all the time.  The very reason they OUTSOURCE is to get rid of those hidden costs and we now have taken on.


And then of course the hidden days down for work on computer, waiting for storms to pass, and the various and asundry responsibilities you take on and absorb that the company you are contracting with gets to turn loose of. 


 


p.s. and oh please don't pop up with ITS WORTH A LOT TO TYPE IN MY JAMMIES.  No, we are expected to be professional whether in Gucci or WalMart specials.  And we should be paid accordingly.  That argument doesn't fly.  and being home with the kids doesn't either.  Only one thing can be done at one time, and you can watch the kids or you can transcribe but you can't do both simultaneously.  The guilt factor may be less when one needs to do errands in the day -- but guess what -- while people are sleeping guess who is up into the night beating the keys.  No, this should not be a trade off.  It's a business like any other business who does a contract with another company. 


phone costs
Hi,

Cell phone runs 89 per month,, that is the whole package, unlimited internet access, free text, nights and weekends, etc,,,,and I was able to do away with home internet altogether. No longer have a land line or DSL at home so the savings there made up the difference
Actually, VR actually costs the client....sm
less money,which is why some are changing to it...to pay less for transcription, which is why WE get paid less. That is how it is with my company. So in essence, the company is taking a cut in pay as well....why else would anyone use it, including the MTSOs??? I'm just sayin'.
Well, it costs sometimes. I have had to change employers before because
they were not going to negotiate with me. HOwever, there are plenty of places to work and I have luckily landed in 2 good ones.

I feel very fortunate today with my employment. I know full well it may change tomorrow but I am prepared - emotionally and financially - and will not let that disrupt my life. Too many options out there, folks.
I noticed this too! Costs me approximately
$50.00 more for the usual items such as health and beauty aids, cleaning supplies, paper products. Cost of living is going up and our salaries are not.

India's MTs are living very well, according to a friendly gal working for AOL out of Bombay.

I don't know what I am going to do. I got cable t.v. for the winter and feel like I am living extravagantly. There is so much I need. Even keeping my car warrantly valid requires a $500.00 tune up which is hard to budget for.

One thing I do not have is credit card debt.
MediSpell is decent and only costs around
It was about $10-$20 when I first got it, but I'm sure it's gone up since then. There's a free trial (or at least there was) and you can compare it to others. Not sure what Dorland's is like so I can't tell you comparison, but I've found MediSpell to be a decent medical spellchecker at a reasonable price for starting out. You can add to it, of course, too, but I don't think they ever issue updates like new drug names, tec. so you might want to invest in a more thorough one later on.
I too believe it is a trend, basically to cut costs. As far as MQ, SM
I don't work for them, but honestly, from reading posts, seems like they were just bought out by a mad scientist who thinks up ways to drive people crazy. Sort of a game of how far can we drive people before they crack.
Keeping up cert costs too
I was a CMT for 20 years before I finally let it go.  Only one company I worked for in all that time paid extra for the CMT; then they were bought by Medquist who didn't care.  If you ever change companies - voluntarily or otherwise - the CMT may no longer bring you extra cash.  Remember, too, that you'll have to pay to keep up the cert.  I went to the conventions every year.  They ran me at least $1000 then with registration, airfare, hotel, food, ground transportion, etc.  Worked in-house then, and my employers didn't reimburse.  I was *lucky* I could get my vacation then.  It would probably be more now; everything else is.  If you don't have PTO where you work, then it will cost you what you would have made for those days as well.  Perhaps you're lucky and have a strong local chapter that will provide you CEs for much less cost and aggravation.  If you use the articles in the Journal, it will still cost.  Plus, it's not just any credit-worthy activity, it's one from column A, two from column B, etc.  It makes it much harder to get what you need (which may or may not have anything to do with what you REALLY need to improve your skills).  I didn't regret it while I was doing it, but I wouldn't do it again unless forced.  I hoped for 20 years that it would mean more than *personal satisfaction*, but it never did.
Help with raising food costs sm

While not available in all areas, this is a wonderful program to help out families and communities.  I used it for years when I lived in Colorado and now that I have moved, I am in the process of finding this program in my state. 


The program consists of paying a certain amount for a given box of food (you can buy more than one) on a certain day or days.  Then, you put in volunteer hours in your community for each box you purchase.  You have a volunteer slip signed where you volunteer.  On D-Day, you go and pick up your boxes of food. 


The boxes consist of fresh fruits and vegetables and meat items.  Occasionally there is cheese too.  There might be pasta and/or rice.  There is often a prepared food item.  They offer seasonal boxes for holiday baking, meat lover's boxes in time for summer grilling and Thanksgiving boxes.  The retail value of what you get in a SHARE box is usually at least double the cost of the box, and that has been my experience.  The kids and I used to go and help on D-Day, passing out boxes, cleaning up for our volunteer activity.


http://www.sharecolorado.com/


is for Colorado and several other states, but should link you nationally too.


