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what is MTSO?

Posted By: ? on 2005-07-30
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I'm an MTSO. I can tell you....
We don't hire *anyone* unless they have successfully completed a college education, meaning an associate's degree, in medical transcription.  It doesn't matter if they learned on the job, learned in their garage, learned on their patio, learned it on their own 25 years ago or 25 months ago, taught themselves or  taught the next door neighbor, or if they used to be a nurse, doctor or janitor.  The short and simple of it is:  No formal college training in MT, no job!  (And that includes the "make-$40,000.00-a-year-correspondence-courses, too!).  We've seen the handiwork of those who say they're self-taught, and it's not pretty! 
I'm an MTSO
and trust me I believe in paying above average for an above average job, but when you can't get the docs to cough it up because you've got third-world countries and VR breathing down your neck, not to mention newbies fresh out of school who will do it for even less, well, what do you expect...the MTSO to pull it out of her pocket to pay for you to work.  Never forget ....MTSOs have to make a profit.  They're entitled to that dear....If not, there's no reason to be in business. If you don't like what you're being offered, you're always free to get brave, strike out and get your own accounts. 
When I was an IC I sent my MTSO
Christmas lottery tickets, which he loved. Nothing compared to the $500 bonus he gave me. Now that I am working for a large national, I'm just another number lost in the shuffle. I probably won't send them anything, don't expect anything from them and probably will receive nothing, though a full day's work would be nice once in a while.
I am a MTSO

I am a small MTSO and also IC'd for another company a couple of years ago and something similar happened to me.  However it was probably a little different as I did the pick-up and deliveries although I was an IC for the company.  When she did not bill the clinics so that I could not get paid, I knew the clinics and so I went to them and told them that after a certain date I would not be doing their sevice because I was not being paid -- a little different than your story but you can also let the clinics know how that service is being run.  Again, only after you write your calm, fact filled letter.  But if someone threatened my business with anything like that - going to my accounts -- they would be paid within 24 hours.   Reputation is what counts in this business.   But again, just write to them calmly and with the facts asking them to prove that you had signed a contract, then giving them 48 hours to produce such contract or send you a check for your services or you will see them in court.   Again, I would threaten to go to their accounts to let them know how they run their business but only as a last resort.  But just do it, write them you deserve your money.   Was there problems prior to quitting and that is why you just left suddenly -- I know this leaves them in a lurch but if they were a crummy company they probably deserved it.  Also if you did not sign a contract stating you would not go after any account you worked on for two years go for the accounts. 


I'm not a MTSO, but

my hospital's TAT is between 24 and 48 hours depending on type of report.  When I worked in-house, it was from 2 to 48 hours, with Op notes/HP having a 2 hour TAT.   I think it varies a bit between hospitals, but as a general rule most reports are no greater than 24 hours. Sometimes discharge summaries have a longer TAT, such as 48 hours.   I don't have any experience with VA hospitals, but they probably aren't much different.  

What would you do re this MTSO?

I am an IC for a small MTSO.  I have a deduction taken from my invoice every pay period for renting Transnet equipment.  My foot pedal broke and I asked urgently Monday morning for a replacement foot pedal to be Fed Exed to me - work was on the system and needed to get done.  Well, after many many phone calls and e-mails I got the replacement foot pedal via Fed Ex (they shipped on Friday) on Saturday morning.  So I worked all weekend to get caught up on a whole week's worth of work.  Got my invoice yesterday (late - the MTSO has rescheduled their payment schedule as they are not getting promptly paid by their clients - the ICs had to accept the new payment schedule or quit).  There was a deduction for $40.13 for delivery fee for the foot pedal.  The Accounts manager says that "many memos" have been sent out that ICs are responsible for delivery fees.  Huh?  I looked over the memo I received about Transnet rentals and it said our invoice deduction covers maintenance costs for faulty equipment, etc. (the MTSO had originally said I would be billed for a new foot pedal - then I brought up the memo on rentals that covers faulty equipment and that got dropped pretty quickly).  I told the Accts manager that postage is the MTSOs expense, just like it is my IC expense to return the faulty equipment to the MTSO.  I also mentioned that the MTSO pays for phone charges to fax stuff to ICs; likewise the ICs pay for their phone charges for faxing to the MTSO.

