A community of 30,000 US Transcriptionist serving Medical Transcription Industry
Where the finger should point - MT2
Posted: Jul 20, 2011
So much ire and angst pointed at MTSOs. I even read where the TAT is a marketing ploy :) It helps to remember that we're all in the same boat and for the same reasons, to support ourselves.
What so many of you don't seem to get is that the INSURANCE industry is dictating much of the TAT. If reports aren't on a chart in xxx time then the facility/physician is dinged financially.
If an MTSO doesn't meet TAT, they are dinged financially. So they are doing what they can to see that doesn't happen.
For every MT who is dedicated and shows up on time, there is at least one who does not.
Believe it or not, patient care IS driven by the product we produce. As EMR becomes a steadfast reality, TAT will be expected to be shorter and shorter.
Thank your insurance companies for driving standards of care, standards for charting, etc. The rest of us just ask how high to jump.
You cannot make stuff up and expect people to believe it. - sm
[ In Reply To ..]The insurance company has no idea when a document actually makes it to the floor. They don't "ding" the doctor or facility if the report is not on the chart within 30 seconds of being admitted to the floor. The closest you are going to get is having claims denied because of inadequate documentation of certain charges, but that is going to happen well after the patient is discharged, not before, during, or even immediately after the hospitalization.
I hate when we attribute every positive comment to a "suit", but I cannot imagine that anybody else would think we were dumb enough to believe this lame excuse.
2-hour turnaround benefits nothing but the MTSOs bank account (I wonder if they charge the client extra for these rush reports) and looks great in their sales packet. But it's not a requirement anyone had or needed until the MTSO started using it as a selling point.
Thank you for speaking out. I totally agree - nm
[ In Reply To ..].
You must not know much about AR in hospitals. - The quicker the bill gets out sm
[ In Reply To ..]The quicker the $$$$$ gets back to the facility. The insurance companies are very involved in setting that pace. The OP is right in what she is saying. As hospitals demand faster TAT to keep up the process, the MTSOs are forced into overhiring so they aren't let down by the MTs that are supposed to work. This does reduce the work available to all, but it does accomplish the goal of instant TAT. Technically, we could blame the MTs that take off to go shopping when they should be working, giving lame excuses when they get back.
Everybody's not a newbie here. - sm
[ In Reply To ..]Some of us actually work/worked in hospitals and we know exactly what goes on. And whether you're the same person as the OP or a different one, it's still an elaborate con that might work on people that are naive but it's not fooling anyone else.
The ridiculousness is evident in that billing cannot take place until the patient has been discharged. Period. You cannot bill for an unidentified disease, maybe surgery, possible SNF care. All that billing is done after discharge, and not minutes after discharge.
Maybe you can convince somebody fresh out of MT school whose only previous work experience was the drive-thru window at Burger King. But everybody else knows exactly how the how and when the billing is done, and further illustrates why the MLS are disgusted by today's MTSOs-- the fact that you are taking 'creative liberties' to justify overstaffing indicates somebody missed their business ethics class.
You must have never worked for a for-profit hospital. - They rush Trans so they can bill right away.
[ In Reply To ..]Not-for-profit hospitals are like you say, very slow to bill, sometimes suffering financially for it. The buck is the driving force behind all this, not the welfare of medical transcriptionists. I'm just talking about reality. Transcription doesn't exist for the sake of our line counts. It exists for the sake of billing with a side benefit for patient care. I was an MT supervisor for the largest chain of hospitals out there (or was). I am right about this. MTSOs have to live with the demands of the hospitals they work for.
As I said before, maybe naive newbies will believe you. Those that have BT/DT - know it is just rationalizing. nm
[ In Reply To ..]x
You may not be newbies - mt2
[ In Reply To ..]but you are naive-bees!
I actually work on the insurance end where the meetings are held with the physician offices, where the data is mined for helping to develop standards of care (dictated by insurance most often), etc.
No, the insurance company doesn't know if a record is put ON the chart on Monday or Friday, but for every report an MT generates there's usually a DATE DICTATED and DATE TRANSCRIBED and these days carry weight.
The move to the electronic record didn't start yesterday, it started in earnest a decade ago. And, sorry but believe me or not, the insurance companies are dictating the hoops for healthcare facilities and workers to jump through.
I also transcribe for a very large teaching hospital in NY and sat in on meetings a few months ago where issues like when a DS is to be charted as opposed to an OP note, etc.
I don't really care if you believe me, I know what I'm talking about, and I know that the "fast" will only be expected to be "faster" and yes, that hospitals AND physicians ARE financially penalized for their efficacy-- and some of the MTs at the very big services are feeling that crunch.
Oh by the way, it has nothing to do with how BILLING was done, I never said it did :)
Ask the person at your hospital who does the audits, you might be surprised what you learn.
I worked for a large insurer until a disability sent me to working at home. - What you say is news to me too. nm
[ In Reply To ..]x
It would be like paying for groceries before you finished shopping!!! sm - JJT
[ In Reply To ..]The insurance company definitely plays a big roll here, but they can't be billed until the patient is discharged.
Exactly - some have no clue - Anon
[ In Reply To ..]Exactly. You can tell who actually has a medical in-hospital background and are familiar with the day-to-day operations regarding patients, various departments, acute care, etc. and those who only have transcribing/running an MTSO background.
Where the finger should point - unbelievable
[ In Reply To ..]I don't know where you get your information but the only reports that would affect the payment from an insurance company would be OP notes or discharge summaries. Those reports are needed to code the reports. The insurance company does not regulate or penalize the doctor or hospital for not having a complete chart. The hospital does that themselves and threatens to suspend the doctors becuase of JCAHO. They are the ones that check over the charts for proper documentation and they are the only ones that can penalize a hospital for not having proper documentation.
I have worked in hospitals for the past 17 years and have never heard of a doctor or hospital being "dinged" for not having all the documentation on the chart. They are "dinged" all the time for not coding the chart right.
Have you never typed a report that was made a stat just to find out the patient was discharged months ago? That always happens in June when the residents are leaving or new residents are coming in. Then they all back up the system with making sure all of their dictations from months ago are done.
I agree - SoCal MT
[ In Reply To ..]I have found that to be true as well. I had one dictator who dictated only once every few months, and then he sent every dictation through as a stat.
And considering the number of docs that do that, it destroys the TAT as a - product of insurance industry. nm
[ In Reply To ..]x
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