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My son's Podiatry doctor said he is not doing EMR - CTMT

Posted: Nov 20, 2012

He asked me for my card, says he dictates onto mini cassettes and a lady picks them up and prints them on this post-it sticky paper. He asked me for my card and asked if I would be interested in covering for her if she were to quit, be on vacation of what have you. He says is not doing EMR, does not want to do it. This got me thinking, he is middle-aged, small 2-man practice, how many other small office need MT help and not going through nationals or doing EMR. I am getting a transcriber for $20 on Ebay and going to get him my card and resume'. What do I have to lose, and was thinking of getting my card and resume' to other small doctors offices. They could have a need as well. Anyone doing this and can give me some pointers, how much is the going rate, do you deduct your gas and mileage with the IRS? Anyone heard of this sticky paper, do laser printers like it?

Yes I have heard of sticky paper. You get it from office stores. - sm

[ In Reply To ..]
The entire sheet is sticky with a backing that peels off. However, you will be buying printers like crazy as that stuff is hard to feed through and I felt like it kept breaking my rollers. I went through 3 printers transcribing for an ortho practice that used that sticky paper. I cursed it! LOL

sticky paper - CTMT

[ In Reply To ..]
he says they cut them, I guess to separate each patient, I am guessing, you type small notes on several patients and just separate with paragraph and account #. I have a pretty good printer, a Cannon Laser, don't want to ruin it.

Used sticky paper for years - no problem with laser printer

[ In Reply To ..]
Only reason I stopped was because the office dictation came to me digitally and I sent it back that way. They print their own now. At least, until they went to EMR, which by the way is not going well and they hate it.

Office supplied the sticky paper. I paid for my own toner, taxes, gas -- all tax write-offs as an independent contractor.

I thought office had no choice, that they had to go to EMR. Am I missing something?

I though that too, but he was adamant about it - CTMT

[ In Reply To ..]
maybe they can opt out, he is a small practice. I am just glad for maybe getting a little extra work, starving for work right now, I have a small account with a small MTSO and only make if I am lucky $200 a week. My husband is the breadwinner, but my money helps so much, I miss making $400-$500 a week, I fear those days are gone

As an independent contractor, did you file for a tax ID? - CTMT

[ In Reply To ..]
if I do this and start picking up work locally, I wonder if I need to bother with a tax id, I think it cost $500 for a business license, ouch! For the last 10 years working as an IC for a MTSO, I always file under my social security number combined with my husbands tax return. Are the rest of you doing the same, or have a tax ID and business name?

No, your SSN is fine - Kathy

[ In Reply To ..]
Since you've been working as an IC for 10 years, you are already a business -- being an independent contractor means that you work for yourself and not for someone else. The company or companies you work with are your clients and not your employers. You don't need to file for a tax ID or EIN unless you hire employees to work for you. You might want to check to see if you need a business license. I have to have a license for my city, but it costs less than $100 a year.

They do not have to go EMR but there - will supposedly be penalties. sm

[ In Reply To ..]
I don't have the freshest info on it. Apparently it has something to do with reimbursement by insurance companies and also tax incentives for the ones who go EMR.

I have no clue. My OB/GYN said she will not do until the final countdown which she said is 2014 but even then she said she would hire someone to data input, although she'll probably retire first. LOL

it is my understanding that if the doctor is doing... - anon

[ In Reply To ..]
medicare/medicaid, they are the ones that have to do emr or be fined. If they don't do medicare/medicaid patients for reimbursement, I don't believe they HAVE to, nor will they be fined. At least that is my take on it.

that's what I was told, too. - no/msg

[ In Reply To ..]
=

Laser probably was fine. I was using ink jets. - This was about 8 or 10 years ago. sm

[ In Reply To ..]
It used to get stuck in my printer and caused the rollers to dysfunction. I could never afford a laser printer when I was doing it. I hated the sticky paper. It used to smear, too. I had to wait a few minutes for the ink to dry. :D

EMR use is not mandatory - Small offices might not find it pays off

[ In Reply To ..]
Since he is a podiatrist, not an MD or DO, his need to use an EMR is less than it would be for a medical office. The cost of implementing it now would outweigh the benefits. That might change later afte costs come down and bugs get worked out.

Information about informatics and EMRs is available free on the internet. You can access he same course material that is being used in universities. Try Google.

When you contract to do work as an IC rather than as an employee, you operate a business. You do not "deduct" expenses as a deduction the way you do now. They come off of your gross income to reduce the total income on which you pay taxes. All expenses, including insurance, use of your home, references, supplies, and everything else need to be tracked so they can be used to reduce your income. If you do not know how to do that, please consult an accountant.

I recommend getting a transcriber better than that. There is a considerable difference in the way cheapies and good ones, like Dictaphones and Laniers, operate. They literally slow you down. You will never realize it if you have used only a cheap transcriber, but you can do more lines per hour with a good one. That is why they are more expensive. If you do enough transcribing using one, even 10 additional lines per hour at 10 cents a line will equal 8 a day, 40 a week, and you will have paid for the transcriber in a few months. AND you take the entire cost OFF your taxes as a business expense. Whatever you do, run your business as a business, not like you are couponing for dollars at the discount barn.

maybe the other MT can help you - since you would be filling in for her

[ In Reply To ..]
I'm sure she would not mind helping you and answering your questions, since you'll be covering for her when she's not there.

