1Quality

One of the most common mistakes you can make while choosing a transcription service is to place a very high emphasis on cost and features and relegate quality to the background. If you aren't lucky this results in an inordinate number of corrections and errors. Often you might need to go through several transcription vendors before you find one who meets your standards. Needless to say this results in a lot of wasted time, effort and money. Look for the following:

Process : Always ensure you pay attention to the processes the transcription vendor follows to achieve quality. Most vendors outline their transcription processes on their websites. Others will be glad to explain if you call and ask them about it.
Accuracy : Enquire about the initial percentage of accuracy of the documents the vendor transcribes. Keep in mind that the average rate of accuracy in the transcription industry is 98.5%. Your transcription vendor should have an idea as to where they stand when compared to this number.
Corrections : A transcription vendor should never charge you for corrections and should have a clear process for handling corrections. If the vendor does not seem to have a clear process for handling corrections then something is amiss.
Patient Name errors : These are the most common errors in transcription. Ensure that the vendor has a clear process for avoiding and correcting such errors in documents.
2Turnaround Time

A 24 hour Turnaround time suffices for the majority of medical organizations. While several transcription organizations offer shorter turnaround times, they usually come at additional cost.
Caveat: A shorter turnaround time is not necessarily always a better thing. It is more important that the documents you get are of high quality and do not need corrections. Pick a turnaround time that works for you instead of the shortest turnaround time at the lowest price.

3 Reputation & References

No matter how established the transcription vendor seems, asking for references never hurts. A five minute call could save you a lot of effort and heartache in the future. When asking for references, instead of specifying your specialty, explain your dictation speed and accent and ask the vendor if they currently service such clients.
Medical Transcriptionists are trained to understand terminology for every kind of medical specialty. When in doubt, they also use various look-up tools for medical terminology. However there is no substitute for experience with different accents and styles when it comes to comprehension.

4 Contract Terms & Conditions

Gone are the days when you had to sign a term contract of 1-2 years for transcription services. For obvious reasons this is a very fortunate development. However, there are still some transcription companies who offer lower rates in exchange for term contracts. Resist the temptation and look around. You are bound to find a vendor who will offer the same low rates without the burden of a term contract. Avoid locking yourself into an unfortunate future position.

5 Billing Methodology

This is perhaps one of the most confusing aspects of outsourcing medical transcription. The reason is quite simple. There are a variety of billing methodologies used by transcription firms today, making it very difficult to compare costs across different transcription service firms. Some charge by the line while defining a line as a fixed number of characters or keystrokes. This is the most popular method and is also recommended by AAMT (Now AHDI - Association for Healthcare Documentation Integrity). A line based method where a line is defined as a fixed number of characters is perhaps the best method considering that such line counts can be verified using simple Microsoft Word statistics.
A number of transcription vendors also charge you based on the number of physical lines in a document and some vendors charge by the number of words in a document.
If a transcription vendor charges by the number of physical lines in a document, it is recommended you avoid such a service. While verifiable, the cost with such a service is almost always much more than what other transcription firms would charge, and is not apparent until you receive your first few bills. The higher cost is because of blank lines and lines with a word or two, which are also charged at the full rate. Additionally because of the font sizes used and formatting changes, the cost of a document becomes very variable.

6 Electronic Records and compatibility

Most medical organizations at some point would like to (and should) make the transition to electronic records because of the vast number of benefits a good electronic records system offers. While many are considering such a shift, there are few that have already made it.
If you have not yet implemented an electronic records system, plan ahead. You do not want to be stuck with hundreds of thousands of documents, that will need conversion a few years down the line.
Ensure that the documents delivered to you are in an electronic format. MS Word and RTF format documents are the most popular and hence possibly will have the best support in Electronic Records systems. Some vendors also support additional services like making the documents compatible with your electronic records system or uploading documents directly into your electronic records system.

7 Online Medical Transcription & Document Management Tools

One of the best developments in medical transcription in the last few years is the advent of online medical transcription and associated document management systems. These online document management systems come with a variety of features that simplify your day to day tasks by providing you features to search and pull up your documents in a fraction of the time it took earlier. Ensure that your medical transcription provider supports provides such a system. Request for a demo account and take it for a test drive.

8 Hidden Costs

Hidden costs are just that - hidden. Here are a few common ones you can check for:

Line Definitions : Be sure to find out what exactly constitutes a line as defined by the medical transcription service provider. A line should be defined as 50 to 65 characters or keystrokes(including spaces). This is the industry norm for a line definition. Avoid physical line based billing methodologies. Even blank lines and lines with a single word will be charged.
Minimum volume contracts : Avoid transcription contracts that specify a minimum number of billable lines per month. If you don't use the transcription service in a given billing cycle, you will still end up paying for services you didn't use.
Additional charges for corrections : Most reputable medical transcription service firms offer corrections free of charge. Ensure that there are no charges for these.
9 Optional Services

Some optional services you might need, and your medical transcription service should support:

Setup & Delivery customizations : If you are a multiple location organization or would like to provide physicians and dictating personnel direct access to the online system, your Medical Transcription service should be able to customize your services, to accommodate these requirements
EMR specific customizations : Your transcription service should support document and delivery customizations in the event you require this.
Automated Faxes to Recipients : Documents are faxed to recipients marked at the time of dictation, immediately upon completion of transcription. This requirement depends on the habits of your physicians and the urgency of your daily reports. Some medical organizations might never need this feature.

10 Dictation by Exception (Templates & Macros)

Dictation by exception is a process in which documents are based on templates and modifications are made in the appropriate areas to complete a document. These templates already contain all the 'normals' and the person dictating just needs to dictate exceptions and changes to the template to create a report.
This method of dictation saves considerable amount of time for physicians and dictating staff. However usage of such templates and macros is a personal preference.
The medical transcription service you choose should be able to provide this feature, in the event you do need it.

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