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The Best Medical Transcription Companies of 2020

By
Adam Uzialko
,
Business News Daily Staff
|
Feb 04, 2020

Medical transcription services help healthcare providers turn audio into finished documents, either on paper or in their electronic medical records. Here are our best picks for 2020.
Best Overall
InSync Healthcare Solutions
InSync Healthcare Solutions continues to innovate in an industry where many companies simply offer medical transcription as an ancillary (and sometimes seemingly forgotten) service. InSync not only offers a strong medical transcription service that includes a thorough quality assurance process and experienced medical transcriptionists, it is also rolling out a virtual scribe service to support real-time provider dictation during the patient encounter.
High Volume
Aquity Solutions
Aquity Solutions is the child of 3M's $1 billion acquisition of voice recognition software giant M*Modal in 2018. Aquity emerged as a medical transcription and coding service following the deal and has since earned 2019 Best in KLAS honors and Black Book Top-Ranked status. It processes more than 300 million minutes of dictation worldwide each year.
Most Flexible
World Wide Dictation
World Wide Dictation has a wide range of transcription experience, not just in the medical dictation space. The company also covers legal dictation, data conversion, insurance claims transcription and much more, but medical transcription is naturally a large part of its business. It is a flexible service in every aspect – in its audio submission options, document delivery methods and turnaround time.
Medical transcription services help healthcare providers turn audio into finished documents, either on paper or in their electronic medical records. Here are our best picks for 2020.

Healthcare organizations generate a lot of notes every day, from clinical documentation of patient encounters and patient records to administrative documents. Voice recognition software has become a go-to way for many healthcare providers to dictate their clinical documentation, but it has its limitations. Accuracy remains spotty, requiring providers or their assistants to spend a great deal of time proofreading work that has already been completed. While speech recognition software is improving all the time with new technological advances, sometimes medical documents require a human touch.

For those times, there are medical transcription services, which allow healthcare organizations to outsource their medical transcribing. By simply uploading audio files that you deliver to them by one of several methods, a medical transcriptionist can turn your voice into written health records. These transcription services' accuracy rate is generally much higher than speech recognition software's, and proofreading is part of their quality assurance processes. Some medical transcription services go above and beyond by entering data into the appropriate systems for you.

Fill out this questionnaire to find vendors that meet your needs.

Choosing a medical transcription service can be difficult at first, as you must separate the wheat from the chaff. Transcription outsourcing requires you to send sensitive information to a third party; not only must you be sure it will deliver a quality product so you get your money's worth every time, you must also trust it to manage your patients' records with care.

This guide will help you conduct your research of the medical transcription industry and vet companies before signing up for their services. Business News Daily has also arrived at several best picks and written extensive reviews of their services to help you in your buying journey.

Reviews

InSync Healthcare Solutions: Best Overall Medical Transcription Service

InSync HCS offers competitive pricing, which starts at 8 cents per line.
The fastest turnaround time is one hour, which costs 11 cents per line.
The company offers a lower level of encryption than other medical transcription services we reviewed.

InSync Healthcare Solutions combines the four elements of flexibility, accuracy, security and innovation into a competitively priced package. With multiple methods for audio delivery and return of transcribed documents, InSync can cater to a variety of provider preferences. Beyond simply transcribing audio dictation, InSync can work directly within healthcare providers' electronic medical records (EMR) systems. For these reasons, InSync is our best overall pick for medical transcription services.

Pricing

There are multiple pricing models for medical transcription services. The industry-standard method of pricing involves the use of "visual black characters" (VBCs), which is largely considered the most transparent and auditable method. Most medical transcription companies charge by the line, defined as 65 VBCs. Some services might charge by the keystroke or by the hour, which are generally considered less auditable metrics than the 65-VBC line.

InSyncHC employs the 65-VBC line pricing method. Specific pricing depends on the complexity and volume of the work. To receive a quote for your unique circumstances, you'll have to contact the company's sales department, but these are InSync's general rates:

  • Standard medical transcription services with 24-hour turnaround: This option costs about 8 cents per line, which is about average for the medical transcription services we reviewed.

  • Medical transcription services with expedited turnaround: To receive transcribed documents in less than 24 hours (as quickly as one hour after InSync receives your audio), you could pay 10 or 11 cents per line, depending on the difficulty of the work and how quickly you want your documents returned.

