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

Info from an actual QC person - QC1

Posted: Jun 20, 2013

I have seen a LOT of posts on here about QC and most of them are completely inaccurate. Since we have joined with Nuance I think things have gotten very confusing and this is where some of misinformation is coming from. Quality is now split in two, predelivery and post delivery. Those of us in predelivery (QC1) are told NOT to "ding" the MLS for for any kind of punctuation unless for some rare reason it would impact patient care. We are told to use a very light hand and most of our job entails filling in blanks. Eventually we will be doing 100% on all reports and WE will be audited on what we do by QC2 and if we miss something it will affect our jobs. No one is to be dinged for commas, etc., and if you ever are you should protest. However, also know that NOTHING we do in QC1 predelivery affects your quality score for bonus or anything else. The post delivery is what is counted for your scores. The feedback you get in Fiesa shows both and if it is predelivery it is just a better way to get feedback from us than us sending you track changes in an email like we use to have to do. We do not have bonuses in QA.

100% QA on all reports? - seriously?

[ In Reply To ..]
the manhours! How many of you are there?

QA - anon

[ In Reply To ..]
Yep. The quality for most of the hospitals is really bad and they're noticing. There are definitely not enough of us and we're spread really thin. Just remember that we are held accountable too and get our fair share of emails about things we've missed too. I know the MTs don't like Fiesa but the majority of QA and QC are trying to help out the MTs, not make their lives miserable, as most of us were MTs are one time ourselves.

If they would listen to the MTs and do something about the - wannie

[ In Reply To ..]
quality of the dictation that we receive, the quality of the reports would probably get a lot better. We are held to incredibly high standards but the dictators aren't.

I agree with you on some points - SM

[ In Reply To ..]
I used to QC and I can attest, there are no bonuses for QC, at least there weren't when I was there. I also agree that, yes, we are held accountable by the "post audit staff." I don't think you are trying to make anyone's lives miserable, as I know I never did. However, the "post audit staff" most definitely does a good job of making lives miserable, whether they are trying to or not. I'm sorry, that is just a fact. There is just too much evidence to support that to make it a figment of someone's imagination.

Hmmph...Every single one of my post-audit reports were.....sm - LoveMT

[ In Reply To ..]
done by offshore QA... All of my QC1 reviews were done by onshore staff. I have a nearly perfect score from my QC1 reviews, which really makes it a shame that they don't count that score.

My post-audit score, however, just sucks the life out of me every time I look at it. EVERY SINGLE ONE of the dozen or so reports that have been post audited were done offshore, and I have been dinged just enough times to drop my score just under 99%, just low enough so I can't make the incentive bonus, and I definitely won't EVER qualify for any quality bonus at this rate.

There would be way more consistency if all of the reports were done by onshore staff for those of us who are actually working in the U.S. instead of them allowing India QA to do our post audits... It's just ridiculous. I don't understand how someone who speaks English as a second language could possibly audit the report of someone who has a far better grasp of the English language and grammar than they do...

If only....

QA - Dottie

[ In Reply To ..]
I have not been audited 100% since I started out in this business many, many years ago, and that was because I was new and still learning. Makes us seasoned MTs feel like we are being slapped in the face. Again. Why do we put up with this? I know, we all need the income and until something else comes along. Nuance has lostand will continue to lose a lot of good MTs.

You're so right.....sm - LoveMT

[ In Reply To ..]
It does make me feel like I've been slapped in the face. I've been put on "emergency audit" in the past because I made a very critical mistake in a report because I was working way too many hours and was way too tired. I was just sick when that happened, BUT I passed that emergency audit with a score of 99% and not one critical error in the reports that my supervisor randomly pulled. At the time, everything I did was straight transcription.

Now with all of this editing, it's a whole different ballgame. I'm not going to go over every single report with a fine-tooth comb just to make sure I didn't miss "a", "an", or "the" somewhere. Minor errors are going to happen with editing because we are having to work faster in order to make a halfway decent paycheck, but the things that QA deducts as Major Errors with Nuance are just plain ridiculous, almost laughable if it weren't so damn frustrating.

