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yes, your cranky; the patient visits are actually coded sm

Posted By: ex coder on 2005-07-01
In Reply to: Doctors documenting hours worked - eyetype

due to time spent in the room. this is to document to CYA if needed. so remember, the more you talk in the room with your doc, the higher bill you will see. like office visit, regular; office visit extensive, etc.


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I guess I'd be cranky too, if I had such an (sm)
uncreative, BoringAss job. At least MTs are creating something real.
cranky beach
I would have to agree with you on the tools.  I was semi-retired for six years due to pain syndrome from what they are now calling "repetitive stress syndrome"  MT itis is what I called it.  LOL
I have been called cranky but it is because I can't be disturbed
even for a few minutes. I get irritated when I tell people that I am working and they look at me like, "yeah, right!!!" I end up being abrupt when talking. My office is by my front door and if someone comes to my door, I answer through the window. I have thought about a note saying "no solicitors." I rarely answer the phone unless I hear my supervisor or the voice of my QA person. I can't afford to stop and talk or make an error because I was in the middle of a report and stopped, then started only to make a mistake (it happens to me more often then than any other time).
Cranky staff is not your imagination.
The attitude you describe seems to be prevalent. It is as if we were a necessary evil rather than support staff. I think personally it is due to the amount of time needed to keep the paperwork in order. Everyone hates paperwork (even if it is electronically) and we produce a ton of it.

Also, in my view, physicians and care providers absolutely hate to make errors given their jobs are so important and the likelihood of a lawsuit keeps them paying very high premiums. We MTs tend to be one of the few who can say that an error has been made. It can irritate some doctors though I have met a few who are very thankful for it.

In the 20 plus years I have been in the medical field, there has been a change due to pressure from insurance companies also, plus the change in patient complaints as the population ages. This may add to frustration as the bottom line is not only finding relief for the patient but making sure treatment is approved by insurances. This can only get worse from where I sit as cuts are coming with Medicare and Medicaid payments.


kudos to cranky beach
LOL... I just have to say this cranky beach...... with that nickname I would not have thought you to be so helpfulllllll....LOL  You are just a peach of a person to be taking your time to help...and for that I send you mucho kudos......thanks....even though it is not me you are  helping here.
Answer for Mary and Comment for Cranky

Mary, I have never worked for Transcend so I don't know much about the company except what I see here and by looking at their web site.  It looks as though they offshore, never a good sign as it usually means low pay at the very least.  If you don't have a problem with offshoring, and you should, then think about giving it a try.  If India is in there, you probably won't be treated very well.  I have been told it is a "cultural thing."  Whatever.


Cranky Beach, I worked for a wonderful company (never though I'd leave) that was acquired by Acusis, a company with major offshoring.  It was the same situation as you, they told us everything would stay the same, nothing would change.  They were just biding their time . . . and after a while they started throwing all management from the old company under the bus.  Then it was change after change after change, none for the better, mostly to transition to running things "the India way" and eventually ended up cutting everyone's pay. Soooo glad to be out of there.


Visit ataus.org - Keep our healtchare info and jobs in the US


Visits to MTSTARS...sm
How many times a day, on average, do you come to this website?  Just curious.
Chiropractor visits
I take myself and my two boys (14 and 8) to the chiropractor every 4 weeks. It is just to keep us "tuned up". My kids notice a difference in themselves if we miss a month. They actually like going because it makes them feel so much better. I would be concerned about it if they are going every week though. If you are paying for it, you should have the right to ask about it.
9 YO Chiro Visits

As an insurance claims specialist, there are two issues here.


1) Since the mother works for the chiro, it is likely he would not bill the mother for treatment. And, if he did approve of professional courtesy by not charging the mother, then any claim to insurance would be fraudulent in the first place. This will be a policy provision in your own insurance policy.


2) The mother is probably filing fraudulent claims. You MUST speak to the Chiro on a personal and confidential basis. I would either try to contact him by phone, or send a certified letter where only the chiro can sign for the letter. Then you have proof that he received it. It won't take long for the provider to find out if the mother kept the money.


3) Filing a false claim is unlawful and can result in treble damages. You bring it up to your carrier and if it is truly a false claim, you could be entitled to part of the recoupment, if that happens. This could even potentially be a police matter of embezzlement.


4) 50% of all doctor's office will expeience some form of theft by an employee. I've seen it time and again.


No matter what, it doesn't sound right. And since the boy obviously hasn't been to the chiro in a while, it is very suspicious. Since you pay for the insurance and presumably the difference not covered by insurance, you have EVERY right to get involved. Furthermore, just as an innocent bystander, when you know someone is breaking the law, you have an obligation to report it. Don't be intimidated, find out what's going on. Best of luck.


Cyndee Weston


 


 


You might try a few visits and then switch to
Massage therapy. I too have muscle spasms in my neck and I have done both chiropractic and massage therapy. I have found that a good 1 hour massage does wonders!! and the effects last longer than what the chiropractor does. Sounds like a luxury but to me its preventative maintenance in this line of work. When I'm crying because it hurts so bad to hold my head up straight I can't very well type!
Yes, you're cranky. The docs may be instructed to do so to appease Medicare or other such entity.
x
Limiting MTStars visits! LOL.