If he offers that, I will - CTMT

[ In Reply To ..]
but it seems like he wants another person for backup if something happens with the other MT, he does not want to be left out on a lurch, maybe he will just send me a little work here and there. If he offers me to call her with questions I will, but in the meantime I wanted info about sticky paper and if anyone ever heard of it

Clients-small practices, etc. - me

[ In Reply To ..]
There are a lot of smaller practices as well as larger ones that prefer to use local transcriptionists instead of larger MTSOs--usually because they do not want to pay the price of doing so or for other reasons.

When I lost my largest account to EMR, I had to start all over, but I now have clients to include a plastic surgeon, general surgeon, orthopedic surgeon, pain psych, physical therapy, and pain management doctors' offices as well as the surgery centers from my accounts that went EMR (they do not like doing their own procedures or operative reports). Some of my accounts are small but really add up altogether and augment the surgery center work very well. I also used to pick up other accounts as well (piecework or vacation coverage), business obtained from a website I built.

I purchased a dictation system, and after that, I got a lot of clients. Beats getting dressed up and picking up tapes, although prior to the dictation system, I used a courier or my husband.

Congrats and good luck. Remember, when you go to any doctors office, even for treatment, it is a potential to pick up a new client! Dress nicely with a neatly transcribed report of your medical history. I have had so many physicians comment on the nice work just from that.

sounds like an MT's dream - CTMT

[ In Reply To ..]
I love surgery and operative reports and miss them so much. Good for you, nice to hear something positive on this board for a change. I hate the fact that I am somewhat antisocial and shy of people, I am not the type to march into a small practice and hand out my card and resume'. How did you go about getting your accounts? Did you mail your info to their office or deliver it in person? Also, can I ask what you charge a line or page. I have no clue, I make 9 cents a line on my small MTSO account and I know that is good, but low for private accounts. How did you coordinate the dictation system purchase with what the doctors have, its seems like everyone uses different systems, ie, digital, micro cassettes, etc.

Answers.. - me

[ In Reply To ..]
The dictation system purchase was up to me, although my second dictation system was the best but has since been replaced.

I landed the surgery center accounts from doing their office transcription that since went EMR and picked up clients from my website, cold calling in person (directly after my fusion wearing a huge brace), word of mouth, and surgeons from the center and a lot of hard work. I get paid different on different accounts to include 12 cpl for surgery center operative/HPs, 10 cpl on other accounts, page rate (around 10-11 cpl), and 11 for an ESL but with normals and procedure reports paid like radiology in a way.

Mailing out advertisements did not land me any clients by the way.

I quit picking up tapes and such and transitioned all clients to the call-in system and online access of reports.

Good luck to you!

Sticky paper, FTP the reports and let office staff print - me

[ In Reply To ..]
Let the office staff deal with that... and ruin their own printers.

I have not had to print and deliver reports in years, as I set them up with online access immediately. One MTSO I worked for did not even know what the Internet was let alone know how to transmit reports. I had to train her MTs and get the doctors online. Beats driving in the middle of the night after working all day and night!

I just - schanuzermom

[ In Reply To ..]
Left a job in the summer that was a 2 man operation. the job was in house and there was not that much work. I found a home job that was more work. I offered to work at home for them for 2 weeks till they found someone else or work at home from then on. I was told "no the job is here" Keeping in mind I had taken work home with me previously when the office was closed to get it done. Apparently it was only at home when it worked for them. I got called inconsiderate and that was the end of that conversation. I thought I was being more than fair. The office was extremely noisy, I had a cubicle in the main part of it and frequently had to stop working till it quieted down (I refuse to ruin my hearing my turning my headphones up). Now they have someone come in once a week (not the schedule they had set up for me). So I would say that there are quite a few offices out there that would need your help.

Cheaper sticky paper - Frugal MT

[ In Reply To ..]
Back in the day I bought my sticky paper from a company called PATSystems in Flower Mound, TX. MUCH cheaper, and really nice people, too. Quick delivery, great service.

He either has a tremendously successful practice, or - is retiring before too long, or will be doing EMR.

[ In Reply To ..]
A very large portion of podiatry patients are on Medicare, and he'd ultimately lose that portion of the business.

Regardless of that, and MUCH bigger, he'd also start losing referrals from doctors and removed from lists of insurance company providers who would be quickly aggravated by the inconvenience of no EMR. It's like e-mail and other similar advances--once you use them, no going back to paying for snail mail.

I know a bunch of people who make a lot of denial noise over changes, like the neighbor who stocked up on old-style light bulbs and swore she'd never use the new "fascist-mandated" low-energy ones, but I've seen them in her lamps and it's way too early for her to have used up all her incandescent bulbs.

All a way of saying, take him on as a client but don't invest in a big stock of sticky paper. :)

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