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

Interesting Article re EMR - Dawn

Posted: Sep 22, 2012

http://www.nytimes.com/2012/09/22/business/medicare-billing-rises-at-hospitals-with-electronic-records.html?smid=pl-share

Please read!

You're right - please read this. Let me - provide a clickable link.

[ In Reply To ..]
When you post a link, if you use the
"URL/Link" box below it will be clickable.

Bad coding/ Upcoding - coding student

[ In Reply To ..]
Thank you for posting this interesting article. It looks like doctors were participating in the coding process and everything got screwed up. I can only speak from my work experience in medical billing/ outpatient coding (I'm in school right now to become certified to do inpatient coding), but I had the discussion with providers many times about evaluation codes. You have to follow the law and code them correctly or the practice/hospital will run into a world of hurt with fines- most especially with Medicare. It seems to me like someone (clueless administrator?) thought that they could add a little coding to their new EHR technology and is getting a big smack of reality upside the head.

I read this today: http://online.wsj.com/article/SB10000872396390444620104578008263334441352.html?mod=googlenews_wsj
and wondered, in the situation mentioned in the article where a hospital is trying out "open records" between patient and doctor (allowing patients to access the record more easily), how many doctors are missing the professional and local MTs that used to be available to them.

Those who messed with medical transcription are finding that it is not so easy to mess with coding. Perhaps their mistakes will come back to haunt them. Highly qualified coders are sought out for their expertise, but also to avoid fines and prosecution. I can't help but wonder if highly qualified MTs will be sought out, now that more transparency is happening with medical records with EHR. Perhaps not to avoid fines, but to avoid liability? Something to think about.

How it happened - Coder

[ In Reply To ..]
When doctors start using electronic templates and ar expected to generate their own documentation, they try to save time with all-inclusive boilerplates. Either the EHR provides them or the doctor makes his own. He is supposed to edit it to remove what he did not do, but that takes time. They also discover how easy it is to document more so that the documentation meets higher EM levels. They can do it by cloning entire exams and ROS or by just clicking a few more times to add extra things. If the EHR tells them they are short one body system for a level 4, they click one more.

When coders code from documentation like that, they can be unable to tell if the entire exam was done or not, so they assume it was. The EM level ends up too high. If a savvy coder knows the level cannot exceed the medical necessity of the diagnosis, the doctor will start increasing the severity of the diagnosis or adding extra conditions to up the EM level.

They become really good at gaming the system.

upcoding - saw this firsthand 20 years ago

[ In Reply To ..]
At my last hospital job the most valued coders were the ones that were the best at upcoding.

What would happen if we all started letting our insurance companies know about all the services that were billed and not provided?

Are you kidding? Drs are the last to care about quality. - Not that it matters as SM

[ In Reply To ..]
Drs do not hire the support staff such as MTs or coders. Suits do that and all they understand is "save money." Doesnt have to be true, just has to be said.

It's not a question of quality, though - coding student

[ In Reply To ..]
It's a question of liability. Doctors and hospitals can easily end up with million of dollars in fines from upcoding. That's a separate issue from MT. I still think that the changes from the evolution of EHR are going to bring greater transparency to MT.

A variety of people participate in hiring coders. The best comparison I can make is that coding is a little like accounting. Coding has a ton of information to keep up with and most doctors don't want to have to keep up with all of the changes.

I've been part of medical support staff for years, but good coders bring in money to the practice and keep the practice legal. A "suit" is no match for CMS or a coder who knows her stuff.

Healthcare and business are always going to be at odds with one another. Hospitals have shareholders that they put first sometimes instead of patients. It's wrong, I agree.

Administrators can only take that situation so far, however. Doctors are never going to be able (or willing) to do their own accounting or to be their own attorney. Coding is not easy, but that's (a little) job security.

I'm sorry for being a little gleeful that the doctors (and probably "suits") in the article got themselves into a mess.