But one must check in from time to time throughout the day. Only trouble is, I find myself using that time to also check my e-mail, do a bit of browsing. Amazing how those the clock ticks quickly and the minutes can add up. 


if the average person who visits the doc
Only knew where their private records were going, I think there would be an uproar to say the least. 
emergency room visits

I have often wondered this exact same thing. A lot of people go to the ER who have no health insurance or no primary doctor. 


I had one woman bring her child in because he made a funny face after eating a sour fruit candy, I mean come on! 


sounds like my clinic visits ... sm
When sick for a visit, have done very interesting things with bodily fluids (including regurgitating on the doc). When rattled, have screwed up HPI and ROS. Have had conversations with other patients/office employees during my visits. Used to take at least 1 small child for every visit (one doc even let her play games on the computer while doing my exam, a tech let her help place EKG leads, and a radiologist let her help "read" a mammogram). Now that the small child isn't so small, have answered her calls during doc visits. They do put up with that and more. Seriously, I'd rather type about a pelvic exam than do one, especially if yeasty. Your post actually made me appreciate the doc more and be more tolerant of the way they dictate.
I have Blue Cross through Webmedx. Office visits are $20. nm
x
Putting patient versus The patient (sm)
When did this "rule" come about? I've been an MT/Editor/medeical records tech/ART for 30 years - Never, ever was I told to put that. You cannot make the sentence be "The patient sent to Radiology" but you can put "Patient sent to Radiology."

Thats just insane.
Husband's plan has no deductible, just copay and pays just straight up to 12 visits a year.

I do have a high deductible for mine, I think $5000 but the important thing to me is that I only pay $35 office visit copay. The deductible only kicks in on lab, x-ray etc.. and I have prescription coverage. The other thing you have to consider, as I also work in a physician's office doing medical billing, is that there are substantial contractual adjustments if you are with a BC plan. Say, your bill is $100 and the "allowable" from the insurance company is $75, that means that your doctor's office has to adjust off the extra $25 and you are not responsible for that; whereas, if you had no insurance, you'd have to pay the whole $100 out of your own pocket, no discount there.


Is the patient
x
patient name
It's surprising your company lets you put the name in the report.  The trend has been to use "the patient" instead of the name.
The patient is...
The patient is a 2-month-old elephant.

The patient is a 2-month-old infant.

Work from India.
The patient will . . .
be maintained on a clear liquid diet. He is specifically instructed that beer does not constitute a clear liquid. (pt in for alcoholic gastritis) Still chuckle every time I think of that one!
Also that few MDs can say a patient is
slurring without stuttering or slurring the word, "slurring."


the patient
The client preference is to type "the pateint"    To be even more exact, my account instructions state:  "NEVER put patient's name in the body of the report, even if it is dictated.  Always put 'the patient.'" 
Usually if it's a no patient name
allowed either. 
yea, but me as a patient...
when i asked to have copies of my medical records, i was APPALLED at the crap that was in them, by this I mean the errors ran rampant throughout, even if it was just a capitalization error, or incomplete sentences (which i consider errors).

I did not like what I saw at all, but would the average person care, if it doesn't change the meaning?


Patient logs
We are required to do a log for each batch of reports that we do.  I will fill the info on the report and then control + end to the log and record the same info.  Says time for me at the end of the whole document.
Patient info?
Where is my post on typing in patient information???????????
It took me 30 minutes to look-up a patient.
x
All FIVE of the patient's extremities....
Okey, dokey.  This one's American, too.
Yes, and patient demographics.
I'm not going to compare myself to others, though.  I've made a lot of progress, and that's all that counts.  I've only been on this account for three months.  Who's to say what I'll be able to do next year?
My doc would put that patient on protinix --nm
x
patient names
This is a problem that I am currently struggling with. My accounts are not 'searchable' and some docs don't spell out the patient's names. I have QC'd these many times with a note AND my e-mail address asking QC if I should be sending all these reports to them minus the patient's name, or send it to them GUESSING the spelling, or just spell the names phonetically and NOT QC them. About 15 requests now, and NO REPLY!! Very frustrating!!! Otherwise, the account is really good. I am new, so did not realize that other platforms gave credit for footers, headers, etc. I know on DQS you get a fair line count on just the body of the report. Don't know about the rest.
when I can't figure out the patient name (sm)

I just leave it blank because, like the other post said, I cannot get any feedback on what is protocol, so I make up my own.  I aint gettin' paid enough to fool around trying to figure out what the dumb doc is saying!


 


Wow, I think I have PMS or something..I don't usually gripe this much!


Patient Names
You'd be surprised how many facilities have the patient's name on the report. Its not that uncommon. Depends on the facility and the company you work for.
No patient transfered to the LSU
I'm in the procedure section where I cannot abbreviate...Help
RE No patient transfered to the LSU
ICU or CCU maybe - Intensive Care Unit, Coronary Care Unit, can't guess what LSU is in relationship to other than what was said above about football.
The patient is a male

The doctor said:   "He denies bloody or cloudy urine, pain with urination and vaginal bleeding."