What would you do?  I am so fed up with this MTSO...I don't make that much money on Transnet anyway (most of my lines are from microtapes) that I am tempted to just tell her to take all of my doctors on Transnet and quit doing these willy nilly deductions without my approval or knowledge.  This is the third time the Accts manager has taken "deductions" from my invoice without telling me - the last time was for Chicago taxes on rental equipment (totally illegal according to Cook County govn't) - that took 2 weeks to get straightened out!  Arrggghhh!!!

i'm not an MTSO,
but i think you did right and my guess is that within 6 months to a year, they'll come back to you.
I have checked the labor sites and just could not find anything. In the beginning, my accountant told me I would need to either collect sales tax or get a wholesale exemption from my client, but after calling the local and state sales tax offices and being told I didn't need one, she changed her mind too. The problem with offices is you don't always get the right answer but you are still responsible for the results. I just thought if nobody else charged, then I could be pretty safe in not charging as well. Thanks for replying anyway!
I am just starting with an MTSO and looking foward to many, many happy years with them; locally based to my area. Can't wait. Start training tomorrow.
Everyone should be IC/MTSO at least once
it gives you a great prespective on where your money goes and how much goes to taxes... people think that when you are an employee the employer is "giving" them benefits, paying their share of the employee's SS taxes, etc. but actually the employee is paying indirectly, reflected in their wage amount, cpl, etc. They just don't have to write the check for the taxes, it's taken from them before they can see it. The problem with being in this business and being IC is that you need to make a better line rate than an employee and people do not realize that until the tax bill comes. I had to go with a national last year as my large physician group went to an EMR, so I switched to employee status. They were only going to pay the same line rate either way, so it works out better for me now to be an employee. As an IC/MTSO I had alot of deductions, kept every reciept, took depreciation, mileage (a big ded for me as I live in the country), etc. but now with my national position everything is internet, no printing documents, etc. so it only made sense for me to switch to employee. I have another sideline business which provides plenty of deductions right now and not much income. Planning is key whenever taxes are involved, check out the IRS publications or home business books, etc. Some great information to avoid the same tax problems next year.
I loved your comment about the outhouse!! :) (And some of the matchbook schools could well BE outhouses for all we know.)
mtso, who?
or stirring up trouble?
As an MTSO, I would want to know

if an MT is directly contacting my client and I would appreciate the tip that I could follow up on.  A good MTSO will be able to handle the situation in a way that would not result in you being in the middle.  Perhaps the MTSO could approach the MT and simply say that the client said that they were contacted by one of the staff about whatever the topic may have been and to no longer make direct contact with the client. 

I wouldn't necessarily say it's none of your business considering that the job you hold is your bread and butter and if your coworker says something to the MTSOs client that could jeapordize the MTSO/client relationship, that COULD affect you, so I believe you have grounds to speak up.

I worked for someone like that as well. I bet it was the same company/person. She expected you to work 24/7 so if she needed you all she had to do was IM or email. I wasn't supposed to have a life. I have 2 children and a disabled husband. I did my own accounts -- always on time and when my work was done I had other things to do. Well if your work was caught up you weren't suppose to have a life or rest you were supposed to do more work for her. The paychecks starting coming later and later until one day I had one returned for NSF. I quit at that point. You have every right to vent. Your family comes first. I have had a number of job offers since and I am currently working again with yet another offer on the table. Good Luck!
MTSO here

I am a small MTSO that has two part-time IC's and can only pay them 0.85 cpl to 0.9 but because of the account they can make $45 an hour.  Again, I stress to me it is what I can make an hour.  But it is a psych account, I pick up tapes, meet the gals, and then they have 3 days to do the reports which are long, 10-12 pages but I developed so many templates that they can do them about 60 to 75 minutes.  They E-mail to me and I E-mail the reports to the docs.  We pick up on Thurs, and they have to have to me by 10 on Tues.  My other accounts they sometimes help me with but again I can only pay .85 to 9.  Again though they can make $25 an hour which I don't feel is bad pay.  I just cannot charge the docs more than I do at 11.5 to 12 cpl.  They pay on time, never a bounced check and appreciate what we do so I feel we all benefit.   Also they have been loyal to me and my psych account has been with me for over 16 years.   See what you make per hour. 

