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

All talk about lawsuits cause of VR crap in jobs. But does anyone - have solid evidence that has happened? SM

Posted: Sep 01, 2012

I havent seen any real evidence of a lawsuit brought on by bad VR (is there any other kind?) I dont think anyone even cares enough to bring a lawsuit.

No lawsuits - Inquiring minds

[ In Reply To ..]
No lawsuits to my knowledge but Medicare has withheld reimbursement in some cases because there were too many errors.

Interesting. They obviously dont do that enough. Certainly not - enought for it to make a difference. nm

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:( $$

No lawsuits-Inquiring minds - Anon

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That is very true. My friend is a compliance officer and said that it is considered FRAUD when mistakes are made and payment is then withheld. Doesn't seem to be hitting the hospitals hard enough to care. Again, they are just interested in the money they save by cutting down on Full-time personnel! Sad!

Money is the bottom line for everything. Health care, education, g'ment - manufactureing etc. Everyone wants SM

[ In Reply To ..]
to get as much $ as they can for themselves. Too bad for everyone else, let me get mine first, THEN you can get yours. Greed is killing this country. Heck, it is killing our world.

That is not accurate - Compliance here, too

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The statements that you and Inquiring Minds made that errors lead to withheld payments and that they are fraud are no correct. I hear what you are saying, but you seem to be misinterpreting things in the context of MT issues, resulting in erroneous beliefs and statements.

I also think your compliance friend was correct in what she told you, but you rephrased it in repeating it here, so that it is now misleading.

The problem stems from a difference between what MTs call an error, i.e., bad VR, spelling and grammar errors, mistyped words, incorrect dosages, and what Medicare or insurers call errors. Medicare errors that result in denial of payment are things like incorrect entries on a claim, not in the doctor's note. For instance, some services cannot be performed in certain places of service. Brain surgery will not be paid if the claim says it was performed in a doctor's office. Hospital admissions for conditions that do not require hospitalization will not be paid.

Other "errors" include incorrect use of codes, like using two procedure codes that cannot be used together, or using a diagnosis code that does not justify performing the procedure.

When MTs here talk about "errors," they are talking about THEIR types of errors and about things that annoy them.

Medicare and insurers are not concerned with typos and bad grammar or incorrect drug names because they do not even see them most of the time. They see the electronic claim. In the event they do see the documentation, they look for CONTENT, not MT errors. Auditors do not fault MT errors- they look to see that the content of the documentation justified what was coded.

When MTs hear error they think about the errors they get dinged for by QA. That is not the kind of error that affects payment. It is definitey NOT fraud.

Also, errors in coding are not fraud. Fraud is intentional and criminal. It is an intentional attempt to deceive, to obtain payment that was not warranted. Coding errors can result in incorrect or undeserved payment, but errors are unintentional. They are considered to be "abuse," not fraud.

Thanks for explaining this. - nm

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Didn't say they were fraud - see message - Inquiring minds

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I said I experienced a situation first hand where Medcare payments were withheld because of errors, I didn't say MT errors. Thanks for clarifying.

The entire discussion had been about VR errors. - sm

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It is a little misleading to come in on a thread about VR errors with a comment about some other kind o errors without making it clear that you were talking about something else, don't you think?

You did not say it was first-hand experience, either.

You did not say fraud, but Anon did. If you will read her post correctly you will see that Compliance referred to both of your posts.

Would you say it is accurate to say, then, that nobody but us gives a rip - about this stuff? long message/thought

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If insurers don't really care about the quality of the wording, writing, etc., i.e. transcription style, then who besides us does? Some doctors complain bitterly about style issues, but then they are part of an overall clueless and inconsiderate bunch anyway. They catch themselves in a dictation error and chuckle at themselves while remaining completely clueless to the fact that, for every error they chuckle at themselves over, they miss a dozen, and if the transcriptionist doesn't catch and correct them, their butt(s) could be in a boat load of hurt, not to mention the problems the patient could experience as a result of the inaccurate health care documentation that came out of their doctors' mouths.

My point is and always has been that, if no one else but us cares about grammatic and style accuracy, why do we as a profession continue to beat ourselves up over this stuff. Style books have been written, paychecks docked, jobs terminated, etc., all because we are trying to present a superior-appearing product and service to people who ultimately don't give a rip one way or the other if it doesn't impact the bottom line. Sure, "they" complain about style issues to some extent, but only so as to assert their authority or personal preference. It makes the whole thing a joke because basically no one cares about this stuff but us, and the joke is, therefore, on us.

When I say no one cares, I say that in the sense of caring for the sake of being correct. We care about doing it right. Doctors only care about having it (the transcription) their way and getting it (the dictation) over with, and don't try and confuse them with the facts. Medical records personnel seem to only care to the extent that their personal preferences are followed, and don't try and confuse them with the facts, either.

These are legal documents and should reflect that level of importance in their grammatic and formatted presentation, and they should definitely read like someone with at least a highschool education wrote them. Alas, nobody cares. Why? Because it doesn't add to the bottom line.

My point is, if everyone else is happy with the current approach, then we should stop beating each other up over this stuff and just start transcribing exactly what the doctor says and not fix anything. If he/she said it, he/she gets it. I personally think doctors deserve the impression such an approach would leave of them and their profession over time. Of course, the patients would ultimately be the ones that suffer, but at this point I tend to feel like if their own doctors don't give a rip then why should we? If they don't feel it important to handle health care documentation in a professional and accurate manner, then why does that continue to be our montra? Perhaps it is time to set industry pride aside for the moment in an effort to promote industry survival.