I wonder how much it costs? will it be cheaper in the long run?nm
.
I'm a member, it costs me $20 to take a webinar.
Over 3 years, 30 CEs at about $20 each.

Over 3 years, CMT differential at $6K a year.

You do the math.

LOL

high healthcare costs

two little words,  consider waste and fraud,   people who have zero hope of meaningful life being on total support which many of them do not want, many disposables could be changed back to reusables by proper sanitation.   up coding to get more $$, etc etc.  there is probably more but those two came to mind. 


 yes $40 an hour seems excessive to me too. 


It costs $275 bucks. Robbery sm

I don't see how it helps money-wise (job) You need to renew every 3 years $.


I think the association that offers this is not with the MTs but with business.  They are the ones who helped Medquist manipulate line counting..  Oh yes, it is documented in court papers and can also Google Medquist and AAMT, articles come up.   They sell their Style Guide for a whopping $90 bucks 2nd edition, now $70 still toooo much about 400 pages.  One can get a hugeee meedical dictionary for half that.  They are not for MTs.  Years ago when this test was developed, nobody could pass it, so what did they do, they reveloped the test so MTs could pass (thus they got income).  Hardly a validity of MT skills.  Been doing this 30+ years and I am not bothering.


I use a AirCard 875U but costs almost as much - sm
as satellite would. I pay $67 a month for it but is is faster than dial-up, but not as fast as DSL. I live in a rural area and rumor has it we are getting DSL in 2 or so more years, we will see, it is available 4 miles from me, but is not quite reaching out to the farther out areas right now, need to live within a mile of our major highway through the county. Dial up will probably still work for you, just take a lot longer. Hope you figure something out.
Because owners, managers, and CEOs are all trying to cut costs
so they can make as much moolah as possible.  EVERY OTHER JOB I have ever had provided on the job training, EVEN the salaried professional white collar positions.  Going to school or college does NOT train a person to automatically step into a position knowing everything.  Nurses, doctors, lawyers, managers, HR directors, personal bankers, vice presidents, all of them had apprenticeships, internships, training, or worked their way up.  MT is the only field I know of where nobody is willing to train or mentor newbies.  The training at my last MT job consisted of an emailed two-page explanation of how to pull up their jobs.  That's it.  No account specs, nothing.  Go live on day one.
Daycare costs have tripled between the time I had my
first and third children.  Yes, many of us do work at home and need flexible schedules to accommodate our kids.  It would cost $1,040 per month to put my three kids in daycare, and that's considered CHEAP!!!  You might as well work in the office if you're going to just put your kids into daycare anyways.  How much money do you think will be left of a mother's paycheck after daycare, gasoline, car expenses, wardrobe, and all other work-related costs?  Besides, I didn't have kids for someone else to raise them in a snot-infested daycare where the workers are underpaid and don't care for your kids as well as you can.  Times have changed since you raised your kids.
Amazing.. I think I will have to look into it. Anyone out there know actual costs for family ins?
Thanks.
There are a lot of things MTSO hidden costs..

MTSO bills for a lot of things to run the business that have nothing to do with line counts, but they may be billling them as line count as opposed to breaking them down individually. 


Rising costs always causes the consumer to look for another solution
in the MT field, this includes offshore, EMR and SR, and people taking pay cuts. Once everyone around your wonderful doctors are getting the work done reasonably well for much less, they will take a second look too.
But, if you don't need a lot of minutes per month it costs BIG TIME.
p
My point exactly. If lowering costs is an issue

Costs for small MTSO equipment
This question is directed to our wonderful small MTSOs who participate in the site postings:

I have a question about what extent of expenses you incurred for equipment and related components for the physicians to dictate, i.e., FTP services, server, physician call-in phone services, physician digital dictation uploading/downloading services, and all that related equipment to send and receive dictations (voice files) and send/receive reports, all pertaining to internet and latest advances.

Considering a small MTSO venture of just three small doctor's office accounts, enough for 1-1/2 MTs, with a total physician dictator capacity of 5 physicians, not necessarily at the same time.

I would be also interested in not only cost figures (ballpark) but the types of equipment and software you elected to use (platform if any).

This information would be beneficial to me, and perhaps to other entrepreneurial MTs as well. Thank you in advance for your helpful information.
Anyone work for co. who pays all phone costs? sm
Asked before, perhaps did not post. Anyone have a company who pays all phone costs, FTP, etc., I just want to either transcribe or edit,,, no added expenses, but they can absorb the cost for me. Sound crazy? You just never know.Doesn't hrt to ask
I believe Transolutions pays all phone costs. nm
//
Foot pedal. Gearplayer costs, but it is worth it! nm
:)
The federal gov't is urging paperless MR to save costs.
dd
My brother is suing me for the costs of the lawyer.. Unbelievable..nm
/