  • Medical transcription services in preferred EMR system: If InSync transcriptionists are working directly within your EMR system, expect to pay about 3 cents per line on top of the rate you pay for standard medical transcription services. In other words, for a 24-hour turnaround of transcription within your EMR, you'll pay roughly 11 cents per line.

InSync's standard pricing is competitive compared to the other medical transcription services we reviewed, especially considering the quality of service. If you opt for additional services, just be sure to request a specific quote and pricing breakdown, as add-on costs may depend on your unique needs.

InSync does not require you to sign any formal contracts, but it does request that you enter into a one-year business agreement. That agreement does not contain any required minimums, so you can stop submitting work requests at any time and will not be charged further. The agreement instead guarantees the agreed-upon rate for the entirety of the term, and it also keeps both InSync and your medical practice in HIPAA compliance for your transcriptions.

Features

While medical transcription services are relatively straightforward – the company takes audio dictation and turns it into a written document – there are many important factors in this process. These include the quality assurance check that guarantees accuracy of documents, the flexibility of turnaround times, and the security measures to ensure the proper protection of medical information.

Here's a look at some of the most important features we reviewed and how InSync stacks up.

Quality Assurance Process

InSync's QA process guarantees that at least two pairs of eyes review your transcribed documents before the company returns them to you. The first is a medical transcriptionist, who transcribes the audio dictation your practice uploaded. The second is a senior staff member and certified medical transcriptionist, who listens to the audio dictation and reviews the transcribed document to ensure accuracy, and they also edit for grammar, spelling and format. The average InSync staff member has five years of medical transcription experience, and all senior staff members are certified medical transcriptionists.

The QA process takes place within the secure web portal and is reviewable by clients, so providers can track what stage of the process their documents are in. InSync guarantees a 98% minimum accuracy rate for all documents.

Turnaround Times

InSync has relatively flexible turnaround times. Its clients include small medical practices as well as large hospitals, so it can adapt to varying turnaround needs. The standard turnaround time is 24 hours, but upon request (and for an additional fee), transcribed documents can be returned within one hour after the company receives audio dictation from the provider.

Audio Dictation Delivery Methods

To upload audio dictation to InSync's system, you and your staff can use a toll-free telephone number, a digital audio recorder or the mobile app (compatible with iOS and Android devices).

Transcribed Document Delivery Methods

Transcribed documents can be created in any template format that you preselect. These documents can be returned to your practice through the secure web portal or an encrypted email.

The secure web portal also serves as a document management system, where providers can log in with a username and password. From the portal, providers can edit reports, sign and print documents, and export them to a PC or laptop. Documents can also be faxed or emailed directly from the portal, which is secured with 128-bit encryption.

Integrations

InSync integrates with many leading EMR systems and maintains the internal team necessary to build out new HL7 interfaces with any EMR system you might use in case the integration does not already exist. The ability to integrate with any system in use by any medical practice guarantees compatibility and enables InSync to work directly within your EMR system if needed.

Security

InSync maintains 128-bit encryption on its ISO 9001:2000 certified web portal, which it uses to return transcribed documents to clients. It also employs a 128-bit encrypted email system for alternative document delivery.

Under HIPAA's privacy requirements, 128-bit encryption is the minimum standard by which healthcare organizations and service providers must abide. InSync meets this regulatory standard for the protection of sensitive healthcare data, but some services we reviewed go the extra mile and use stronger encryption than this.

Other Services

Beyond its standard medical transcription services, InSync offers transcription directly within your EMR system, filling in the appropriate fields and saving time in generating clinical documentation.

In the near future, InSync is also planning to release a virtual scribe service, which will allow providers to dictate in real time as a transcriptionist creates a written record of a patient encounter.

In addition to its medical transcription services arm, InSync is a purveyor of EMR systems and practice management software. It also offers a revenue cycle management service for outsourced medical billing. It primarily focuses on the behavioral health, OB-GYN, primary care and pediatric therapy specialties.

All of these features make InSync one of the most comprehensive services we reviewed. It covers all the major bases we looked for in a medical transcription service and then some. However, some useful features represent an added cost, so be specific about your needs and request a detailed pricing breakdown when you request an estimate.

