Pricing can be quoted in various ways, the most common being:

Price per line of transcription

Price per minute of dictation

Price per page of transcription

Price per keystroke

There are some industry standards to help navigate your way through the pricing maze.  The Association for Healthcare Documentation has standardized a line of transcription as being 65 characters and spaces.  Which means “Dear Sir:” is really only 9 characters, not one line.  Ethical companies count the total number of characters and spaces in a document, then divide by 65, and round up to give you the line count.  For example, this paragraph has 519 characters with spaces, or 8 lines.

When you choose pricing by the line for your medical transcription, it is easily verified.  In  Microsoft Word, go to Tools (or Review) > Word Count > Characters (with spaces).

The next most common way of measuring is per minute of dictation.  Take for example, a transcription company such as Transcript Divas that charges $3.48 per minute of medical dictation for next day service.  People on average speak at a rate of 8 – 12 lines per minute.  Taking the average of 10 lines per minute, the cost per minute of medical dictation would be $0.35.  You’re also paying for the time that you pause during dictating to organize your papers or your thoughts, unless you press the pause button on the telephone or digital recorder.

Price per page of transcription is a common way of billing for home-based transcriptionists, who tend to service a small number of local clients.  You’ll pay for each page of transcription, regardless of whether or not it’s a full or partial page, unless you negotiate otherwise.  Remember, your signature block, letterhead, font, size, margins and page format all contribute to the length of the document.  Squeezing your dictations to try to save money results in less white space, makes them less readable, and impacts on the professional look of the document.

Keystroke counting is usually reserved for the larger hospital-based transcription companies, but it is used by some smaller ones as well.  While HOSPITAL is only eight characters, it’s 40 keystrokes (each letter is capitalized, bolded, underlined and italicized).  It’s difficult to document and verify the number of keystrokes in a document, as it’s a program on the transcriptionist’s computer that tracks the count.

Here’s a handy chart to try to make sense of some of the differences you may encounter in pricing.  For a five minute dictation (approximately 50 lines of dictation or up to 3 pages of dictation), you could expect to pay:

These are common prices for the Toronto, Ontario marketplace.  Pricing varies depending on the volume, the type of work, how good the dictator is, and local employment trends.

2Ascribe medical transcription agency offers quality medical transcription services to physicians and other health care providers.  Based in Toronto, Ontario, they offer medical transcription services throughout Canada and the United States.

On average, people can write approximately 30 words a minute, type 45 words a minute and speak 150 words a minute.  So, for most of us, we speak five times faster than we can handwrite and three times faster than we can type.  And the faster we handwrite, the less legible our handwriting tends to be.

If a physician spends one minute dictating a patient’s record, it follows that it would take them approximately five minutes to write it out by hand.  The challenge to the physician is three-fold – how much time do they spend documenting the patient visit, how detailed are the patient notes, and how legible are the patient notes?

Dictating patient records addresses all three of these issues – less time is spent documenting the patient visit (as we speak faster than we write), more detail can be included as more information can be conveyed in the available time, and transcribed notes are perfectly legible.  For physicians who already type their patient records or reports, the first two benefits may still apply.

For example, a family physician who sees 30 patients a day, may spend 20 minutes dictating their patient notes in SOAP format at the end of the day.  If they were to spend even twice, or up to five times, as long handwriting their notes instead of dictating, they would have at least 20 minutes less each day to see patients (or would work at least 20 minutes more).

If each patient note is 6 – 8 lines, then having the notes transcribed would cost $30 – $40 per day.  Under 2010 OHIP Fee Schedule for Family Practice and Practice in General (00), General Listings, this cost is substantially less than the family physician’s capacity to bill OHIP for an additional consultation(s)/limited consultation(s) during the time saved by dictating the patient notes, instead of handwriting them.

The physician has a net increase in income (increased number of patients seen and billed less the cost of having patient records transcribed), as well as the added advantage of excellent legibility and even perhaps the benefit of having more detailed patient records.

To see what the effect would be for your practice, consider tracking your time for a day or even a week.  Note how many minutes you spend documenting your patient record on each visit.  Or even sample the time you spend over the course of a part of a day.  Ask a colleague or staff member to read some of your handwritten documentation.  Does your colleague have to stop and ask you what a particular abbreviation means?  Or hesitate over certain words?

Consider doing a self-audit (as suggested by the CPSO) on your patient records, found at http://www.cpso.on.ca/policies/policies/default.aspx?ID=1686.

If the time to document a patient encounter is greater than two minutes, if more detail would be dictated than handwritten, or if the legibility of the patient notes is questionable, then consider dictating your patient notes and having them transcribed.

If you have any questions concerning how medical transcription may help you, please contact 2Ascribe Inc. – medical transcription your way.

Check our medical transcription dictation tips next month to learn more.

Check our medical transcription dictation tips next month to learn more.

The Company:

• How long have they been in business?
• How many people are there (is it one or two or a larger, established business) and can they handle your quantity of work?
• Do they offer references?