End result of our failing as a profession to organize and lobby for doing things according to a set standard that applies across the board to everyone regardless of personal preference is obvious - transcription industry disintegration. AAMT failed us miserably because, once again, their focus seemingly was also "the bottom line," making that organization and whatever name they now choose to go by a waste of skin and our time. They actually could play a key role in turning our industry around, but there wouldn't be any money in it for them on the front end, so I wouldn't hold my breath when it comes to counting on their support. They are bought and paid for at this point.

We could still try and organize, and if successful we could definitely redirect what seems to be the inevitable course our profession is currently doomed to. If it's truly all about the bottom line, then realize we have complete control over that, too. Do we not collectively realize that? If we don't produce these reports, no one gets paid, including the MTSO's and CEO's as well as the doctors and the institutions they work for. So, if that's all everyone is interested in, then that is where they should all be impacted. "You wanna' get paid, then you need this dictation transcribed. You want me to transcribe it, then this is the way it's going to be. And don't tell me you have any other preferable/viable alternatives to turn to if I don't play ball, because if you did you would be doing that already on a much larger scale than is currently being utilized." Can't have that kind of attitude and control without being organized, though, and yet the response to the idea of organizing continues to be negative and nonsupportive. Just look at the responses to the recent post about unionizing. Collectively, we seem to have resigned ourselves to the notion that it is too late, and yet that is definitely not the case. The leverage that we have had all along as a profession is still in place, and as long as it exists, our ability to determine our own futures rests squarely in our hands. Only if you don't understand what that leverage is do you conclude it is too late to act.

The key to applying that leverage is organization, and the only way I know of to do that is through unionizing. We don't have to unionize on a national level, people. It can be done on a company-by-company basis governed by a national standard, which laws are basically already in place. We don't have to reinvent the wheel. Laws already exist that could be used to force companies to make employee lists available for unionization purposes. But no one will take this step if they are not assurred of having the support they will need to give the idea collective and fair consideration in their specific place of employment. It's not too late, but the clock is definitely not ticking backwards. My suggestion is either support a given idea or offer an alternative or keep silent so as to keep the "it can't be done" thoughts to ourselves.

Unionizing has been brought up many times, always with the same negative, nonsupportive response. However, our only hope as a profession, I believe, is through organization. If anyone has a better idea of how to collectively organize or what we can do alternatively to take control of our own profession, then now would be a good time to make that idea known. We're burnin' daylight.

Besides being too long, in skimming it, there are too many issues - to correct. But one I noted SM

[ In Reply To ..]
you said if nobody cares about quality, just type what you hear. But that would lose you your job. MTSO doesnt want to pay for good reports but they cannot let crap through on the off chance that new Records manager at the facility decides to check a few reports.

Yep, just skimmed it all right. Word "hear" doesn't occur anywhere in my post. Also - you missed it!

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Shouldn't just skim and then presume to comment so as to correct or refute or discourage. Point is organization. All of the "issues" can be addressed in that fashion. Are you another one who is suggesting we just roll over and die, or do you actually have a better idea?

Didnt want to address all the issues, just that one. Do what you - want, I will retire before too much longer. nm

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x

Nobody gives a rip but us?? Heck, most of us dont give a - rip any more. Not for 3-4 cpl. nm

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c

Insurance companies always settle out of court - if possible. In this case,

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just what's happening, I don't know. Long ago I worked for years in commercial liability insurance, and if a SR goof results in serious injury to a patient (the technical term is "proximate cause") everyone involved with that mistake is at fault for the injury. However, many laws have been passed since then limiting our right to seek redress of grievance. Just how large a factor this is beats me, but it has to be huge.

Note that when it comes to putting a dollar amount on settlements, most patients are elderly, and their lives and disability on an economic basis have much, much less value than, say, a young parent and wage earner. Plus, many laws limit or bar altogether patients' ability to sue for special damages, like for turning their lives into a nightmare of intractable pain.

BTW, medical errors may be as high as the 8th leading cause of death in this country. Even with these "necessary" limits on lawsuits, shouldn't we be hearing of hospitals being shut down and insurance companies being driven out of business by the payments resulting from this stunning level of negligence? Even, gasp, new efforts to restore patients' rights to sue for redress of grievances?

"Hello, my name is Susan. I'll be your nurse today. May I interest anyone in our latest strain of VRE today?"

Commercial liability/medical insurance 2 different things. MTs - are not responsible for errors. Dr. is. nm

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You mis-read rather completely. Practitioners' malpractice insurance - IS commercial liability insurance. NM

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Insurance post seemed to imply MT can be sued. Drs only - are responsible for errors. Not MTs. nm

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But the medical errors causing harm are not typos. - Your reports have nothing to do with it

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MT errors and VR errors have nothing to do with the "medical errors" causing harm to patients!

They are talking about medication administration errors, wrongful surgery, neglect, errors in ordering, and errors in medical judgement.

What you type has absolutely nothing to do with that.

What kind of lawsuit do you think should be filed? - Wondering

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Seriously, what kind of lawsuit could be filed over VR errors?

You don't file a lawsuit if you dislike the work someone does . . . you just fire them and find someone else.

I think MTs have an exaggerated impression of the effect their documents have on medical care. They seem to think that a misspelled drug name or formatting error will cause harm to a patient, but they don't seem to realize that there is no way they could.

Your reports are not the only things in a medical record. The orders, daily progress notes, and the rest of the record are what people follow.

Your reports arrive too late to be relied upon and nobody is so stupid that they cannot make out what you transcribe even if it contains some errors.

Perfection is nice for its own sake, not because patient care will suffer.

VR is good enough and that is why your pay is dropping.

Which is exactly why E&O insurance for MTs is - a big scam (NM)

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