Limitations

InSync is a well-rounded service with few limitations. However, its 128-bit encryption falls short of some  other medical transcription services in our review. While it is compliant with HIPAA privacy regulations, some other medical transcription services employ the more secure 256-bit encryption.

The quality assurance process by InSync guarantees a minimum accuracy rate of 98%, which is the industry standard. However, transcribed documents only pass through two pairs of eyes. In some cases, other medical transcription services provide three or even four levels of quality assurance. On the other hand, InSync offers an experienced staff of transcriptionists and the oversight of senior staff members, all of whom are certified medical transcriptionists. Perhaps the only element lacking in the QA process is a final review by a clinically experienced staff member.

More

Aquity Solutions: Best High-Volume Medical Transcription Service

Aquity Solutions possesses extensive industry experience; it processes about 300 million minutes of audio dictation per year.
The fastest turnaround time available is one hour.
The QA process involves a random statistical sampling to catch errors, which means some errors might go unnoticed at first.

Aquity Solutions is one of the largest medical transcription service providers globally, processing about 300 million minutes of audio dictation annually. If you need a lot of transcription work performed quickly, Aquity is capable of managing it for you. With both domestic and offshore transcriptionists, Aquity also offers clients the opportunity to adjust their pricing and service quality based on their budget and preferences. For these reasons, Aquity Solutions is our pick for best high-volume medical transcription service.

Pricing

Pricing for medical transcription services can be a mystifying thing. Some companies use alternative pricing models that sound cost-effective at first but quickly add up to higher costs. The industry-standard method, which is widely regarded as the most transparent and auditable way to bill for transcription services, goes by the number of visible black characters (VBCs). A VBC is any character on the page visible to the naked eye, not including spaces. It generally breaks down to about 65 VBCs per line – but if a company says it bills per line, make sure it means VBC lines.

Aquity Solutions abides by the VBC industry standard, so you'll know specifically what you are paying for each time. Unfortunately, the company declined to provide its pricing, stating that it depends on a client's work volume, requested turnaround times and the complexity of their transcription needs. To obtain a quote for Aquity's medical transcription services for your circumstances, you'll need to contact the company's sales department.

It is worth noting that Aquity offers a choice of labor type, either domestic or offshore. Naturally, offshore medical transcriptionists are more cost-effective than domestic transcriptionists, but domestic transcriptionists are generally regarded as higher quality. Depending on your priorities, this flexibility lets you either save money or guarantee document quality.

Aquity does require some level of commitment from clients, typically a yearlong contractual agreement that includes "minimal consistent volumes." The company declined to comment on what those minimums precisely are. Whenever you consider signing a contract, it is important to have an attorney review the document on your behalf. When you contact Aquity for a pricing estimate, we recommend also requesting a sample contract to review alongside legal counsel. 

Features

Medical transcription services might seem simple at first glance. After all, you just hand off your audio dictation and then a transcriptionist types it up and sends it back, right? There's a bit more to it that you should consider when researching medical transcription services. This includes the quality assurance process a company employs to guarantee accuracy, the times in which they can deliver transcribed documents, the methods of delivery and how documents are secured. Here's a closer look at the most important features we looked for in our review and how Aquity measures up.

Quality Assurance Process

Aquity's quality assurance process involves capturing a statistically valid sampling of each transcriptionist's work and reviewing it for errors. The company also considers any client comments about a particular transcriptionist's work. If at any time a transcriptionist falls below 98% accuracy, the staff member is put on what is known as 100% review. In other words, every transcribed document they produce is reviewed in full by senior staff and certified medical transcriptionists. The 100% review period continues until the errors are fixed and the transcriptionist's accuracy rate returns to 98% or better. By employing this method, Aquity guarantees that its overall accuracy rates will exceed the industry standard of 98%.

Turnaround Time

Aquity is generally flexible on turnaround time, though the company acknowledges that expedited turnaround usually costs more than next-day delivery of transcribed documents. Aquity is capable of returning transcribed documents within one hour of receiving audio dictation from a client.

Audio Dictation Delivery Methods

The available dictation methods include a toll-free telephone number, PC or laptop dictation through a secure portal, and the use of mobile apps compatible with iOS and Android devices.