That is my Saturday 2 cents worth for the day.  If any typo's cannot find my glasses so sorry if there are.   Patti

That must be one of my MTSO...sm
I know the feeling ALL too well. I have one I help out prn, only if I have the time. I never have any idea when she will need me...a week could go by and I hear nothing, sometimes 2 weeks. I have other large accounts, plenty to stay busy. I check my e-mail in the am, see what needs to be done and get busy.

Well, when she realizes she is in over her head and needs help, she thinks I am sitting on my e-mail and should reply ASAP! I sign off at night, the next morning she has a nasty message in ALL CAPS wanting to know why she hasn't heard from me. Well, for one thing, you sent the e-mail at 10 pm...I am NOT sitting on my e-mail at 10 pm. She then rants and raves about how she is short some MTs, and this account, which she has taken on to help someone else out, is putting her in over her head. She is very short tempered and nasty when she gets herself in these holes and then thinks we should bail her out... and if we are not available, it's somehow our fault.

She preaches on and on about how late she sat up getting the work done, as if it is somehow OUR fault she dug herself in this hole. As I told her, just because you do not want to turn down ANY work, do not expect everyone else to be free to help you out when you get in over your head. And I remind her that IC means just that. After 2 years helping her out, she does not want to pay any more than before. So, when she starts a tantrum, I just remind her that I am working on clients that pay me 2 to 3 cpl MORE than she does, and they are my priority.
ok, i give up, what does MTSO mean? i been reading this for months and i can't figure it out. "My Tired Sore Ohhhhhhh...." lol
She's not an MTSO
But if she wants to train MTs for free I am sure nobody is complaining.
LOL you must be an MTSO
It's not dangerous OR hateful advice and it's worked for me in the past.

The OP *should* hire an attorney if needed, BUT BEFORE she/he spends one nickle on an attorney to collect HER money! she/he should give the MTSO one last chance to get it right - and that would be a with a warning about what is likely to occur if she sues.

If the MTSO has a LEGITIMATE reason for a delay they can speak up about and negotiate. But ignoring a contractor who is owed $ is NOT acceptable.

which MTSO are you?
Not MTSO, but
I have used ibackup for a couple of my clients with a need for multiple people to access files.


It's secure. You just send them your directory link and viola.
What is the MTSO
What is their name?
what does MTSO mean?
not trying to sound dumb but new to the boards and keep seeing MTSO, just curious what it stands for
I think you are an MTSO. nm
MTSO vs. IC?

I'm a student MT, and I'm curious as to what the difference is between a MTSO and a Sole Proprietor working as an IC from home? Right now I am writing a business plan as part of my MT Program, and I am trying to sort this all out.

Also, I saw a post below talking about digital dictation and paying for FTP site service, is this an expense necessary for ICs or only MTSOs with employees? How does an IC usually download digital files from the client?


MTSO can set TAT but cant specify certain hrs.
My MTSO is going to use it. *nm*

Does anyone know what a MTSO
charges their clients (hospitals) for medical editing?

I know the average MT pay for transcribing is 7-10 cpl per 65-characters plus spaces, and the average MT pay for editing is 3.5-6 cpl per 65-character plus spaces, but I was wondering what the MTSO would charge the hospital for primarily an editing account.

Does anyone know?
The above is most definitely an MTSO's

I'm not an MTSO - sm

I've been a Transcriptionist since 1990, starting out transcribing tapes into my IBM Selectric from home so I could raise my then 4-year-old daughter as a single parent.  The industry has been very good to me and I'm very proud of the fact that I was able to make a good living in as an MT all these years.  And as I said, I used to be opposed to outsourcing - at least until I really started looking at it, asking around, talking with people.

