Medical Transcription in India: A challenging career option!

Upendra Singh | MyNews.in
1/7/2008, 7:04:10 PM(IST)

Medical Transcription is one of the fastest growing fields in health care business in Western countries, especially in the US where the entire healthcare industry is based on insurance, and detailed medical documents are needed for processing insurance claims. Therefore, the hospitals and doctors avail medical transcription services to cater with the demands of documental records, basically outsourcing the business. In the last few years, India has shown an unprecedented success in this field of medical transcription cashing in on the outsourced business from US and other western countries.

Medical Transcription provides an exciting and challenging job option with an ever expanding knowledge based career. It is the process whereby a medical transcriptionist has to accurately and swiftly transcribe medical records dictated by doctors and their associates comprising of history and physical reports, clinical notes, office visit notes, operative reports, consultation notes, discharge summaries, official letters, psychiatric evaluations, laboratory reports, x-ray and MRI reports and pathology reports. A medical transcriptionist is a person who carries out the process of converting the voice format of medical data into text data.

The data is received in the form of digital data files and voice data files and converted into text format in the process of transcription. There are certain prerequisites to convert those voice files into text documents which basically involve transcription and editing. To ensure maximum accuracy, the editing part of the transcribed files include quality checking, visual proofreading, spelling checks, grammatical corrections, rephrasing to streamline the context, and removal of inconsistencies and illogical content so that the desired accuracy of at least 98% is met before being uploaded back to the clients.

India provides an ideal locale for conducting medical transcription work with a large population of educated English speaking people, a large pool of IT professionals, the internet revolution, and the computer-savvy new generation aided by free market policy. Advancement in technology has tremendously metamorphosed the global economy and work place and the field of medical transcription has undergone tremendous progress because of constant advances in communication and Internet technology. Majority of the work is outsourced from US, but even British and Australian doctors are beginning to consider India as a possible source of getting this work done-quickly and efficiently.

Outsourcing of medical transcription work to India has the direct and immediate advantage of cost reduction, reliability in turnaround time, and total document security. The comparative low cost in India to those of US or other developed countries serves as an encouragement for companies abroad to outsource their work to the Indian Medical Transcription field thereby making India to be one of the top destinations of medical transcription industry. Turnaround time is critical in this industry, and India, because of its advantageous time zone in comparison to America and Europe, holds the advantage of delivering the work the very next working day for them.

India witnessed a boom in medical transcription field a few years back with a plethora of companies and training institutes mushrooming all over the place, but due to lack of training, experience and planning, most of them went into oblivion. Those who augured well with this new concept of business still persist and are providing job opportunities to thousands. The success of the surviving companies is a kind of indication that medical transcription, if handled appropriately, has the capability of creating opportunities and maneuvering the Indian job scenario to an extent.

Transcription services in India range from small, one-person home-based businesses to sophisticated, high-tech IT enabled corporations which employ transcriptionist on well paid pay rolls. In the metros and major cities, many big business names have ventured into this field and are flourishing and expanding day in and day out. Most of the bigger companies prefer to have in-house training programs so as to cater with the demand and curb down the effects of growing attrition rate. Some medical transcription firms even get their work done by employing on-site as well as home-based medical transcription basis.

It is not a cake walk for Indian companies in this field to compete with the medical transcription professionals of the western nations who seem to enjoy all the advantages of language and backdoor environment. Every now and then there is an anti outsourcing voice raised for the work outsourced to India and trying to bring out faults in the work done here. At the same time, Indian industry is pitted against some new developing destinations like China, Philippines, Sri Lanka and others who are eager to fight out with Indian dominance. But still India enjoys an upper hand with its efficient work force and competency which augurs well with the high demanding western world. Ultimately, what matters most is the honest work, truthfulness, and diligence which would win against all odds!

 

Sheriff: It’s highly unlikely thieves accessed personal information

July 2, 2008
KSL team coverage | ksl.com

A tip led authorities to stolen medical billing records and to the arrest of the men behind it. That’s reassuring news for the million and a half patients affected by the theft, but is their personal information safe?