I crack up laughing and quote this to my husband, stating the patient's gender.

And his response was, "I hope so."
(think about it)  


 


This is actually between the doctor and patient.
Your job is to transcribe what the doctor wants. He's the one who needs to be compliant by having the paperwork in order to send these copies on. It's not your problem.
Probably something in patient care, maybe CNA. sm
They make about as much as I am making and with benefits on top of that at the hospitals around here.
Tks you all for being so patient. Looks like I'm out to buy WORD. I

computer and I don't see much, and nothing that says "autocorrect" or auto anything. 


Yes, after being jerked around for several months now and starving to death I will feel better to get my feet on solid ground again with a local company that I know will be around and I know what the rules are (wink wink). 


I'm off to find WORD.  ((I don't know how people who have no time with computers at all, get geared up to work for MQ and do all this stuff with no help.  I know a little bit/very little! and I just can't imagine just starting to work on a computer))


How old was your oldest patient? sm
Doesn't matter if it is someone you took care of or someone you typed a report about. I just did a report on a 103-year-old man and once while working as a aide, had a 104-year-old male patient. Cute as a button and sharp as a tack. Also had a 101-year-old lady at the nursing home. 
As MTs, our #1 priority is the patient, just

as it should be for doctors, nurses and health care professionals.  I know how frustrating it can be trying to translate broken English, etc.  I complain about it, too!!  Sometimes I get so angry, because it actually takes money out of my pocket in that I spend so much time trying to "get it right" instead of just using my knowledge and typing skills typing dictation from a clear-speaking doctor with good English.  Sometimes you want to just scream!!!    BUT, again, it is part of our job to provide an accurate  and presentable medical document.  I wish things were different, but it appears that we have to work with what we've got or learn a new profession. 


That is my humble opinion.  


Pain Patient - Where are you??
I have been SO WORRIED about that lady last week who was withdrawining on her own from OxyContin and was gonna go alone to a hotel and float in their pool, supposedly with a load of VALIUM that was recommended to her on this board! Good Lord!! I just pray she is not dead. Seriously. I tried and tried to post, but was banned for some unknown reason. At any rate, if you are out there, please let us know you are OK. Also, PLEASE don't withdraw from these meds on your own - you can easily seize from opiate withdrawal - everyone is different, and no way should you take VALIUM.  NO WAY. I am a huge pain management buff, being in the midst of it myself. Its not safe to do alone - I know - been there done that. The best thing to do is check yourself into one of the 3-day detox programs at any local hospital - no matter who your pain mgmt doctor is. I seriously doubt your doctor wants to keep you addicted, and if you called any authorities and reported that, he'd be in deep trouble. Narcotic scrips are one of the few heavily monitored items today. PLEASE DON'T TAKE VALIUM off scrip. There are outpatient meds like Suboxone - supposed to be a miracle pill. 1 or 2 pills a day, no withdrawal, no urges. Or you can get detoxed under anesthesia in a few hours. Or do the inpatient detox in 3 days with clonidine and possibly Ativan for anxiety. NO VALIUM. And they are set up for giving you the antiseizure meds immediately should you develop seizures, which is common. PLEASE tell me you are OK, and I have given you my email address if you want to write privately. I have been so worried about you. And I 100% totally understand.
PAIN PATIENT
www.pillsanonymous.com
Well, the patient does have some control, actually.
The patient can see another doctor without mentioning seeing this doctor, if he/she believes this MD's opinion is worthless. You can hope the best for the patient, but that's about it. Now if you worked in this MD's office as an employee or you were an IC (I am assuming you are doing hospital work and he is just one of the dictators), then you could decide you didn't want to earn your living from him anymore, but if you are in a service/hospital employee situation, then you just groan when you get him, call him ugly names if you work at home, type his reports, and steer your family and friends toward better MDs whenever possible.

I think most patients can recognize a jerk when they meet one.
The patient has never been pregnant
x
Sounds like she should be a patient there -

First of all, your supervisor(s)/lead(s) or whoever else is overseeing this dept. should be fired.  Sounds like it's out of control - but if they are dumb enough to hire her - what do you expect???


If it is a quotation of the patient, I put it in ==sm
quotation marks. If it is not and just something the doc says, I try to change it without losing the context of the report. patient notes are no place for cuss words. I had a question about it one time and asked my supervisor. she said she wanted to know about it, so I flag it. I even had one doc cussing out the Transcriptionist during the dictation for misspelling a word on a prior document, which I thought was rude, because he has no idea which transcriptionist is getting his dictation. I told my supervisor about that too. He has not done it since.
We are not allowed to keep any patient sm
records on our computers, at all.  They should be stored in the provider's files if they want to keep them for access. 
The patient's status
I got one yesterday that the patient's status currently is deceased.  Wonder if that status is going to change in the future.