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

What am I doing wrong? - MTC

Posted: Dec 28, 2013

Hello,

Let me start by telling my fellow MTs what I am doing. Please point me in right direction, because I can't figure out where I have gone wrong.

My job is ending as the small company I work for doesn't have enough work. I don't have unemployment as a backup since I have been subcontracting clinic work for the past 4 years. This has been my only MT job. I am limited on what I have applied for because I have no acute care experience, only clinic transcription.

I applied at MModal, Nuance, and a few others. I have even applied as a new MT because I am willing to start over just to "land" a job while I get through my medical coding class. My heart is in MT, but I am looking into coding because there are no MT jobs, or at least this is my experience...I would glady stay as a MT because I still love it. My husband works nights. I know if I take a job outside the home, I would never see him. I also know it would be difficult to work outside the home, but not impossible, while I completed my coding class.

I have an associates degree, but know companies don't care about that. They just want experienced MTs. Should I be listing associates degree and the certificates I have earned or just transcription experience? Also, should I be applying as a new MT. Again, no acute care experience and I'm not a new grad. I answer both those questions honestly and can't get a job to save my soul for that very reason.

I see many MTs leaving one job for another, and/or working 2 jobs because they have to while they look for greener pastures. Please point my in the right direction on where to find a job, because this tunnell I seem to be stuck in is going nowhere. I'm afraid I will end up losing my edge in this business. Any helpful advice you have for me is much appreciated. Please, no bashing because I feel down enough about having no job.

My Advice - see msg

[ In Reply To ..]
Clinic is very limiting, so without acute care, you're pretty much stuck unless you somehow find clinic work, which is fewer and farther between than acute care.

No company will test you as a new MT if you haven't gone to one of the schools they recognize as a good MT school.

As to your associates degree, if it's not medical related, it speaks to nothing. You could be the smartest person on earth with a PhD in microbiology, but it won't get you an MT job.

Best you can do is be honest about your clinic work with the MT companies--it's speaks louder than a new MT with no schooling. If you are very clear you need to do this MT stuff, then that's probably your only option.

As you know, a lot of clinic work, as well as acute care, has gone the way of EMR.

Best of luck to you. I'm guessing you will get through your coding pretty quickly since you already have some of the terminology.

Doing wrong - MTC

[ In Reply To ..]
The associates degree is strictly medical office, so I would think that would account for something to these companies; maybe not. I have 4 months of my last advanced medical coding before I can take the test for CCS with AHIMA, but will earn a coding certificate. I'm kicking myself for turning down MT jobs over the years at a local hospital, because now I have no job. Never put all your eggs in 1 basket.

Dont feel bad about turning down hospital jobs, because - those are going out fast SM

[ In Reply To ..]
I assume you've seen those type of posts on here about people losing their cushy hospital jobs, outsourced to a service. If you had gotten one of those, it wouldn't last long.

I know personally of at least 3 people hired for a local hospital about 2 or 3 years ago or so, while the director of records knows full well she's getting rid of the department at the end of next year.

All you can do is get the coding degree, and/or another degree in something else, because coding eventually will likely go the way of MT. Don't lock yourself into these careers that can be outsourced overseas or replaced by point and click forms.

Point and click - Anon2

[ In Reply To ..]
Not to open a can of worms, but what documentation do you have that coding will likely go the way of MT? My facility is currently looking for coders and someone with a CCS as the OP will have, could probably have first pick at many jobs. It's been said many times, but a person with training does not have to limit themselves to a traditional coding job, there are other things to in in health information management.

CCS is no guarantee - Depends

[ In Reply To ..]
Hospitals in my area are only hiring nurses, not much else. Office work doesn't pay much more than MT where I live. Many factors in play. I wish I hadn't believed all the hype. Good luck to the OP.

She doesn't. - sm

[ In Reply To ..]
A lot of MTs like to talk like they know a lot about coding when they really haven't a clue. They also fail to comprehend that coding isn't a one-hole job like MT is.

Every hospital in my area is also hiring coders.

It obviously depends on where you live - Delphie

[ In Reply To ..]
I've spent the last year paying very close attention to what jobs are advertised in my area so that I could determine what I needed to do to get out of MT. Coding is almost never advertised around here. I see it here and there but never in the hospitals. Other areas may be different, but the lack of coding jobs in my area was the deciding factor in me NOT taking a coding course. I asked my own doctor about it and she does point and click reports AND coding herself while in the examining room with the patient. She showed me the program. Her nurse/office manager does the billing and everything else. So, I think some of you coders are very naÃ¯ve in thinking you can never be replaced by point and click or sent overseas. It is already happening. Perhaps not to the degree transcription is, but it's only a matter of time for you, too. But you'll believe what you want to and the rest of us don't know what we're talking about.