VR has brought many opportunities for liability, if it was going to be - an issue. But it isnt, nobody cares. nm

[ In Reply To ..]
x

So wrong, they DO care! - Definitely not the cheapest MTSO

[ In Reply To ..]
You are definitely incorrect here. They do care and do "talk to the suits" whether their transcription is good or bad. Not only do I provide transcription to several facilities and at a higher cost than most in the area, but they switched to me at a higher cost then they were receiving it prior. I also have several friends that are nurses, and I can definitely tell you they care.

If all would be happy w/ what they are suppose to have, the world - would be such a better SM

[ In Reply To ..]
place. But everybody wants to get that little bit more than they are entitled to.

Similar Messages:

Jun 14, 2011

http://health-information.advanceweb.com/Article/VBC-Compensation-for-MTs.aspx Read the comments too. The second one is on point! ...

Aug 07, 2011

This just basically proves that it still takes a human to do what a computer can't do... ...

Jul 12, 2012

found this interesting and encouraging... ...

Aug 11, 2011

http://www.faqs.org/sec-filings/110316/MEDQUIST-INC_10-K/ ...

Mar 11, 2012

http://www.dailymail.co.uk/news/article-1226934/Indian-police-arrest-company-boss-accused-selling-medical-records-British-patients.html ...

Mar 22, 2012

I was reading an email about current trends in the industry and it talked about Nuance's acquisition of Transcend and how Nuance had acquired 43 companies since being in business, gaining some of those acquisitions by bullying competitors with lawsuits and then buying them out. Then I stumbled across this article on Bloomberg Businessweek. It's a little dated (May 2011) but quite interesting, especially the quote from the Dave Grannan, CEO of Vlingo: "Competing with Nuance is like havi ...

Jul 12, 2012

It was from a 2011 article on SR ... the comments are being made by Lynn Kosegi from M*Modal: Someone else who has been very eloquently making the same case for a while is Lynn Kosegi of M*Modal. Lynn presented at AHDI Florida twice last year, at our technology workshop and at our annual meeting, and she explained that paying speech rec editors at 50% the line rate effectively punishes the best producers and those producers will ultimately be lost to the profession, replaced by transcription di ...

Aug 28, 2013

"Wow, the rates have gone down! Only $8-$10 per hour for these folks? Thatâ��s great! Minimum wage in Oregon is currently $8.40 per hour. That means that I can get someone smart enough to learn medical terminology (the average medical studentâ��s vocabulary doubles over four years of medical school), operate an EMR (every one is different, and most all of them are hideously complex), listen carefully (a rare commodity in itself), type quickly (remember, the average follow-up visit only las ...

Mar 01, 2014

From Health Care IT News - February 2014. Interview with an ER doctor about using scribes in the ER and the process of documenting/entering information. http://www.healthcareitnews.com/blog/medical-scribes-history-present-illness-now-narrative ...

Jun 23, 2014

Personally, I think it would be great if we had TV commercials or radio commercials showing the impact and decline of the accuracy of patients' medical records and the starving of US MTs to death by greedy MTSOs offshoring to other countries. http://www.ahdilounge.org/index.php/2014/06/is-it-time-to-take-to-the-streets/ ...

Oct 24, 2014

From Boston Biz Journal http://www.bizjournals.com/boston/blog/health-care/2014/10/apps-the-next-frontier-to-the-electronic-medical.html?page=all ...

Jun 10, 2015

I came across this today when I was searching info on medical transcription. I found it interesting when it said offshoring was once popular in the 90s... http://www.ahdpg.com/calling-all-transcriptionists-the-world-needs-you/ ...

Jun 01, 2010

Below is the link to article. http://business.nashvillepost.com/2010/03/15/spheris-seeks-approval-for-850k-bonus-plan/ ...

Apr 11, 2015

See especially the paragraph about driving down wages and controlling hiring. This reminds me of MM and N's recent calling of ex-employees, and the recent post about the ex-employee being BULLIED (the post is on the board here). ...

May 22, 2012

Although this article dates back to March, I found it interesting. Had no idea that Nuance and MQ (M*Modal) only had 20% of the transcription business when this was written in March, 2012. http://seekingalpha.com/article/408141-can-transcend-services-write-its-own-ticket ...

Mar 09, 2014

Hmmmmmm...I think I'll pass on trying to become a scribe. I don't think I could do what this scribe is asked to do. ...