Transcribed Document Delivery Methods

Generally, Aquity returns your transcribed documents directly through your EMR system. Alternative methods of delivery are available upon request.

Integrations

Aquity supports more than 3,000 clients in the U.S. and integrates with all leading and midlevel EMR platforms. In case an integration for your EMR does not currently exist, Aquity maintains an in-house staff capable of building the HL7 interfaces necessary to work within a new EMR system.

Security

The company declined to comment on the specific cybersecurity measures it employs. However, all staff members of Aquity Solutions, from entry level to the C-suite, are required to take annual ISO and HIPAA security training.

Other Services

In addition to standard medical transcription services, Aquity Solutions provides medical coding services and virtual scribes, which can perform medical transcription in real time while observing a provider's clinical encounter remotely.

Aquity also offers interim management services, which helps healthcare organizations fill vacancies in healthcare information management positions and medical coding departments.

Aquity Solutions offers a comprehensive and professional service that covers all the major bases we looked for in our review. However, the company was less than forthcoming with certain details, making it difficult to precisely gauge how it stacks up. Still, it offers all the features necessary to handle your medical transcription needs.

Limitations

The biggest limitation we encountered with Aquity Solutions was its refusal to provide ballpark pricing estimates or the contract's specific minimum requirements. Without this information, we cannot provide an accurate baseline of pricing you should expect. To receive a personalized quote based on your service requirements and the complexity of your needs, you need to contact the Aquity Solutions sales department. The company wouldn't give us details on its security features either.

More

World Wide Dictation: Best Flexible Medical Transcription Service

Worldwide Dictation offers competitive pricing, starting at 8 cents per line.
The company offers a range of flexible services adaptable to the needs of healthcare organizations.
The fastest turnaround time is 4 hours, which is slower than other services we evaluated.

World Wide Dictation brings wide-ranging experience in the transcription space to its medical transcription services. With multiple ways to upload audio dictation, reasonably fast turnaround, certified medical transcriptionists dedicated to each account and significant security measures, World Wide Dictation offers a high-quality transcription service that can adapt to your existing workflow. Its breadth of options in every aspect earns it our best pick for most flexible medical transcription service.

Pricing

Pricing structure should be a major consideration in your choice of medical transcription service. Some companies have less-than-transparent pricing models that are no longer considered the standard, such as the per-minute rate. Billing per minute makes transcriptions difficult for a client to audit and puts them at high risk of abuse by disreputable companies. Instead, look for a medical transcription service that bills by the line, in terms of visible black characters (VBCs). As the name suggests, a VBC is any letter, number or punctuation mark you can see. In the standard pricing model, 65 VBCs equals one line, and the rate you'll pay per line should be clear in your agreement.

World Wide Dictation employs this per-line method and charges a competitive rate. Starting at 8 cents per line for the standard 24-hour turnaround, the company is right in line with the prices for the other leading medical transcription services in our review. Additional services, such as direct EMR system data entry, cost 2 or 3 cents more per line, which also aligns with other leading companies.

One nice feature World Wide Dictation offers that we didn't commonly encounter with medical transcription companies is a free trial. At no charge or obligation, you can test out World Wide Dictation's services by uploading an audio file of your own to the company's system for it to transcribe. It also allows you to test different methods of audio dictation delivery and transcribed document receipt to make sure the service will line up with your existing workflow.

World Wide Dictation requires no setup fees or long-term contracts, making it a great option for companies that only need one-off or occasional medical transcription services. Many medical transcription services require you to sign a business agreement at the very least, while some require a minimum 30-day commitment. Still others require a yearlong commitment, so the lack of long-term arrangements makes World Wide Dictation notably flexible.

Features

There's a lot more to medical transcription services than meets the eye. To be sure you get everything you need in a service, it's important to review a list of key features. Here's a closer look at the features we examined in our review and how World Wide Dictation measures up to the competition.

Quality Assurance Process

World Wide Dictation assigns dedicated, certified medical transcriptionists to your account. This is especially useful because providers all have unique styles of dictation, not to mention varying inflections and accents. A dedicated transcriptionist learns the nuances of your practice's and staff's dictation styles, making for a more accurate transcription.