Outsourcing transcription work isn't any different from bringing in people from Belize and Honduras to clean hotel rooms - Americans don't want to clean toilets either, not any more than they want to work overnight typing.  The companies who do not outsource will go out of business for several reasons, all of which are OUR fault -

1.  People don't want to work overnight or weekends but it's a 24/7 business.
2.  The quality of new transcriptionists coming out of school is, for the most part, horrendous as is their work ethic.  In order for it to be cost-effective to train newbies, companies will have to make sure they're up to speed quickly and most trainees aren't willing to do that because the schools have told them they can make a ton of money right out of school, even though they aren't qualified to type a prescription, let alone a legal document.
3.  MTSOs still have to provide quality work for a lower price than the next guy to their hospitals; it's not that they don't care about the quality, it's that the hospitals are squeezing them for lower costs, just like everybody else, wanting to get more for less.
4.  The offshore folks are willing to work and work hard.  Yes, the MTSOs have to spend more time reviewing the work, but at least the work is getting done within turnaround.

Now, we all have a decision to make.  Me?  My decision is to work when the work is there, not when it's convenient for me and do my very best to make sure my quality is better than anyone else so the company won't be able to say that I didn't do what I had to do to stop the need for offshoring.

What about you?  I don't post to these forums often because I'm too busy working.  Seems like you all have a lot of idle time with your hands to post here - maybe you should work more and then there'd be less to offshore.

not with MTSO
It's with Aurora itself, but thanks
what is MTSO?
because I am an IC and I'm "supposed" to generally make more than an employee. how does that save them money? I suppose I'd jump on the chance to be paid vacation pay. Didn't know it was against IRS rules
Former MTSO

I used to be MTSO of my own company and in my best year I made almost 6 figures (gross).  I had 6 MTs subcontracting for me.  I paid them 2/3 of what I made as I felt they were worth it but I still worked 7 days a week, 12 hours a day with no vacations and worked every holiday.  When we did our taxes that year I made $30,000, divide that by the number of hours I worked and it was minimum wage. For that money I could have stayed in corporate America, had paid time off and weekends off.  I should have gone back to school then. It ruined my health, I had to have surgery, closed the business.  8 years later, I keep making less and less.  The company I work for just lost our acct to someone cheaper and the hospital did not even give her notice.  We are done tomorrow.  I go back to college in January. I've had enough.

According to how CS is set up. My MTSO
counts spaces and we use CS.
Don't take the job. Most MTSO pay for
cheap - and believe me, it gets worse.  It will cost you about $400/yr.  Why should YOU pay to work for someone else?  I have worked for many MTSOs and only found one that require I pay my own insurance.  It is NOT worth the write off and you lose money in the long run. 
You can e-mail me if you'd like. I will share info with you.

Best wishes!
No, I am not an MTSO, I am an MT,...
but believing that all MTs will all of a sudden refuse to make VR is just ridiculous. I agree that the pay went down to 1/2 if not even less, but there will not be general 'strike'.
You cannot say 'let's not do it'...yiu should rthr say ..'I am not going to do it and I quit and I look for another career.'

There are technology scientists out there who just believe that this MTing can be done better and cheaper and with less aggravation by machines.

That's my point and maybe once it will come to that.

not much you can do if the MTSO sm
won't listen to you. Only thing you can do is make it a point to get good at the crap and do it all! Sorry thaht sounds pretty blunt, but really its the only thing you can do.
Any small MTSO need PT help? sm
Okay, I have tried the big nationals and that did not work out for me.  I would like something for a few hours a day - would love to do family practice SOAP notes again or something where I can just type away and make some decent money.  I promise a fast turn-a-round and I am willing to work hard, but no complicated platforms and no set hours.  
What do you expect MQ or any MTSO to do?
if they have MTs scheduled to work that don't work their shifts, or that don't produce, their TATs will suffer -- and keeping the client happy is the bottom line to staying in business and keeping you and me employed. So if the work isn't getting done, then they must hire some people that will work. Then of course those slackers will holler when they don't have any. I guess its just the way of the world...
but what does MTSO stand for?
I don't think this person is even a MTSO.
She/he/it is just a bitter, negative person with nothing better to do on the weekends than anonymously slam people on the Internet.  If she really had her own company, she'd either be working or taking some well deserved time off instead of telling other people how arrogant and incapable they are.  (Pot calling the kettle black there.)  If she did name the company, she knows the truth would come out.  If all of her MTs really love her as she claims, she has nothing to fear by telling us.  The fact that she won't tell means that her company has been totally and truthfully thrashed on these boards.
as a former MTSO owner

Personally, I would not hire anyone unless they could transcribe the hardest dictator I had. And that is at LEAST two years of acute care experience.