Delphie - sm

[ In Reply To ..]
If there are no coding jobs in your area, of course you shouldn't go into it. We tell people that all the time. We also recommend not limiting the search to hospitals because they have relatively few coding jobs, which stay filled.

I won't say you don't know what you are talking about because you certainly seem to. You gave an accurate description of the situation in your doctor's office. You are just unaware that you are talking about billing, not coding, and that this is nothing new.

When we talk about "coding," we are not talking about that.

No. I am not talking about billing - Delphie

[ In Reply To ..]
The doctor does the CODING in the exam room at the same time as she is filling out the diagnoses. She points and clicks on a diagnosis and it has the ICD-9 integrated into the program. One click and that is it. Her nurse does the billing and all other office functions. They are separate and I know the difference.

Jumping in here - just call me naive

[ In Reply To ..]
Now, I'm just an MT, not a coder, but I'm confused about what you're saying. It sounds like the doctor is just filling out an electronic form of the chargemaster? From my understanding, that's not really coding, or if it is, it's way low level and is more inline with the billing process than coding process. I was always under the impression that actual coding involving more extrapolation of data? Maybe someone with more coding knowledge can speak on this?

You are correct--coding involves much more - sm

[ In Reply To ..]
The doctor is choosing codes on the chargemaster or charge ticket, which generates a bill. This is not "coding," per se.

Yes, coding involves a lot more. It is not just choosing the same codes over and over from a short list like the doctor is doing. If it did, there would be no need for education and certification.

There is a huge difference between that and summarizing an inpatient stay using complex rules, for one.

Yes, you ARE talking about BILLING - You just do not know the difference

[ In Reply To ..]

So, she clicks on a diagnosis and there is the code. Whoop-de-do. Before she got that EMR, she had the diagnoses and codes listed on a charge ticket.. She checke them off and Nurse Nancy copied them onto the claim form.

You and that doctor can call it coding all you want, but it is billing. I don't care how many ICD-9 or CPT codes that doctor clicks on, she s just generating bills. I don't care what the nurse is doing, it is ALL still billing.

It really doesn't matter, because professional coders do something else. THAT is not what our jobs are. We don't do that. Your doctor doesn't even need a coder and never did.

No mstter how much explanation I try to give you, it isn't going to change your mind because you are using a different definition of the job than we are. WHAT YOU ARE DESCRIBING IN THAT DOCTOR'S OFFICE IS NOT*NOT*NOT OUR JOB. REGARDLESS OF WHERE WE DO IT, THAT IS NOT OUR JOB. What we do is more complicated, involves more, has higher stakes, is more subject to federal scrutiny, and is more difficult.

What, do you think all we do is click on codes? No. There is more to it than that.

Look, if you don't want to go into coding, that is fine.

Oh, one more thing...that EMR with the codes built in? One of us does that. Yup, that is one of the new jobs opening up for people who have coding skills. THAT is a job coders do.

Exactly as I said before - Delphie

[ In Reply To ..]
You coders will continue to live with your blinders on no matter what. The rest of us are uneducated idiots who couldn't possibly know what we are talking about. Coding is just so advanced no one but coders can understand what it is.

My doctor does it herself. She specifically said to me she will not higher a coder because she can do it herself. That is just one example from one person, but the fact that you refuse to believe or accept it proves my point.

Bury your head in the sand if you want.

I believe you. - see msg

[ In Reply To ..]
No, believe you. Your doctor is correct that she does not need a coder.

If that type of job is what you wanted to do, then, yes, you are wise to avoid it. That job is what is taught by "career colleges" as "medical billing and coding." It is primarily billing, with just enough knowledge of codes to understand what they are and where to put them on claim forms. It does not prepare you to pass certification exams given by the AAPC or to qualify you to take anything offered by AHIMA. It does not prepare you to work as a coder, especially not an inpatient coder. Some people who learn that job do go on to become coders. They do this through on the job training or formal coursework like the one the AAPC offers.

A lot of doctors and people doing the job call that job "coding" because they don't know any different.
Those jobs are at the far lower end of the pay scale.

Medical coders are primarily people who are certified in coding by the AAPC, AHIMA, or both. They primarily code more complicated material than your doctor has, and they rarely have anything to do with a claim form. They typically learn their job in a 1 to 2 year college-level program, which may be taught by a private school or a college, or in a 4-year RHIA program at a university. Jobs in this field range from around 30K to 70+K. They range from actual coding of records to clinical documentation improvement, to consulting and education to programming EHRs like your doctor uses.

