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

Fiesa BS - nn

Posted: Jul 26, 2012

How frigging nitpicky can they be???? Whatever it takes to keep you below 99%. If they can keep you below 98 you will feel your job is in danger and be ever so grateful to continue employment with this fantastic family-friendly company . (Gag, puke). Wrong word, wrong spelling, wrong format -- okay. But REALLY!!!

I hear you . . . its a racket. - anon

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I was just under( and I mean a fraction of a percent under 99%)last quarter and had 3 challenges that were fair and should have been reversed but do you think I have heard anything back now 4 weeks later, nope, not a word.

I have no other real issues with Nuance, I get my lines and like my TL and accounts, but this FIESA/QA stuff is unfreakinbelievable and a total fraud.

Like the old streetwalker said: Let go of my ears. I know what I'm doing. - nm

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So sad how relevant that remark is to this job. NM - anon

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QC point of view - anon

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I know I will probably get a lot of negative responses for this, but I think it is important to take into consideration that as QCs, we also get audited for our work, and if we don't assign appropriate error codes or overlook things, this counts against us. It is nothing personal, we are just doing our job. I have never been instructed to do anything but score fairly and make sure we send quality documents to the clients. I think it is absolutely ridiculous if a QC is counting points off for forgetting to place a comma or something ridiculous like that (which I would never do), but if you are making legitimate errors that affect the quality of the document or could negatively impact the patient, these things cannot be overlooked. I understand how difficult things are right now in this field and how frustrating things can be, but unless you have some crazed, power-hungry QC, remember we are on your side and aren't intentionally trying to sabotage your quality scores, we are just doing our job, just like you.

Best of luck everyone. God knows we all need it!

I appreciate your point of view . . . - anon

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and, obviously, we all agree that when we make a legit mistake we deserve our lumps. I am always mortified when I make a major error.

It is the small stuff that I think we are all upset by.

Let me ask this, when you get QA'd do you lose points for having incorrectly marking and error? If not, then the playing field is not even and you are getting breaks that we are not.

Also, the inconsistency of instructions between the different QA/QC people is problematic for most of us as well. It just seems the 2 departments are run rather poorly in regards to instructions.

oops . . . - anon

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I meant do you lose points for having incorrectly MARKED AN error. Sorry, I am insanely tired today, very early morning.

same boat - cassie

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I am in the same boat. The QA staff with Fiesa, well I am speechless. I am marked errors for so many things, challenge them all that should be reversed, never hear anything back. I am marked off for everything. If I would make a major error that would impact a patient's care, ok fine ding away, however, my errors are always this should have been a semicolon or a period. Now all the sudden we don't put a comma here (one QA says), the next day a different QA marks me off for the same thing only now the comma goes there. Hypens, same thing. Its a bunch of bs if you ask me. I am so frustrated that I hate checking my QA daily. I am frustrated with the company completely at this point. Always wanting us to work extra hours, thats great and all, but now this has to be done, now that has to be done to the dictation before you actual get to do the actual dictation. I have been working with them for 6 years, nearly 7 now and i'm still making the same per line as I was nearly 7 years ago as a newbie...anybody else think there is a problem with that? I get so many dictations a night that come through as an edit and have to be retyped b/c the speaker put the wrong name in the speaker field...am I paid for that, nope. Oh and I love how our pend percentage doesn't go only for blanks, nope...if you have to pend b/c the dr didn't give the patient's name, that is against you, dr doesn't give their own name and they clearly typed it in the speaker field wrong (they are a female and its a man's name, etc) my ding to pend % again. Anything that the dr doesn't do right on their end that causes me to have to pend goes against my pend %. Incentive pay, HA. There is no way to even get an incentive pay anymore, the more you have to pend to things that are at no fault of your own, the less you are able to get your incentive pay. We used to get paid for header and CC field line counts, not anymore. There are days that I spend more time on the header or the CC's than what I do on the actual dictation, only to pend and get marked on my QA b/c the QA could understand it. I always wonder when the tape cuts out, how the QA can make out what is said when it is not there. I love being an MT, but I really think we need to be more appreciated for all that we do. While everybody else in the health field gets a raise, the only way we can get a raise is if we type faster. Try doing that with a dr that is constantly telling you to go back and add this or take this out or that you can barely understand.