You know, that pitiful 2/10 of a degree difference in a patient's NORMAL temperature (98 versus 98.2) that I was marked off 1 point for as a Major Error is just STUPID! In my opinion, that is just nitpicking at it's finest because it absolutely doesn't endanger the patient in any way if the temperature is off by 0.2. It really doesn't change anything medically in the report except that the .2 was put in after the 98.

That 1 point for that crap is what put my score down just enough that it's under 99% and I don't qualify for the incentive bonus. As for the quality bonus that they want us to try to earn with 99.5% or higher for each quarter, I'll NEVER see that happen for me, especially with an offshore QA auditing my reports and stabbing me for really minor stuff.

I think I'm just not going to look at the Post Audit reports at all anymore. It just pisses me off and is not really helpful. I'll stick to my QC review side and use the advice, filled in blanks, and other things that I do find helpful. Nuance can stick their bonus where the sun doesn't shine.

Curious... - MTSlave

[ In Reply To ..]
Is there a way you can tell for sure if you are audited by offshore QA?

look at reviewer info - anon

[ In Reply To ..]
I believe all stateside ID's have "US" in their QA identity listed as the reviewer.

Thanks!! - MTSlave

[ In Reply To ..]
Mine are all On Shore (TG).

For the platform that I work on..... sm - LoveMT

[ In Reply To ..]
it shows up as "ON" after the platform name for onshore and "OFFS" for offshore. I just want to scream every single time I look at FIESA. The QC review and feedback is usually helpful to me, more often than not. However, I have a couple of reports on my QC review side that were reviewed for 1 and 2 blanks and because the person who did the review was able to fill the blank, points were taken off for "Invalid Blanks", which I personally think is a load of hogwash... I have one from today that I sent in with ONE blank for a medication that the physician was clearly mispronouncing, but I didn't have a clue as to what the medication was. I actually left a note with the flag stating this, and I still got the "invalid blanks" points deducted. Sorry, but I absolutely will not guess at a flipping medication.

Since I only have 2 reports in the entire bunch that were hit for "invalid blanks", I pretty much believe it's the same QC person that did both reports. 0.25 points taken off for each blank, even the ones that weren't filled in by QC because they couldn't figure it out either!

BUT, the majority of my QC review has been positive....

That Post Audit crap just makes me want to reach out across the ocean and choke the life out of someone OFFSHORE! My score right now is 98.5% by Post Audit, and every single one was done OFFSHORE. My QC review score is 99.8% and ALL of my QC review has been done ONSHORE. That alone speaks for itself!

response to questions - QC1

[ In Reply To ..]
To address the questions....As far as I know QC1 are all onshore. They do have QA that are offshore, but as far as I know they are not predelivery except their own stuff. I agree with all of you. I have a huge problem with offshore people "proofing" our work. I have seen the work from their MLS and it is horrible and they are the main reason for us having to go to 100%. Nuance utilizes offshore way more than Transcend ever did and I don't like it. As far as reviewing your reports in Fiesa, we have been told that MLS can see completed reports and can see everything we have changed...voice I'm not so sure about. Don't ask me how to do it because Fiesa is still new to us and we can't see what you see, but your TSM should be able to tell you. As far as blanks being counted as "invalid" that is what we are suppose to do. Each account is allowed a certain amount of blanks to go through for the MLS...anywhere from 0 to 3-4 on some accounts. If the MLS sends a report to us that has 4 blanks and the account only allows 0 then all blanks have to be counted as invalid unless we can't get them either and then they are valid. If it has 4 blanks on an account that allows 2 blanks then 2 of them will be invalid. And yes I think it is unfair also, BUT keep in mind we can count off all we want and it won't affect your scores. AND again QC1 and post audits both should not be counting off for minor errors. We are told just like MLS that especially with the edit reports not to over edit. No one should be counting you off for an A, or a comma, or minor things like that. It must affect patient care in some way. To the person who protested the 98.2 I believe, any kind of lab value or vitals is considered to be affecting patient care. I agree the 0.2 is not going to kill someone, but there has to be standards and we need to be consistent. We can't say those things are major errors, but then have wiggle room at our discretion because not everyone thinks the same things are major. Just keep in mind that most of us have not been on Fiesa long and it is new to us also.

Thank you for your response.....sm - LoveMT

[ In Reply To ..]
Thank you so much for taking the time to address some of the issues that a lot of us are experiencing! I haven't been exposed to FIESA for very long either, but I have already formed an opinion about it (and it's not a good opinion, lol). Nonetheless, I do know that none of my QC1 reviews were done offshore, just my post audit QA were all offshore.