Can I ask - coding

[ In Reply To ..]
Do you look at the hospital's own employment site? Or just Career Builder, Indeed, etc.

In my area, not all hospital coding jobs are titled as coding. I've found it better to search the hospital's job site with keywords like CCS or CPC -- that tends to pull up a lot more jobs than just scrolling the board.

Also, I just read a big thread on the AAPC website about Epic and coding and how EMRs/EPIC/point 'n click, etc can't effectively code. It's an interesting read.

Can I ask - Delphie

[ In Reply To ..]
Yes, I've searched the hospital job sites as well as others... no coding. Then again, as I said before, that is just my area. Other areas may be different.

I don't know the efficiency of point and click systems in coding or anything else, I am not a coder or a coding expert, but how many times in the past have we heard that VR cannot effectively produce a coherent document and there will always be a need for editors? Look at the state of transcription these days because of technology upgrades and offshoring. Sure, there are editors, but look at how much this profession has deteriorated. Do you really think coding is immune to the same? If they can find a way to do it cheaper, you better believe they will. And they will.

So what ARE you going to do, Delphie? - What is immune to change? nm

[ In Reply To ..]
NM

The first thing I'm going to do - Delphie

[ In Reply To ..]
is to stop trying to introduce reality to the coders who obviously think they have superhuman skills. It's a futile effort.

Found this article interesting - Ariverinegypt

[ In Reply To ..]
Coders and coding students will tell you that offshoring will never happen to them. I remember when MTs said the same thing and dismissed all the evidence presented to them.

http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_050329.hcsp?dDocName=bok1_050329

Offshore coding?? - oldtimer

[ In Reply To ..]
In the article, I found this interesting:

For example, in late 2012 a jury awarded $140 million to the family of a woman who received a lethal dose of medicine as a result of an offshore transcriptionist's error that was left undetected by a US-based transcription company in 2008...

As an editor of mainly offshored medical transcription, I have worried a great deal about these errors going unnoticed and ultimately impacting patient care. I also believe our profession will continue to be degraded by continued offshoring until the lawsuits begin to pile up in response to sloppy transcription and editing being performed by people whose first language is not English and resulting in grave medical outcomes. When the lawsuit costs begin to over run the financial savings
gained by sending medical transcription offshore, then maybe we will see MT (and coding) work returning to our shores.

As most of us in this profession know intimately, and quoting John Lennon, "Money doesn't talk, it screams..."

Something interesting that you missed - More to it than meets the eye

[ In Reply To ..]
Google the authors. They are VP & COO and Director of Coding Integrity or something at H.I.M. ON CALL, a company trying to capitalize on ICD-10.

In all likelihood they use offshore coding services. That article is nothing more than self-serving advertising. They have probably encountered significant resistance to their use of offshore resources, so they have written a seemingly innocent article to explain it away. "Why, no! No, it is perfectly secure! Really! Give it a chance!"

They seem to be preying on the fear that ICD-10 will take so much longer to code that facilities will go bankrupt if they don't outsource. They cited that fear, but no hard studies documenting how long it actually takes. One recently showed that it doesn't take that much longer.

I am not in denial about offshoring, but just think you deserve to know the backgrounds of those authors.

I especially liked the part where they exhibited prejudice against US coders because "nearly half of coders are over the age of 50." Nice.

My suggestion - sm

[ In Reply To ..]
Since you are so close to finishing your coding program, I think you should start applying for coding, coding-related, and other health information jobs ... anything in any HIM department from scanning to transcription coordinator to record review to secretary. Even billing.

You are anticipating the CCS, and that is fine, but you should also take the CPC exam. Chances are good that you could pass it now, so sign up for it and try. If you don't pass, you can take it again within a year at no charge. Taking it will give you valuable practice for the CCS, as well as increase your job prospects. There is nothing to lose by taking it.

Do not limit your search to hospitals. Consider offices and clinics, as well.

Studies are showing that you have to be employed to get a job, so getting some sort of job is very important.

Experience is important, so you should try for something at least remotely related to coding.

Yes, you should use your degree on job applications. You should use everything you have on job applications. Don't just fill out the application and think the employer is going to somehow know it all or put it all together. You have to point it out, tell them how it relates to what they are looking for, sell yourself. Convince them that they need you and that you will go the extra mile for them.

Medical Office - see msg

[ In Reply To ..]
One needs actual acute care transcription experience or graduation from a really good transcription school, so medical office degree/credential/training really doesn't count for MT work. MT work is highly in a plane of its own.