It also monitors 100% of the work on a new account for up to a month to ensure it's going smoothly. During this time period, transcribed documents go through multiple layers of editing to ensure accuracy. As the dedicated transcriptionist and your practice develop a relationship, the oversight is reduced. It is worth noting that many medical transcription services maintain layers of oversight throughout the life of the account; however, many of them do not employ dedicated transcriptionists like World Wide Dictation does.

Turnaround Times

World Wide Dictation offers relatively flexible turnaround times, though its STAT option is a bit slower than some other companies' expedited services. The standard turnaround for all clients is within 24 hours, while a STAT option makes delivery of transcription available within four hours. Some of the other services in our review can deliver transcribed documents within one hour of accessing the audio dictation.

Audio Dictation Delivery Methods

World Wide Dictation offers several methods for you to upload audio dictation, including a secure web portal and a toll-free telephone number for call-in dictation. It also offers a mobile app for iOS and Android devices that uses a secure distribution server to protect sensitive data.

Transcribed Document Delivery Methods

Generally, World Wide Dictation returns transcribed documents via the same secure web portal you can use to upload audio dictation. In the portal, transcribed documents are accessible alongside the audio dictation in perpetuity. World Wide Dictation also offers direct entry into your preferred electronic medical records (EMR) system for an added cost of about 2 cents per line, depending on the complexity and volume of the work.

Integrations

World Wide Dictation does not maintain or build HL7 interfaces to EMR systems but does offer direct data entry in your EMR. Instead of maintaining integrations, the company logs in to the EMR system directly and populates the appropriate fields with data from the audio dictation.

Security

World Wide Dictation employs 256-bit encryption on its secure web portal and mobile apps. This exceeds the HIPAA requirement of 128-bit encryption. In addition, all medical transcriptionists must be certified, indicating that their knowledge of HIPAA compliance is up to date.

Other Services

In addition to medical transcription services, World Wide Dictation offers services targeting the insurance, legal and government spaces, as well as court reports and live transcription of public meetings.

Overall, World Wide Dictation offers a flexible service that checks the major boxes.

Limitations

World Wide Dictation's major limit is its lack of a one-hour turnaround option. While that speed is usually only necessary in hospitals, it is a nice option to have in case you ever need a document returned very soon after uploading audio dictation. However, if you expect to rarely use the STAT option, or if four hours is expedited enough for you, World Wide Dictation offers an excellent service with high security and certified medical transcriptionists dedicated to your account.

More

Transcription Services and Voice Recognition Software

Medical transcription services have long been a tool of medical practices and hospitals. Trained transcriptionists – whether they're employed in-house or by a third-party service – save physicians time by writing out and editing dictations for personal notes, charts or communications with other medical professionals. Third-party transcription services often have several layers of quality control, meaning more pairs of eyes scour the transcribed document for mistakes before it's returned to the dictating physician. Most services charge a fee – usually 6 to 14 cents – per line of transcription, but for a practice that generates a lot of reports, it can be worth the cost to shift that workload to an outside source.

In recent years, the medical transcription industry has undergone a massive shift that has made another option widely available. The arrival of relatively cheap and fairly accurate voice recognition software has driven down the demand for human transcriptionists. With voice recognition software, physicians can complete their reports and finalize them in real time, without waiting for a transcriptionist to return it.

While voice recognition software reduces turnaround time, the dictating physician now must act as the proofreader as well. Although voice recognition software has come a long way, it still makes plenty of mistakes and requires human oversight. Many physicians find the extra workload unnecessary and irritating, and more errors are likely to get through without the added layers of protection a transcription service offers. Others see voice recognition software as the best, cheapest way to quickly and efficiently generate notes and reports.

Dr. Joseph E. Glaser, a nuclear medicine physician at Radiologic Associates PC, told Business News Daily that whether you use a trained transcriptionist or voice recognition software is really a matter of your own workflow and personal preference.

"You have to look at the needs of your practice," he said. "If you dictate very infrequently and somebody in your office [or employed at a service] can take dictation, it might not pay for you to invest in medical transcription software. If it's frequent, you might want an in-house software package, but then it depends on the kind of work the doctor is going to do all day. It comes down to workflow."

A key benefit of both transcription services and voice recognition software, according to Dr. Kathleen A. Bishop, a professor of health sciences at Purdue University Global, is that they allow doctors to have more personal encounters with patients, rather than be distracted by filling out charts during the appointment.