Authorities are confident the suspects did not access confidential information, even though they knew early on, from media coverage, what was in those stolen tapes. A $1,000 reward was just too much for one of their friends to keep quiet about it.

Sheriff Jim Winder said, “The criminal element in this case is a circle, and within that circle, fortunately, there was someone willing to contact us.”

A phone call Monday night led authorities to the missing records and to the suspects. Sheriff’s deputies arrested 37-year-old Shadd Hartman on one count of possession of stolen property and one count of unlawful possession of another’s ID.

Fifty-two-year-old Thomas Howard Anderson was arrested on one count of theft by receiving and one count of identity fraud. A third suspect is in jail on unrelated charges.

“These were individuals with substantial criminal histories that found an opportunity and did take these tapes,” Winder said.

Investigators say last month one of the suspects randomly broke into the SUV with the records inside. The vehicle belongs to a courier for an offsite storage company. That courier broke policy by taking the records to his Kearns home.

The records contained information for 1.5 million University of Utah Hospitals and Clinics patients, including Jenni Todd. She said, “I’m glad they found it. I’m glad that they found the records and arrested some people.”

But Todd says, she’s still a little concerned. “It almost scares me more because if there’s a ring of people, maybe they were really trying to steal our identities,” she said.

But authorities don’t believe any patient information was compromised. They say the suspects didn’t have the means or the knowledge to access them. “They definitely are not techies. There’s no question about that. I don’t know if they could find their rear ends with both hands,” Winder said.

But the U isn’t taking any chances. IT plans to work with the FBI to determine if any patients’ records are at risk. The U is still offering free credit monitoring for a year.

Jenni Todd plans to take advantage of it. She said, “Just to make sure, and it’s also just good to have credit monitoring anyway.”

The U has spent $2 million to notify affected patients and offer services. University Health Care says until the FBI verifies through forensic testing that the personal information was not accessed, the hospital will keep current safety measures in place.

“We take our patient confidentiality information very seriously, and so that’s currently in place. And we’ll continue to work with law enforcement officials to determine whether there’s any risk of that information having been accessed,” said David Entwistle, CEO of University Hospitals and Clinics.

University Health Care has also released a statement on the recovery of the records. Two class-action lawsuits have been filed in this case.

The KSL Team:

E-mail: syi@ksl.com
E-mail: corton@ksl.com
E-mail: mgiauque@ksl.com

 

Medical Transcription: Automation is Driving Growth in Speech Recognition

Friday, 27 June 2008, 06:02 CDT | redOrbit NewsHealthcare automation is driving growth in speech technology, with the leading vendors providing specialized solutions, according to a new report by Datamonitor. Although use of PC-based speech recognition is not widespread, the technology has found its niche in the healthcare market, where automation and cost savings are key drivers.

Tight budgets and the need for accurate patient records are forcing healthcare providers to automate processes with speech recognition. In order to reduce the error rate in diagnosis and ensure that information is recorded efficiently, healthcare providers are adopting electronic health records (EHRs).

By dictating notes directly into EHRs, using speech recognition with digital dictation systems, doctors can update information faster and with lower error rates. Patient information is gradually becoming digitized in order to deliver test results and records more quickly. By reducing the number of illegible handwritten documents and simplifying processes, providers can eradicate errors in diagnosis.

Speech recognition is also being used for medical transcription, easing pressure on transcriptionists and allowing healthcare providers to save on staffing costs. Medical transcription is estimated to be a multi-billion dollar market and speech recognition vendors are taking advantage of this.

Healthcare currently represents 85% of the PC- and server-based speech recognition market. Datamonitor estimates that the market for speech recognition in healthcare globally is worth an estimated $170m in 2008. Between 2008 and 2013 the market will more than double in size.

Imaging is one area in which speech recognition has seen a significant uptake, as an increasing number of radiologists use the technology to dictate reports. Radiologists work in controlled environments using specialized vocabularies to dictate reports that, as they often use repeated language, are an ideal target for speech recognition vendors.

Healthcare is not the only industry where speech recognition is thriving. Investments in speech technology are expected to grow in the professional services, where it can help with legal transcription. The technology is also likely to be increasingly used to assist with language learning in education. However, healthcare will remain the largest market for speech recognition through 2013.