I think the expression is, "burned once, twice shy." 

Speaking as MTSO...
As MTSO and having 20+ girls who work for me, here is my slant:   I never give out more work to my MTs on a Friday than can actually be DONE on Friday.  I would spread it around before I would make someone work a weekend.  Now occasionally -- every few months -- there might be some weekend work, but that is unusual, and I always ask who wants it and who does not.   Note, none of my clients work weekends either -- all private practices M-F.    You did 1000 lines -- at your skill level, that is a full day for you.  If she ended up doing "most of it", then she is not fully staffed enough to cover her clients.  Not your problem.  Unfortunately, they probably scream at her.... so she uses you as excuse and screams at you.  Still not your problem.   I would much rather have my MTs tell me "I don't do weekends" right up front -- then I can plan around that.  You should do same -- then there won't be problems in future.    Hang in there!
Speaking as an MTSO
All I can say is the work has to be done some how, some way. Do you realize that there may be a $ penalty involved if the work is late? If the work is not on the medical record it may impact patient care? What gripes me is many complain that we are sending work out of the country. Those out of the country do not complain about the workload and are willing to go the extra mile even if it includes working on the weekend. People are sick on the weekends too. That is the nature of healthcare. Documentation of medical records does not depend on how much time you want to spend with your family on Saturday and Sunday. If your family member came into the emergency room on a Saturday would you not want their medical record to be available for healthcare professionals in a timely fashion? What if the doctors and nurses decided they wanted to be off with their families every weekend instead of taking care of you or a loved one? Please look at the big picture here.
I had a small MTSO ask that once. sm
As I was heading toward the exit door, she asked me to send her every single one of the normals I used.

So, I sent her the exact ones she had sent me in the beginning, before I refined them to a fine tune, which had taken me hours and hours to do. I'm telling you, I had most tests for every doctor where I could just hop around and fill in the blanks. No way was I giving those hours of work away!
Any MTSO would know that.... smsg

it takes a lifetime ++ to know it all.  The medical field is far too vast for anyone to ever know it all.  One can be in this business for 25 to 30 years and still not know it all.  I do believe, however, that a successful MT will do what he/she does best.  I know a lady who has been doing op notes for 30+ years, and she is very successful; but when it comes to the off-the-beaten path of op notes, she would have to stop and do some research.  I also have a relative who has been in the business since 1965, doing a wide variety of clinic notes, and you couldn't out clinic her, no way!!!  She has recently gotten into procedure notes - does them like a charm! 

On another note, these 2 ladies have done the good, the bad, and the ugly, but they have had enough sense and experience to stay away from those places that dish up nothing but the ugly and ugliest.  We all know they're out there, and there is no living to be made on that stuff!

Exactly. There are a lot of BAD MTs. I've been an MTSO

that the people who answered my ads for help were people I would not have transcribing my work.  I found very FEW good MTs over the years.  The fact is, there are a few cream of the crop and a lot of duds.  Computers/spellcheck/Google searches have made it easier for not so good MTs to be able to fudge and get by.  You used to have to KNOW the stuff or it was abundantly evident.

smaller MTSO
I once worked for a very small MTSO in their office. They were in a suite. But they were located in a metropolitan area, very busy. At the end of my second week of employment with them, the CEO walked by the office I was working in and conveniently said VERY LOUDLY that a "certain medical center" (account I was solely working on) owed the company over $30,000. This was before I received my first paycheck. I was stunned. How's that for shock value? I received my check in a timely fashion and it did not bounce. However, CEO was sure to let me know of HIS SITUATION.