QA gets paid by the hour - anon

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so they can go slow. I too understand that if I make a major error that I deserve to get marked off.

However, they do mark off for hyphens, commas, tiny little insignificant words that mean nothing and change nothing. They also QA very short reports where a 0.25 minor error will cause a very low audit score. They claim it all evens out in the end but if you have a lot of short reports, it doesn't and on a long report they seem on a mission from God to find a ton of tiny "errors" and those 0.25 add up fast.

It is frustrating and unfortunately does not seem to be something they care to change.

exactly - cassie

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Exactly!!! It does not even out in the end, at least I don't see it. If I was paid by the hour, I probably wouldn't miss anything, but i'm not! Its very frustrating, they don't see it as broken so why fix it. The less our QA score is, the less we are not qualified for incentive pay, which means they don't have to pay us more, just straight time, well line.

Hourly pay - QA

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I need to chime in on this. I am a QC but I don't do the scoring. I edit the reports before they go to the client. When you say we get paid hourly so we can go slow ..... We do get paid hourly, however, we cannot go slow. We have to maintain a certain number of lines per hour also as a requirement of our job. Yes, we get audited also on the reports that we edit. If we fail to maintain a line count and accuracy with our editing, we are at risk of losing of our job. I have seen this happen to my teammates. I certainly understand the frustration of being marked off for commas, etc. Since I don't do the post auditing, I don't know their rules for editing. I don't worry about commas when I get a report. I check it for accuracy and demographics, fill in the blanks, and send it on. I like to send positive feedback if I don't find any errors. There are many good QC people out there. We aren't all bad. : )

QA also are NOT to mark off for petty punctuation - sm...current post audit QA

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UNLESS it changes the meaning of the sentence. If your TL is not fighting the petty mark offs for punctuation GO ABOVE HIS/HER HEAD to THEIR manager so it gets reversed!! We also cannot "go slow" because we too have a line count that must be met AND we also get audited off your reports. There are also many good QA who do not mark for petty things. Our focus is supposed to be on major and critical errors and minor errors such as grammar, capitalization of drugs and medical words, misspelled words, and acct spec errors.

Agree there are many good people - anon

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you will get no argument from me. I have had feedback that was extremely helpful, nice and respectful.

If I make a major error, I take full responsibility for it and expect to get dinged on an audit, so this isn't about MTs who want a walk on major errors.

I have noticed there are 2 or 3 post audit people who are extremely HARSH. So it is by no means the entire group. It is just that a couple of bad audits are all one needs to lose incentive.

I think whoever is in charge should take a look at the auitors who are giving excessively harsh audits and do something about them.

yes there are good QAs out there... - cassie

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While yes I do agree there are good QA's out there and I love seeing what my blanks, especially on a Dr that is so hard to understand and is repetitive in his/her dictations. If I miss something major, I have no problems being marked off for that, I should have known better. I think what the majority of us are saying in our issues with this is that we are being marked off points for things that just don't matter. Going above your TL's head, ok that would work if you would actually get a response from somebody. I can't even get a response from somebody with a question on sudden account specific changes that I then have to blank or assume...sometimes I get an answer weeks later and sometimes not at all. There are so many times that you ask one QA a question, they say do it this way, you are marked off. You do it the way the correction states in the fiesa corrections, a different QA audits you and you are marked off. It is very frustrating leaving you sitting here saying well which way do you want it. There are also those QA's whom give you smart comments on your audits as well, such as "this was clearly understood" well if it was clearly understood, I would not have blanked it, pending is a pain in the you know what. There are also those blanks that I leave b/c it clearly is a discrepancy in the dictation and instead of that being pended to the client for verification, it is filled in and sent on through. Like I said before, I love being an MT, I just think that there needs to be a better way to go about many aspects of our jobs and for goodness sakes, allow us to have a raise. Getting paid pennies by the line, ok so increase us a quarter of a penny or half a penny or if you are working on an all ESL account, why not pay us more for that harder account that you can't get the higher line counts on. I'm just saying. I wish we could actually speak to our HR department or other departments about these things w/out being penalized for our opinions or thoughts.

sounds like you need to use alt+s more - sm

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to play the silent parts in the dictation. That is how they are hearing it and you are not.