The introduction of digital dictation and EHRs has given speech recognition new channels to market. Speech technology adoption will increase as it becomes more tightly integrated with these solutions to provide a seamless document production process.

Source: Datamonitor

 

DATA OWNERSHIP ISSUES FOR THE PHYSICIAN PRACTICE AND A MEDICAL BILLING SERVICE

Article Date: April 4, 2008

Medical billing services assist physician practices in billing, coding, accounts receivables and management activities. By outsourcing to a medical billing service, a physician practice may realize increased profitability by decreasing the administrative time and expense involved in the billing process. The relationship between the physician practice and a billing service is an important and complex one. The issues are not limited to the billing service’s effectiveness in collecting payments. Both the physician practice and the billing service will benefit from a clear agreement, appropriately documented, as to all aspects of their relationship, including matters relating to data ownership of medical records and termination of the relationship.

Information technology systems are making it easier to rapidly transmit medical records and associated claims data while also reconfiguring and manipulating the data to exchange. To protect patient’s privacy and security, the American Medical Association (AMA) and the Healthcare Billing Management Association (HBMA) encourage physician practices and medical billing services to consider discussing, agreeing upon and including provisions in their contracts regarding software and proprietary information, claims data-ownership with respect to both original and copies of physician practice records and termination procedures. Physician practices are encouraged to consider the value the relationship will bring to the practice before entering into an agreement.

Typically, the physician practice will provide a medical billing service with a variety of records required for various billing, coding, accounts receivable, and management activities. A medical billing service may incorporate the records into proprietary forms, templates and other tools to prepare reports for the physician practice. This document will list topics for physician practices to consider addressing with prospective medical billing services prior to entering into an agreement.

Definition of Physician Practice Records

Typically, three categories of records belong to the physician practice: (1) patient records, claims, Explanation of Benefits (EOB)/Remittance Advice (RA) and other documents containing patient information, (2) managed care contracts, fee schedules and other proprietary information of the physician practice itself, and (3) final reports, such as accounts receivable (A/R) registers, prepared by the billing service for the physician practice.

Definition of Medical Billing Service Records

Typically, three categories of records belong to the billing service: (1) internal notes and work papers prepared by its employees, such as records of conversations with third party payers relevant to documentation needed for appeals, (2) papers relating to the billing service’s software and other proprietary or licensed tools, and (3) other proprietary information of the billing service, such as the forms and templates used to prepare reports furnished to the physician practice. The billing service may also have proprietary or confidential information regarding its operations.

Transfer of Documents and Electronic Records When Relationship Terminates

Prior to entering into an agreement, the medical billing service and the physician practice should agree on how to handle any termination of the relationship. Questions to consider include:

• What materials should be returned by the billing service to the physician practice or a successor billing service, subject to any transition agreement, for the practice or successor billing service to: (1) enter patient and charge data into its computer system, or (2) seek to collect pending billings on health plan claims for the physician practice.

• Who has custody of the documents relating to health care claims filed, which generally fall into three categories: (1) source documents, usually in the form of copies of visit or operative notes, (2) payer generated data, such as EOBs, and (3) reports that the billing service generates on billing and management activities for its clients. Occasionally, when discussing these questions, both the physician practice and billing service should realize that a billing service may have a legitimate need to retain copies of or at least a right of access to any records—even documents owned by the physician practice, as discussed above, in order to document their services, particularly if the billing service codes physician claims.

• What should the format and media for the return of physician practices records be?

• When and how will electronic records be returned to the physician practice?

(1) What information will be provided in file layout?

(2) What file codes and programming will be given?

(3) Which patient account data on the billing service’s computer system or software will be returned to the physician practice or sent to a successor billing service?

• Who will own documents that do not contain protected health information, such as the coding notes, and other work products of the billing service? Will it be the original or copies?

• Who keeps original records and who pays for any copies?

• Who pays the cost of locating or transferring hard copy or electronic records to the physician practice or to a successor billing service?

• Under what circumstance will the physician practice (or a successor billing service) have access to billing and claim denial notes and records made by the billing service as it provided services to the physician practice?

