A community of 30,000 US Transcriptionist serving Medical Transcription Industry

Should the insurance companies take over the daunting task of the Transcription Service? - tulip

Posted: Jun 21, 2012

It just seems like it would save a step, as far as billing goes, the M.D. would get reimbursed more quickly.

Insurance companies may even pay MTs more?

Wouldn't this have substantial savings in administrative and other costs? They would not have to keep trimming back on their transcription costs by lowering the MT pay rates.

insurance companies - ummm no

[ In Reply To ..]
Who do you think is driving the industry into the ground? Insurance companies have been utilizing structured data for at least a decade. They are the ones telling the providers, "If you want paid, we're doing it this way."

To think you'd make out better by having them as the bus driver is just faulty thinking.

Insurance companies in charge? - Runamok

[ In Reply To ..]
In my experience with almost all insurance (car, home, health), they can barely do their job as it is, much less add being in charge of transcription. I know we have to fight and appeal (as does our doctor) for some obnoxious health insurance denials or nonpayment. Their MDs that are apparently over making these decisions are not very educated or up-to-date on diseases, reading lab or imaging data like they would like us to believe. This was a major eye-opening experience for us a few years ago when someone in our family was diagnosed with a deadly disease and the insurance company denied the medication they had to have to LIVE. It's a proven medication that is not just giving them a chance at life but sustains their life and there is no other drug approved as of yet. Finally, it was realized what they were doing was against the law and they were set straight really quick. So, no. I almost think it would be like putting a fox in charge of the hen house and, after what I have seen, I would not want them in charge of my patient data. Just my opinion.

in charge of your patient data - they already are

[ In Reply To ..]
They might not be running the MTSOs but they are certainly pulling the strings. Where do you think the "downgrade" in quality came from? Insurance companies played a huge part. A well-thought-out, grammatically correct document that looks "pretty" is of no use to them. This is why structured data and VR, point and click, etc have become major players. The want 51 YO WM. HTN, DM2. DOE, FAT. PE NEG. WBC 3.5 HGB 13 PLC 243. IMP: COMP DM2. INC MET. DIET. EXC.

What used to be a 2-page report, is reduced to a line and a half and they are telling doctors - do it our way if you want paid.

Locally, we've had some doctors who are refusing insurance so they don't have to jump to their tune.

I have worked in doctor's office for the last 10 - years, and never have

[ In Reply To ..]
I seen any of the insurance companies requesting anything of the such. They could care less about the abbreviations. I have sat through plenty of chart audits with insurance companies, and as long as the medical record was legible and diagnoses/treatment were accurate, they were fine. I'm pretty sure you get dinged though for dangerous abbreviations. Medicare pretty much sets the standard, and the others follow.

I still am having trouble figuring out why an insurance company would force a doctor to take their 2 page report down to a couple of lines. Your documentation has to coincide with the level of visit.

The reasons the doctors are moving away from taking insurance has nothing to do with transcription.

There has never been a time that an insurance company has ever said how they wanted our transcription done or even cared if we had a transcriptionist and just used paper.

insurance companies - datagirl

[ In Reply To ..]
Never? Well, I hate to burst your bubble but I work a job every single day where the major insurance companies are putting it to docs as to how they have to dictate in order to get paid. Structured data. HTN means the same thing for everyone. They are told don't input it as elevated BP. Docs are complying because they want paid.

So maybe in YOUR office, point and click and structured data haven't arrived, but I can tell you for the last five years that I've been doing infomatics, some of the major players in insurance have contracted with us, and the docs ARE doing what they are told.

Isn't it similar to SEO? What's SEO? - Alice

[ In Reply To ..]
Search engine optimization seems to be a big deal these days. I understand that when you do research online through search engines, you must have the correct keywords for the search engines to find what you want. So, it makes sense (maybe not good sense, though) that the electronic medical records are set up the same way. Complete sentences have become obsolete as far as what insurance companies are looking for when it comes to approving or denying a claim. I also understand that some companies in many industries use this keyword search when scanning resumes for new hires, so the resume is ignored if the correct "keywords" are not present.

yes - datagirl

[ In Reply To ..]
and the search engine our company is using is amazing. We were recently bought by a larger company and have brought on bigger and bigger insurance companies (I can't be specific but the Blue Cross/Blue Shields of many states have already signed on as well as others.)

My job is to do many of those searches and create reports, as well as taking the traditional medical transcription and turning it into structured data. It's all amazing what information you can glean and this is all tied into how the doctors are paid, so even the ones who are unhappy about it, are doing it.