I definitely appreciate the feedback that I do get with my QC1 reviews as a whole. I also appreciate that you've taken the time to explain the reasoning behind the Major Error deductions on the QC1 side. I didn't really think about it being a need for consistency, but I can understand it better now.

As for the Invalid Blanks thing, I understand that much better now that you have explained it. I didn't realize that it went by how many blanks could go through to the specific client; so, it now makes more sense because I work 5 different accounts. I didn't understand why some of my reports were being hit for invalid blanks and others weren't, but it would be because 1 facility does not allow any blanks and 1 might allow 3 or less.

I was blowing off a lot of steam because I was so mad about the post audit being done all offshore for me, and so I apologize if I came across as rude for the QC side of things. I do appreciate the input I get from the QC review because I very rarely send in blanks, and if someone else can fill those blanks and help me the next time I get the same doctor, then I benefit from it.

As far as being able to view the completed report in FIESA, I don't think that feature has been made available to those of us working in E-BeyondTXT yet. There's no way for us to pull up the completed report, and there's definitely no way to pull the audio once the report has been submitted. However, I don't pend very many reports and I usually make a note of the ones that I do have to pend for QC, so I remember details when I go into to review any blanks that needed to be filled and were able to be filled, especially if it's something that a doctor might say repeatedly in all of his/her reports and they just speed through it. It's already helped me with 2 new doctors for one of my accounts because QC was able to fill in part of a physical exam on 1 doctor in particular, which helped me with her the next time I got her and I was able to make it through the entire report without having to blank anything.

Please know that your input is appreciated. :)

Post audit reports - BurnedoutCO

[ In Reply To ..]
I had a post audit report that I got 92% on because I did not put the dictated date on and something else that they did not agree on but even that was not a "major error". I went back and listened, the date was not dictated, and I still heard what I heard before. The other "major" error was again laughable, it was not even an error. Really 92% for a report that was otherwise perfect!!! So frustrating. I have worked in many hospitals over many years and it is just not possible in the real world to get 100% the way they want it. But I got 92% for mistakes I did not even make and yes I sent it for reversal but I know that my supervisor is just swamped and she is the only nice thing about Nuance. Helps to vent.

How do you go back and listen? I don't think we - wannie

[ In Reply To ..]
have that option in eBTXT. I can't even go back and look at the completed report.

There isn't a way for us to go back and listen....sm - LoveMT

[ In Reply To ..]
eBTXT is the platform I work on too, and there isn't any way to go back and listen OR even see the completed report after it's been submitted. There's no way for us to "prove" anything. Sad, isn't it? My QA scores were NEVER lower than 98% in the past 16 years, and now I feel just a little bullied and belittled because I'm being "graded" by people that probably learned English as a 2nd language. If the way most of the India doctors speak is any indication of their grammar skills, then I just cringe at the thought that these people are allowed to grade my work and degrade my experience in this field!

Re: Post Audits....sm - LoveMT

[ In Reply To ..]
OMG, 92% would have sent me over the edge for sure! The things they count as major errors are just insane!

The platform that I work on currently does not have any way we can go back and listen to completed jobs. Sucks to be me, I tell ya! I'm now keeping a log of every single job I send to QC and ANY jobs that I complete and send through that I think QA would question dates, doctor names, etc. since I have now reviewed everything that they are hitting my reports for. Since I'm not able to go back and listen, it helps to have a little note on the job to refresh my memory.

But, I am literally not going to look at the Post Audit scores anymore. The only thing it does for me is make my blood pressure go up, so I figure my health is more important than what some QA person on the other side of the world thinks of my work!

I have requested reversal or downgrade of a couple of mine too with my TSM. I have a super fantastic TSM (Thank the Good Lord Above!), but she too is swamped since Nuance keeps adding to her work load by adding accounts for her to manage. I really don't know how she does it and stays sane.

Maybe what she means by 100% - sm

[ In Reply To ..]
is that they will start reviewing the entire pended report they are working on rather than just the blanks. That used to be the policy here, but they changed that a while back, so now they only fill in the blanks and are not responsible for the rest of the report if the report gets a post-audit review. At least, that is how I understand it.