The "default" should be set to play the whole dictation, - not the other way around.

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I get sick of having to reset it with each new dictation. In fact, since the "silence suppression" thing works so badly that it completely misses clearly stated words, they should just eliminate it. The bit of "speed" it provides simply isn't worth the real risk that it creates for missing something critical.

And then there are those times - SB

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when the QC is clearly wrong based on documentation in the archives, and major errors that adversely affect the patient record are inserted in the report, and then I can't get that reversed! That is pretty outrageous to me, because it would seem that the accuracy of the patient record is the most important thing to strive for.

There are a couple of QC people who do a good service--fill in your blanks so you can see a new term you do not know, or something like that. I try to focus on what I can learn, if anything, from the feedback and try mightily to let all the inaccuracies and nitpicking roll off my back (sometimes long walks with my dog are involved).

Gave up on the incentive a long time ago! I try to do a job that will be pleasing to the client. I don't seem to be able to please the QC department!

One of the most important skills to develop is the judicious use of blanks to protect myself from inaccurate QC auditing. I don't like leaving blanks when I know the word or value that should be there, but if there is any ambiguity and I think the QC might disagree, I leave the blank.

I also think it is wildly unfair to determine one's "accuracy" based the audit on 1 or 2 short reports a week, particularly in light of the above. I also am baffled about how a point or 1.5 points can knock a score down to 95%. This accuracy scoring seems rigged against us.

There, I feel better now!

You are confusing QC and QA. They are different - sm

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QC is BEFORE the report is sent to the client whereas QA is AFTER the report has been sent to the client and is the basis for your quality scores that DO matter (post audit). The post audit score and feedback is what you should be more concerned about. There are a LOT of MTs who are confused on this and the 2 departments are different and NOT associated with each other. The QC Dept answers to your TL whereas the QA Dept answers to their own manager.

I dunno.... - j

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I got dinged for not placing a comma after a blank, that QC couldn't hear either, so how did she even know a comma should go there..... seriously.

that happens to me all the time.. - cassie

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that happens to me all the time. I will put a blank and the blank will not be filled in, but a "correct punctuation" will be added. If they couldn't get the blank themselves, how do they know it belongs there. I was also "made aware" of doing something incorrectly via email on a job that I NEVER HAD, nonetheless, it is argued that I did that job. Amazing how it is not in my line counts at all or on my log that I meticulously keep daily. However, somehow it is my error and I was knocked off for it. Anything to make them happy right. Its so frustrating!!!

QA "hitwoman" - anon

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There is 1 lady who is a horror. In over a year I have never passed an audit she has done. I find that very hard to believe unless that is specifically her job as a "hitwoman."

Name starts with a D. Wonder if anyone has ever passed a report audit by her?? She does post audits.

I know it isn't me because I manage to get 100% from other QA folks.

That's ridiculous! - QC Point of View (OP)

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As a QC, I never mark off for anything that is incorrect right before or after a blank. How can you expect someone to punctuate or phrase a statement correctly when the entire content isn't understood?! I was transitioned to Nuance QC through an acquisition, and in fact, when learning the Nuance way of scoring errors, it was mentioned that mistakes associated with a blank should not be counted as an error. Unless I misunderstood, I don't think this practice is legitimate, and I would try to notify someone higher up in the chain if this keeps happening.

Geez, with QCs/QAs doing things like that, no wonder we get a bad rap!

and another thing . . . - SB

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It's a heck of a way to run a business, demoralizing your workforce unnecessarily. I don't get it.

If they WERE styling themselves for a merger or takeover, - then this all could be about prettying up the book

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