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In medical transcription, quality should always trump price. As in the case of Thomas Hospital, which was sued for tens of millions because of a transcription mistake, the rewards of saving a few pennies per line often don’t outweigh the risk that comes from using cheap overseas labor. While no transcription provider can be 100 percent error free, there are a few characteristics that will help you ensure quality transcription:
- Choose a transcription provider that uses only U.S.-based medical transcriptionists (MTs) and that doesn’t subcontract. Providers that employ their MTs keep your medical records from being passed around the globe, sometimes to less-than-trustworthy companies.
- Work with a provider that employs its transcriptionists full-time. Happy employees who are taken care of will provide a better quality service than freelancers who are often poorly compensated.
- Insist that a consistent team of transcriptionists work on your account. Many companies use a pool of contract transcriptionists who take on whatever dictation that comes through to them, regardless of its source. Lack of consistency contributes to poor turnaround times and more errors. Find a providers that assigns a core group of transcriptionists to your account, allowing the MTs to become familiar with your physicians and with your transcription needs.
- Consider combining speech recognition with MT review. Speech recognition applications can output dictation quickly, which MTs then review to ensure high levels of accuracy. The result is not only fast and accurate, it’s also less expensive.
Silent Type has been improving the quality of medical transcription for more than 30 years. While most less-experienced companies see offshoring as a way to pad their profits, Silent Type has strenuously resisted the move toward cheap overseas labor. To learn about how the Silent Type way of transcription can help you improve quality and value, click here or call 201-346-5900.
Silent Type has rolled out its latest STARS offering: STARS Speech, a new, best-of-breed speech recognition application that is built on top of an established natural language processing engine. Clients now have the option to add this technology to the suite of transcription technology products they currently use from Silent Type.
You might be thinking, what’s the big deal? Silent Type is one of scores of companies that offer speech recognition. While Silent Type may not be pioneering the art of turning your voice into printed text, we think we can perfect the art and lead our clients down the path of reducing costs.
In combination with our skilled medical transcriptionists (MTs), STARS Speech will enhance your transcription performance and turn-around time. The new speech platform fits snugly within Silent Type’s workflow, and our MTs apply their knowledge and expertise to the technology to the best advantage of our clients.
After STARS Speech is trained to recognize the specific voices of your physicians, the software is ready to run. It takes physicians’ dictated recordings, runs them through the speech engine, and creates a draft document. The drafts are then reviewed by our transcriptionists to ensure the accuracy rate that you have come to expect from Silent Type. The result: faster processing and shortened turn-around time, permitting you to get to the billing process earlier.
Contact Silent Type today for a demonstration by clicking here or calling 201-346-5900. Let us help you access the future of transcription today with STARS Speech.
Last month, the Centers for Medicare and Medicaid Services (CMS) announced that a hospital-based ambulatory surgical center in Westchester, NY, would be penalized $7 million. This wasn’t a case of clinical errors or negligence—proper care was provided to all patients. This was another instance in a long line of CMS penalties where documentation errors led to billing mistakes.
In healthcare, being overpaid is often worse than being underpaid. CMS is getting more aggressive about finding and penalizing providers who bill for more than what the documentation allows. Proper documentation of patient encounters is the basis for accurate reimbursement. Do you know if your documentation meets all of the requirements for proper coding and accurate payment?
Silent Type has a consulting program to help you review your documents and documentation practices to ensure that all of the criteria for billing are correct. Our document and coding specialists will audit a selection of your documents based on established requirements for full and complete documentation.
Once we complete our analysis, we will develop a program for documentation improvement, which includes educating your physicians on proper dictation techniques. After you incorporate our solutions, Silent Type can manage your documents to ensure they meet criteria for proper billing and reimbursement.
A recent New York Times article questioned whether hospitals are using electronic health records (EHRs) inappropriately to overbill for care provided. Whenever the “overbilling” is used in the context of hospitals, finance and HIM leaders sit up and take notice.
Times reporters looked at publicly available Medicare reimbursement data and found hospitals had received more than $1 billion more from the Centers for Medicare and Medicaid Services (CMS) than they had five years earlier. The report speculated that part of the reason for the increase in reimbursement was due to the use of codes that justified higher reimbursement. It also pointed a finger at EHR software that can automatically provide documentation or allow for cutting and pasting documentation from another patient’s record. The implication was ominous—providers may be “upcoding” and otherwise gaming the system so they can bill more for care.