Record Retention and Access – Points to consider and discuss

At a certain point in time, retained records cease to be of any value, typically upon the lapse of the longest applicable statute of limitations for a third party payer audit or legal actions as to which the records would be relevant. In the case of patient records in the custody of a billing service, the patient records will be copies only, with the originals of the patient’s records at the physician practice or facility at which the underlying care was rendered. Some of the considerations in this section apply principally to original records.

• When the applicable time frame for retention of records in the custody of the billing service expires, will the records be destroyed or returned to the physician practice?

  • What are the state and federal laws pertaining to the period of time records are to be retained?

  • To the extent that the billing service is a business associate of the physician practice, a written HIPAA business associate agreement should be in place documenting among other things how protected health information (either in paper or electronic forms) must be either destroyed or returned to the physician upon termination of the agreement with the billing service. This language can also provide for other equally secure methods of protected health information management upon termination. Additionally, physician practices should ensure that the underlying agreement with their billing services provides for safeguards to the confidentiality, integrity and availability of the protected health information disclosed to the billing service and any other confidential information. These provisions should comply with any state law that is more stringent than HIPAA, and be consistent with guidance from the physician’s professional liability carrier.

• Due to the cost of storage of voluminous paper records, a billing service may scan original paper documents and store them electronically.

  • Will electronic copies of paper records be accepted as the original document?

  • Does the state the physician practices in accept a scanned medical record or other business record as an original as long as the accuracy of the scanned document can be reasonably substantiated?

  • Will the original paper records be destroyed after such records are scanned?

  • If, for some reason, electronic scanning is not permitted due to cost or availability, will the paper records be stored on the billing service’s premises or, especially after the termination of the agreement, in an offsite storage facility?

  • Will there be any costs charged to the physician practice for storage of paper records by the billing service during or after the termination of the agreement?

• Selection of offsite facilities. A storage facility off the premises of the billing service needs to be secure both for the integrity and availability of the stored records and for compliance with HIPAA and state medical records laws. Ultimately, this is the physician practice’s responsibility, although the selection may be delegated to the billing service.

  • Who will pay the cost of storage at offsite facilities during the term of the relationship?

  • After termination, will the physician practice be responsible for the costs of storage or scanning of records retained on behalf of the physician practice (as opposed to for the billing service’s own purposes)?

Audit and Litigation Assistance and Record Searches

Certain records searches and data assembly may be time consuming if the search requires manual review of stored records. This may be the case where, for example, a records search is conducted by date of service rather than by patient name. Physician practices should expect a reasonable level of support from their billing services during the term of the relationship as “part of the service”, but may also anticipate incurring additional costs for assistance which goes beyond that level.

• During the term of the relationship, the billing service and the practice need to determine if there is a component included in the basic service for searching records and otherwise assembling information for litigation or third party payer audits.

• For more extensive work, discussions should include the fee the billing company will charge for personnel and reimbursement for associated costs.

• For services during and after the termination of the relationship, discussions should include the fee and other costs that is the responsibility of the physician practice, such as if the billing service will be reimbursed for copies of records it provides to the physician practice.

For more information on medical billing services, as well as further questions that should be asked before contracting with a medical billing service, AMA members can visit the Private Sector Advocacy (PSA) Website at http://www.ama-assn.org/go/psatools and download the complimentary flyer “What is a medical billing service?”

Prepared by the American Medical Association, Practice Management Center, along with the Healthcare Billing and Management Association, December 2007.

Questions or concerns about practice management issues? AMA members and their practice staff can email the AMA Practice Management Center at practicemanagementcenter@ama-assn.org for assistance.

Contact the AMA-PSA unit:

• Call (800) 262-3211 and ask for AMA-PSA.

• Fax information to (312) 464-5541

• Visit http://www.ama-assn.org/go/psa to access the AMA-PSA Web site.

Contact HBMA:

• Call (877) 640-4262 and ask for HBMA’s Billing Resource Center

• E-mail requests to info@hbma.org

• Visit www.hbma.org

This educational flyer was developed through a cooperative effort between the Healthcare Billing and Management Association and the American Medical Association. © Copyright 2007 American Medical Association. All rights reserved.