It is true that the more well-rounded one is/was in MT, the better opportunity for jobs, but these days, it's a horrible and lousy job. I still had plenty of work as an acute care transcriptionist, but I chose to quit because it was really horrible stuff they put on ASR and expected me to edit with a serious cut in pay. They were also offshoring stuff to India like crazy, so I figure it was only a matter of time before my hospital accounts "went."

If you can, find something non-MT to hold you over until your coding. I'm not too sure about coding careers these days, though.

Doing Wrong - MT4evr

[ In Reply To ..]
Don't beat yourself up and if you need a job, then grab whatever you can even if it is outside the home. You can keep looking for an MT job without the pressure. There are MTs who have years of experience and cannot find a job or cannot pass those tests. Do what you have to do. Better to not see your husband for awhile than go through unemployment or the stress of it and you know it is always better to look for a job when you have a job. With all the UE being cut off, the job market is going to be flooded again, so start now and find something. There was a post about temporary work as well, if you are in a rather populated area. Good luck.

did you type any H&Ps, consults or procedure notes for - the clinic? SM

[ In Reply To ..]
Not exactly acute care, but at least you can say you have some experience with those work types when applying. Did you type for any specialties in the clinic? If so, ysou can list those as experience.

Applying as a new MT is like saying you have no experience at all.

Have you tried - sm

[ In Reply To ..]
Archivus? They are now called Etransmedia. They had ALOT of multispecialty clinic accounts, IC status and you pick your own hours unless thats changed. Google them and click on careers & the contact us tab to send your resume. Thats an option while finishing school.

Etransmedia - sm

[ In Reply To ..]
I just checked out Etransmedia's website, and it says the only jobs are IT, client services, and billing. There are no MT jobs listed under openings. Do you have new information that they're hiring MTs?

Search under Archiivus instead of Etransmedia - I see it now

[ In Reply To ..]
I went back in under Archiivus, and this time I found an email address for employment.

Are you the OP? - sm

[ In Reply To ..]
I wish you luck. I dont know if they are hiring or not, just know that back when I worked for them they had mostly all multispecialty clinic work, IC, you make your own hours, but have to produce 1200 lines a day for full-time or 600 a day for part-time. And they do check to make sure you're getting your lines in. You are given time to get up to speed. Pay is always on time and direct deposit. I wasn't crazy about the platform, it was slow, but very easy to learn. Platform may have changed though. For clinic. Work tapered off around 8pm, but it was usually enough to keep you busy till about 10pm if you got a late start. On of those companies you don't hear much about. Email me if you want. If I don't respond tonight, will tomorrow.

Applying - MTC

[ In Reply To ..]
Thanks for all the responses. I sent my resume to Etransmedia and several other companies. I'm trying to stay positive and not giving up until something turns up. Best of luck to all the MTs out there.

Try USAjobs.com - sm

[ In Reply To ..]
If you are close to a VA Medical Center they may take you with experience and some education, especially if you are currently in some kind of class. Check it out. Good luck to you. I'm a 30-year MT veteran trying to get out!

Thanks, sm - MTC

[ In Reply To ..]
Thanks for pointing me to that site. I have always wondered where the VA jobs were posted for local ads around my area. Thanks to everyone for the help! Best wishes!

WWW.USAJOBS.GOV...gov, not .com - sm

[ In Reply To ..]
For coding positions and other HIM jobs, search for 0675 and 0669. Those are medical record technician and medical record administrator.

If you search for the facility nearest you, then you can see all the jobs. I would advise taking any job you can get into.

Your time in MT should count for some HIM experience, so be thorough when you complete the application.

jobs - Jobs

[ In Reply To ..]
There is a new company with lot of potential to expand. It is called Express medical transcription. I got a job with them as an QA. The web is www.xmedtrans.com.

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This is in followup to the post below, but I am taking it a step further to state emphatically that Nuance is also prejudiced against women. This is predominantly a woman-based occupation, many of whom are single. A lot of us have lost or are about to lose our homes. A lot of us have lost all shred of dignity and self-worth with these cruel and inhumane FIESA rules. A lot of us are are depressed and angry. A lot of us cry frequently. The big corporate fat cats don& ...

Jun 16, 2014

A little while back didn't they make the point to say that numbers in number form were ok to use at the beginning of a sentence? Now I see ASR writing all the numbers out. Which way is correct, just seems as soon as they say this is the way to do it, ASR goes back to the incorrect way. ...

Jun 27, 2014

I got an email from Monster today that said what we are supposed to do is job hop, see? We stay with a company for about three years and then we go to another company where we can command a greater salary, see? If we stay where we are we'll have to keep settling for these measly 3% raises (I'm laughing as I type this, haven't had a raise in many years), oh no, if we job hop, at the next company we can expect to start out at a much higher level than what we are making right n ...