The issue has gained traction in Congress, with some representatives questioning whether this could be an unintended consequence of the Obama administration’s 2009 stimulus package. The stimulus encouraged the use of electronic health records by promising to put as much as $17 billion into the hands of hospitals and physicians who adopted EHRs and demonstrated meaningful use of the technology.
When billions of dollars are at stake, the federal government is likely to rein in spending. This despite the fact that they changed DRGs in 2008 to a severity adjusted model, and despite the fact that CMS has consistently stated that hospitals have the right to the reimbursement they can defend with documentation.
What action might Congress take? They may further cut Medicare reimbursement to providers. They may require more claims adjudication measures. They may pull the plug on the meaningful use program. They may allow federal regulation of EMR vendors. And, yes, they may ratchet up their RAC program to find more instances of overbilling.
It all starts with documentation. With the heat turning up on reimbursement, HIM leaders need to be doubly sure that their documentation can justify their reimbursement claims.
By Marilyn Trapani, President, Silent Type
I’ll be honest: speech recognition technology and other technologies have completely changed my world—for the better. Speech-to-text is improving the speed and accuracy of documentation, and that’s an outcome I welcome.
But traditional transcription is still a big part of accurate documentation. Here’s why:
Doctors don’t typically embrace change. They like to do things their own way. If they’re used to dictating using a telephone, it’s difficult to get them to change over to using an iPad or a digital voice recorder. Speech-to-text often requires doctors to change their habits with regard to phrasing, which physicians can find frustrating. And for doctors who dictate using their own personal verbal shorthand, speech-to-text can be maddening. Using a tried-and-true transcriptionist is often the way to keep such doctors focused on seeing patients, not on fumbling through a new documentation workflow.
Speech recognition isn’t fool-proof. For doctors that do want to document using speech recognition, the output should be looked at as a rough draft. As good as speech engines are getting, they’re not likely to reach anywhere close to 100 percent accuracy. Someone needs to review the transcribed documents for errors, and that’s where transcriptionists come in. Medical transcriptionists can also be great documentation editors. Some organizations want to avoid paying for transcription editing and are asking doctors to correct their own transcribed documents. To me, asking doctors to correct speech-to-text documentation is asking for a mutiny, but that’s a topic for another day.
As Silent Type continues to invest in technology, you’ll be seeing a speech-to-text offering from us soon. But because of the reasons stated above, our transcriptionists will be as busy as ever.
Business has been good for Silent Type president Marilyn Trapani, and she has made it a point to give back. She was able to do just that for students at her alma mater, St. Peter’s University in New Jersey. Marilyn provided her unique insights at the university’s Executive-in-Residence program.
Marilyn joined William T. Price, VP of media relations for Johnson & Johnson, Thomas P. Weatherall, President of the Make-a-Wish Foundation of New Jersey, and James P. McAndrew, director of AdVision, to give St. Peter’s MBA students some real-world advice on leading a business.
ICD-10 is the biggest thing to hit the HIM world since, well, ICD-9. Hospitals are putting a lot of resources toward their ICD-10 conversions, and with good reason. ICD-10 will fundamentally alter the way organizations bill for and get reimbursed for care.
But focusing on ICD-10 is no reason to put needed medical transcription upgrades on the back-burner. In fact, just the opposite is true: when you improve your medical transcription, you’re going to improve your ICD-10-based reimbursement.
Industry experts are predicting a significant rise in HIM departments’ “Discharged, Not Final Billed” (DNFB) metric because of the backlog caused by the switch-over from ICD-9 to ICD-10. Some say we are in for a drop in productivity of as much as 50 percent. How do you mitigate that loss? You focus on what you can control.
HIM and finance leaders are controlling for the loss in coder productivity by automating processes. Computer-assisted coding is one method that’s getting a lot of attention today. Another method is speech recognition in medical transcription. But the solutions don’t need to be complex. Simply using medical transcription services that deliver faster, more accurate results can improve your documentation turnaround time. And improved documentation turnaround time can lead to faster time-to-bill.
Speaking of documentation, mistakes in transcription have always played a huge role in both DNFB and denials. With the industry’s change to ICD-10, that role will be even more apparent. When doctors notes are transcribed incorrectly, one of four things happen:
- Your coders find a gap in the documentation and they query the doctor for a correction, which slows down the coding process
- Your coders miss the mistake and they code incorrectly, leading to a denied claim
- The mistake leads to less reimbursement than was warranted
- The mistake leads to more reimbursement that was warranted, leaving your organization open to audit penalties
With ICD-10 on the horizon, improving medical transcription is an essential element in your risk mitigation strategy.