Apr 16, 2012

I think it is very interesting how a company will make you jump through hoops to "prove" you are an independent contractor but still want you to use an employee based punch in/out system. You don't get it both ways, if I am an independent contractor, then I don't have to use your employee based punch system, especially when you want to charge for it but to keep track of my own hours is free. ...

Apr 27, 2012

ASR put "1,000,000 cm" instead of mobility. What? Why? ...

May 02, 2012

I copied this from another site (sorry not supposed to put names on here): "(Transcription company name) is looking for MTs with minimum one year's experience for its Delhi office. Mail CV at (their e-mail address here). No, we do not outsource!" What the h***fire does that mean? We do not outsource? oh you mean to AMERICA where you got the work from? sad, very very sad. ...

Oct 15, 2012

I saw an ad for radiology. It states no experience necessary. Paid training is available. Typing skills are a plus but not required. Earn up to $30,000 part time adn $55,000 full time. How can someone post an ad like this. Obviously it is an ad to train for medical transcription. I hope that no one falls for this. ...

Jan 23, 2014

NJA yesterday for a significant amount of time. Today, I log on...NJA. Fifteen minutes later, they begin trickling in...jobs dictated YESTERDAY!!! How is that even possible?? omg. I thought there were NJA available yesterday!!! ...

Jan 28, 2014

Been reading the business perspective of what will happen when (not if - when) minimum wage is increased, and 99% of companies who employ low income workers say that will be the day they lay off most of their employees, or have to close their doors altogether. Not that I expect MModal to ever "close their doors", but that does leave open the other alternative for a huge layoff as the need to "supplement" employees who aren't earning minimum wage, or who don't meet their ridiculou ...

Aug 29, 2014

Ran across this bit of information while looking for something else. (Isn't that how it always happens?) I don't know if it's been posted before, but even if it has, it's worth posting again. http://www.mtexchange.com/medical-transcription-exchange/who-owns-mtstars-com/ ...

Mar 11, 2015

...that on the weekend before a big meeting with the client, there's an OOW situation on both Saturday and Sunday when on previous weekends the TSMs were begging us to work extra since MTs are either quitting or there's not enough coverage in the first place. So now we're being told to make up our missed weekend hours during the week, when it's obvious that the work was outsourced to cover the higher-ups' butts! Why are WE expected to be inconvenienced due to their lac ...

Oct 09, 2012

...

Mar 08, 2014

A medical services company owned by a J.P. Morgan Chase JPM +0.85% & Co. private-equity arm is preparing to file for bankruptcy protection in the next two weeks as it struggles under a hefty debt load and declining sales, people familiar with the matter said.M*Modal is in discussions with its creditors on a prearranged restructuring plan that would streamline its trip through bankruptcy court, these people said. The bankruptcy negotiations come about 18 months after One Equity Partners took ...

Nov 21, 2009

Just for the heck of it, I went to the resume section of this board, and noticed there were quite a few MTs with "entry-level or less than 5 year's experience" wanting to be compensated 10-15 cpl -- I really seriously doubt that is going to happen, especially for a "newer" MT. I would suggest that if you are really serious about finding a job in MT, then revise your expected compensation rate to something a bit more realistic. ...

Nov 21, 2009

I also posted this on the main board, but here goes. Just for the heck of it, I went to the resume section of this board, and noticed there were quite a few MTs with "entry-level or less than 5 year's experience" wanting to be compensated 10-15 cpl -- I really seriously doubt that is going to happen, especially for a "newer" MT. I would suggest that if you are really serious about finding a job in MT, then revise your expected compensation rate to something a bit more realistic ...

Jul 01, 2010

us oldies are getting below 98%, in some cases waaayy below, after years or decades of exemplary work, with raises, etc. How much more obvious can it get that they're downsizing the highest paid (and most experienced) MT/ME, to hire the newbies and get the tax breaks. Makes me SICK, so I resigned a couple weeks ago and feel absolutely in shock that I did it, finally, and trust in God for a better job. ...

Mar 22, 2010

http://www.complaintsboard.com/complaints/andrews-school-for-medical-transcription-c183013.html ...