100% - QC1

[ In Reply To ..]
Actually I do mean 100% review on all pended reports. They are already hiring more QC people.

So, they're paying us half to race desperately to make - money, and hiring double to cover? Stupid!!! nm

[ In Reply To ..]
x

Similar Messages:

Jan 17, 2013

Is it still the same? ...

Feb 17, 2015

I am tired of begging for work and then the higher ups send out messages about so many jobs on the system/out of TAT but yet I ask daily for work and there isn't any. Looking for some place that can actually keep me busy with work. ...

Mar 18, 2015

When do you capitalize gram in gram negative rods or Gram negative rods? Also, what is the keystrokes if you accidentally erase a word or sentence to put it back in, instead of going back and retyping? ...

Jun 18, 2015

In your daily job, do you code from scratch or do you more or less verify codes that have already been put there? With the course I'm taking I'm noticing most of the exams are more of a mutliple choice and less of coding it myself. I'm wondering if that's how it works in the real world. ...

Jun 08, 2011

What is the actual title of the Book of Style? I see The Book of Style for Medical Transcription, 3rd Edition - Paperback (June 15, 2008) by Lea M. Sims and John H. Dirckx and I also see The AAMT Book of Style: A Searchable Medical Transcription Style Guide (2nd Edition) - CD-ROM (July 21, 2005) by American Association for Medical Transcription (AAMT). One is by AAMT and one is not - I am assuming the AAMT is the Book of Style everyone refers to? I am buying this for someone and want to ...

Aug 27, 2011

I have had different docs use erythematic and erythemic. Are those actual words? I saw an old post where someone claimed it was in their dictionary, but did not cite the source. ...

Oct 04, 2013

My company requires a solid 8 hours a day 40 hours a week of system time of transcribing in order to not be fired. This is in an 8 hour day (100% of the time on the keyboard). Any tips on how to do this. My back hurts and I don't want to get fired or I will lose my home. Thanks in advance for suggestions. ...

Jan 04, 2012

I have completed a course in medical transcriptioning in a school thats called U.S. Career Institute and was woundering if I just got hoaxed or if it was a real school. If anybody knows I would appraciate it having difficulties finding a job. ...

Dec 11, 2012

I have been here almost 2 years and have been asking for one the entire time. Does it actually exist?? ...

Mar 26, 2012

Do you have to work so many hours at Phoenix MedCom or have an actual schedule, or can you just get your lines in for a particular day/week without working set schedule? ...

Apr 23, 2014

I work for a company that does not monitor my "hands on the keys." However, I am trying to determine what I am actually earning per hour when factoring in all of the patient demograhics, internet research, etc. that is not reflected in my line count. Does anyone know of a reasonably priced or shareware program that would do this? Thanks. ...

Dec 15, 2009

Equally performs NUMBER FOUR SIGNS with assistance of his upper extremities. Could this be putting the ankle in the back of the opposite knee to create a "4" sign? Never heard of this... ...

Nov 25, 2011

posted directions on changing window color in Win 7. I changed mine to a light grey and somehow changed something when fiddling around with this that made the letters a more bold black color and what a difference it made. My eyes do not feel strained like they did with the stark white background and ligher black letters. Thanx. ...

Jul 20, 2012

Over 1000 seconds, took me 1-1/2 hours to do. Total waste of my time. Indian doctor who did not speak clearly. I can't wait to see my line count today...not ...

Jul 30, 2012

What exactly are the duties of a QA person? Whenever I make a mistake she lets me know, of course, but she is always adding a snide remark and make me feel like I am still in school. I am sick and tired of it. I am thinking about complaining to my CCM, but I am not sure I want go that route yet. I have saved all of her sarcastic comments. So I made a mistake, she is not perfect. She should just tell me about it and let it go. I am not stupid. I ack ...

Oct 02, 2012

Has not been given the go ahead for HIPAA training? I got 2 e-mails in the past few months from CCM, stating to have it done by "the date they say," but nobody ever gave me a date. I wrote to CCM who said "they" would be sending out an e-mail letting me know. Just hope I didn't miss anything for this year's. ...

Nov 21, 2012

gets the whole nasty message into the subject and nickname/alias lines and then leaves the message blank? Hates on everybody? Happy Thanksgiving nm. ...