Went to work in a doctor's office and I hear - the doctor

[ In Reply To ..]
frustrated daily and documenting in the patient's chart that the insurance company did not approve tests and treatment and there are 2 full-time ladies trying like crazy all day every day to get anybody to approve anything for the patients. It is very sad.

We might want to remember that when healthcare - reform is discussed. NM

[ In Reply To ..]
x

Agree with general disagreement. Tulip, insurance company - profits increase as costs of patient

[ In Reply To ..]
care are decreased. Health insurance company interests are exactly opposite and inimical to those of the patients.

And NO, they absolutely would not pay us more. Of course not! They would rush to get rid of us altogether. After all, they're not the ones who have to actually use the reports in patient care and they're not the ones who need them NOW instead of whenever.

Now, the insurance companies whose interests are more in line with the patients', and ours, are the business liability insurers. When clinicians cause an actionable injury because they created and worked off of an unedited SR document, the insurance company gets to pay off on whatever damages may be awarded, everything from just paying the extra medical bills, to lifetime disability, to funeral costs and child support for orphans.

This is what I'm hanging my hopes for the future on. I expect a major blowup of this problem as all these dangerously negligent reports created by the juxtaposition of the new SR technology, the health care funding crisis, this recession/depression, and of course greedy business interests, finally come to a critical mass.

Oh, and, of course, I'm depending on the citizens of our country, acting through our evil, villainous government, to tell healthcare providers they have to clean their act up (literally). Do you know that according to various reputable studies preventable medical errors are the 6th leading cause of death in this country? Medication errors the 8th leading cause of death? Medical errors the #1 cause of accidental death? These statistics don't count errors that just ruin lives instead of taking them. As someone who makes a good part of her living typing up reports on deadly hospital-acquired infections, I'm so proud to be part of this ENORMOUS problem.

Everything we type is to try and please the - insurance company and

[ In Reply To ..]
get reimbursed anyways.

I'm afraid I don't agree with that at all. Most information is for - patient care, although how things are stated and

[ In Reply To ..]
what tests and medications and other treatments are ordered are profoundly affected, often doing harm to the patients.

I hate to burst your bubble - but

[ In Reply To ..]
I'm a clinician in another field. What we dictate is filled with the buzz words that will get us PAID and care approved for our patients. I keep written records of my detailed notes, but what gets dictated is worded so the insurance companies will look favorably upon us AND the patient and give us both what we want.

Of course. I used to work in property and casualty insurance. - But it is still about patient care. NM

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x

it would make the job worthwhile - if that were true

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What we do is to satisfy the JCAHO and the insurance companies. It has little or nothing to do with patient care. That is what they drum into us to make us "care" but it's just not true. I wish every MT could spend time in the medical records department and the doctors' lounge and you would soon discover what impacts patient care and what does not!

Insurance requirements do shape the document, but are not - the main drivers for documentation.

[ In Reply To ..]
It's pretty naive to think that the payer wouldn't require healthcare documentation to support the claim for services that the provider is submitting - and even to present guidelines as to how that support should be presented.

However, the main drivers for healthcare documentation come from within the healthcare community itself, i.e. JCAHO, and even professional organizations like the AMA, special groups involved with promoting "evidence-based" medical care, patient safety, etc. Even medical researchers have an impact on healthcare documentation.

so many great comments... - tulip

[ In Reply To ..]
it's defintely a real sore spot

has Obama really ever mentioned HIM or med trans and how he thinks it relates to healthcare reform?

back in the day, it used to be so simple, as the notes we transcribe was all that was needed in order to get the M.D. reimbursed, and we were an important and much appreciated part of the process.

thanks again for your comments

Yes, proper HIM is a big part of healthcare - reform. NM

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x

HIM - tulip

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Proper HIM, of course

have they addressed proper versus convoluted?

wrong question - HIM

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How do we all get on the same page and agree what 'proper' is?

My same page or your same page? :) - "Success is the proper utilization of failure

[ In Reply To ..]
Which seems to be just about where healthcare reform is at right now.

Wish us all luck. This go-round followed a 17-year delay after the failure of the last attempt. Many of us will be among those ruined and/or destroyed by the current system before the next reform cycle if this one goes down.

Personally, I'm hoping to watch my unborn great-great-grandchildren graduate and get married. Barring bad luck and given access to modern healthcare, it's quite possible. Many are now and many more will.

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