Turnaround Time:

• When are your documents returned?
• Can you dictate on weekends, evenings and holidays?

Dictation Options:

• Do they have a telephone dictation system?
• Do they accept digital files?
• Do they accept tapes?

Quality of Work:

• Do they have an editing process?
• What is the first language of the editors?
• What happens if you’re unhappy with the quality of work?

Legal Aspects:

• Do they have liability insurance?
• Do they have a Privacy Policy?  How do they comply with PIPEDA (Canadian privacy legislation) or HIPAA (American privacy legislation)?
• Do all their employees or contractors sign an agreement to comply with the applicable privacy legislation?
• Do they do privacy audits to ensure that everyone involved in your work is complying?

Pricing:

• Do they have volume pricing?
• Will they revisit the price and adjust it after a few months based on volume of work and ease of transcription?
• Do they offer templates with significant savings calculated into final price?

Contract:

• Do they require you to sign a contract?
• Are there penalties to cancel the contract?

Customization:

• Will they transcribe documents onto your letterhead?
• Will they set up documents to your specifications (margins, headers, etc.)?

Getting Started:

• Are there set up fees?
• Are there monthly minimums?

Integration:

• Can they integrate with your Electronic Medical Records software?

Hours of Operation:

• What hours are their customer service representatives available to talk or email with?
• What hours can you dictate or send digital files?
• How easy is it to get a hold of someone if you have a question or problem?
• Do they close for the holidays or take vacation time?

Follow these questions to ensure you find a medical transcription company that can provide you with the quality results you demand.

To learn more about 2Ascribe Inc.’s medical transcription services contact us today – 866.503.4003

• Cost effectiveness
• Addressing the concern of finding qualified personnel
• Improving turnaround time
• Being accurate and reliable
• Reduced infrastructure expenditures
• Reducing human resources responsibility for hiring and supervising
• Managing fluctuations in work load

1. Cost Effectiveness
Pay only for results.  The industry standard is to charge by the line.  One line is 65 characters.  To check the accuracy of a count, in MS Word, use Tools > Options > Word Count (characters and spaces).  Divide this number by 65 and that is the number of lines you should be paying for.  Beware of companies that charge line count based on the number of lines counted in a document.  Never worry again about how productive your medical transcriptionist is, or about how long it takes to format a letter.

2. Qualified personnel
You’ll never have to hire again.  And especially in offices with multiple specialties, you don’t need to find a medical transcriptionist who knows those particular specialties and the vocabulary.  Outsourcing to a larger transcription pool ensures that transcriptionists familiar with each specialty are assigned those dictations to transcribe.

3.  Improving turnaround time
Don’t get backlogged.  If you have an increase in workload, employees off sick, or you are simply a high volume clinic, outsourcing ensures that all your work is returned within a pre-agreed upon time frame.  Your transcribed documents may even be available the next business day.  This greatly aids in reviewing and editing documents, while the patient visit is still fresh in the physicians mind.  It also ensures that referral letters are sent out in a timely fashion, and reduces the amount of time that staff will spend looking for documents, to see whether or not they’ve been transcribed.

4. High Quality and Accurate Medical Records
Medical transcription service providers adhere to globally standardized, PIPEDA and HIPAA compliant medical transcription processes.  Additionally, medical transcription service providers have levels of quality assurance, employing highly experienced and qualified medical editors.  This results in high quality and accurate records.

5. Reduced Infrastructure Expenditures
There are many levels of quality and sophistication for recording and transcribing equipment.  Outsourcing to a medical transcription service provides access to high end dictation equipment as well as state-of-the-art software for transmission, downloading, typing and submitting dictations, without any of the ensuing capital expenses.  If you have your own equipment and it requires service, you may not have access a ‘loaner’ system, and be unable to dictate and/or transcribe while the equipment is out for repair.  As well, medical transcription companies can help you with ensuring that your medical practice is compliant with privacy legislation for your outsourced medical transcription work.  With companies that provide telephone dictation services, you have the convenience of being able to dictate from multiple locations, and not be limited by a system that is located in your office.

6. Reduced human resources responsibility for hiring and supervising
Hiring, training and supervising medical transcription staff can require a substantial investment of the physician’s and/or office manager’s time.  There are costs involved in advertising for qualified transcriptionists.  And depending on the job market in your locality, it may be difficult to find and retain a quality transcriptionist.  Additionally, you never have to worry about staffing for vacation, sick time and maternity leaves.  Or about what to do when your medical transcriptionist quits.

7. Managing fluctuations in work load
The time of year (such as flu season), holidays, and your schedule will influence the amount of dictation and consequent work load for your medical transcription.  By outsourcing your medical transcription work, you never have to consider how the volume of transcription will impact on the overall office workflow.

Outsourcing your medical transcription can improve your office efficiency and save you time and money.  For more information about outsourcing your medical transcription, call 2Ascribe Inc.

Check our medical transcription dictation tips next month to learn about the phonetic alphabet.