Jan 01, 2014

Honestly, every time I get a big ding it is from one person. Everyone else seems to not mark me off much. Pardon my paranoia, but I just have to wonder if this person is targeting me and poring through my work until they find the one that has the errors and that's the one they end up reviewing. And about these "Major Errors" (or otherwise) - one middle digit off in platelets, really? 3 points? I know that is officially the rule, but to my knowledge unless platelets are particularly low or ...

Jun 07, 2015

I read what you wrote and it touched my heart. You sound like a really nice person who is just looking for the right option for you. I understand that. Like I said, it touched my heart, so I started brainstorming in your behalf from what I did and what might work for you. Please don't laugh at my suggestions. They come from my heart. You mentioned that you wouldn't be able to use the $1,000 for Andrews. I can't remember what school you were required to use it at, but ...

Jan 20, 2010

When a company decides to make an account VR, are all the reports a mess to begin with for weeks or months until the voice engine (sorry if that's the wrong term) learns from the "straight" transcription that is done? Why do different platforms matter (i.e., E-scription versus M-Modal, etc). Is it possible for a company to get an account and make it VR from day 1, or do they have MTs do regular transcription on it for awhile? I guess I'm just trying to figure outwhat I sho ...

Apr 07, 2010

There is this PA in the South. I want to hurt him badly. Seriously. I want to poke sharp objects into his eyes or something. He seems to dictate for everyone in this stinking hospital (which has the WORST sound quality, by the way) but he CAN'T TALK FOR CRAP!!!! I don't know what it is with this guy. He can't even pronounce his own name clearly. He talks as if he has his mouth stuffed full of cotton balls and Q-Tips shoved up his nose. All the wh ...

Jun 14, 2010

Please email me! I don't know how to get in contact with you but I sent my resume to the address you had in the post. I worked with you at the Q and hope you remember me. I listed your name in my email. A.P. ...

Jul 20, 2010

Sounds like LMV or LMT...the elderly gentleman saw his LMV/LNV after he had injured himself. ...

Jun 15, 2011

Your e-mail said: "I'm in California and was told I can't apply for it unless I get let go specifically because they are offshoring my job, and then only after I'm already on unemployment. Did you get MQ to tell you that?" No. The caseworker for my TAA case told me that. Said if I knew of anyone else to tell them as well. Even if you have not LOST your job at all but have lost work, go apply for unemployment benefits and tell them your employer ha ...

Nov 28, 2013

and 100% QA? I wonder if that's the rabbit in front of the dogs at the dogtrack to make us run and they don't really exist. ...

Jan 19, 2015

I worked in this business over 30 years and my daughter has always had an interest. She talked to the major school and they told her the starting salary is about 40,000, and that a large proportion pay by the hour. I told her the truth about the hours and about what she could expect to make with pay going down so much. I would like some feedback about what new people out of school are seeing as far as the pay now. It's been a long time since I actually transcribed, I ...

Jun 29, 2010

I had a FB friend suggestion and I decided to go and check it out: Employer: _ _ _ _-_ _ _ (2009) Qaulity Assurance Editor At least now I know I won't apply for the opening this company has posted...if the QA people can't spell, what does that say about the company? Lesson in this is: ALWAYS check your grammar and spelling no matter where you are posting. You never know who is looking and for what purpose. ...

May 11, 2010

A friend is asking me for advice on becoming an MT. My first instinct is to talk them out of it, as this career is on a fast track down the pooper. But I'm sure they'll insist. Anyone know of any good transcription schools that are legit? I have no idea, because I didn't go to school for MT. I got a lucky start from a relative who was an MTSO. Thanks for any suggestions! ...

Aug 12, 2010

I was just wondering how does a person become an independent contractor? I see a lot of job openings for them but not really sure what is involved. Could someone explain how to go about getting into being and independent contractor? Thank you so much! ...

Nov 01, 2010

the word "the," can you imagine how hard it will be to find another job when you have failed audits? People probably assume (and rightly so) that you put in erroneous information or left out vital information from dictation -- something that brought about harm to the patient. There is no way you could possibly get them to believe that in reality you put out beautiful work every day all day, and it was a discrepancy over whether the dictation read "Lab tests were normal" versus "The l ...