"Medical transcription services allow the physician to record the patient information at their leisure, which can be sent to a service that can transcribe it while the physician takes his or her time with the patient," Bishop said. "[The physician] has the ability to look the patient in the eye and hold their hand, if need be, instead of looking at a computer screen documenting the visit."

Choosing a Medical Transcription Service

If you decide a trained human transcriptionist is the best option for you but don't want to allocate internal resources to the task, a third-party transcription service could provide a great deal of assistance to your medical practice. You have to know a few things about the company you're partnering with first, though. Business News Daily spoke with some experts in the industry to find out what questions you should ask.

Costs 

Previously, the industry standard was 6 to 14 cents per line (a line being 65 characters). Now, there is a shift toward what are known as "visible black characters," or VBCs. A VBC is any character of typed text, like a letter or punctuation mark, so spaces don't count. According to Eric Slimp, purchased services director at TractManager, the VBC model is intended to make pricing more specific and exclude spaces from the costs. There are usually about 52 VBCs per 65-character line, he said, so if one line costs 10 cents, for example, each individual VBC would cost 0.19 cents. However, Slimp added, the per-line model does still exist, so be sure you understand the pricing model spelled out in the contract before you sign.

Turnaround Time

Most transcription services have a standard turnaround of about 24 hours. However, some documents can be completed even quicker, and many services can prioritize certain documents for an additional fee. For standard documentation, if a company's turnaround time is much longer than 24 hours, you might want to shop around a bit more.

Domestic and Offshore Services

Another big consideration is how much transcription a third-party service performs domestically and how much it offshores. Offshoring results in a cheaper rate but often sacrifices a bit of accuracy. Make certain that the contract specifies the percentage split (for example, 65% domestic, 35% offshore). Also consider your needs. If the majority of your transcribed documents are for your use only, maybe a heavily offshored service is fine for you. But if the documents must be perfectly accurate, like for clinical records or communications with other providers and health systems, then you'll want the transcription to be done domestically.

Layers of Oversight

A good transcription service will offer two to four layers of quality assurance – meaning three or four individual people, including the transcriptionist, will take a look at your transcribed record before it is returned for your signature. This practice virtually guarantees that errors will be caught and rectified before the transcribed document is returned to your practice. However, some transcription services only have one layer of human oversight. You'll want to know exactly how many pairs of eyes look over your documents before they are returned. More oversight means fewer mistakes. You should also make sure your documents are being created by a certified medical transcriptionist.

Specialty Experience and Certified Transcriptionists

The documents you need transcribed might be very different from those of other specialties, so it's always important to ensure the company you contract with has experience serving your specialty. You should check references for the company and ask to see examples of its past work for your field. Remember, if the company provides you with a list of references, they are probably only the favorable ones. Ask for a complete list of the company's clientele in your area and field to get the real scoop. You'll also want to make sure the company employs certified medical transcriptionists who are well trained and experienced.

Once you choose a medical transcription service, you can begin dictating. There are several ways to do this, and the method might vary based on the service you select. Sometimes, physicians will dial in to the company's database by phone and dictate into the system, where a transcriptionist will access the recording to create the written record. Other times, physicians can use an audio recorder and digitally upload the files to the transcription service. If you prefer, you can always send recorded tapes by snail mail, but this will likely have a slower turnaround.

With the increasing effectiveness of voice recognition, physicians often use the software and employ transcription services more as proofreaders and editors. It's also common for a service to offer a mobile application for Apple or Android devices, through which you can create audio dictations that are uploaded directly to the company's database. Overall, medical transcription services tend to be pretty flexible in how they accept dictation.

Tips From the Experts

The experts and professionals consulted for these tips include Dr. Joseph E. Glaser, nuclear medicine physician at Radiologic Associates PC; Eric Slimp, purchased services director at TractManager; and Dr. Kathleen A. Bishop, professor of health science at Purdue University Global.

1. Consider your workflow.

No solution is right for every practice. Your workflow, the preferences of your staff, your specialty and your practice's needs all influence which service or product will be most effective. For some practices, outsourcing transcription services might be an immense benefit; for others, it could be a waste of valuable resources when in-house voice recognition software would have sufficed. It's all about how you work, the volume of your documentation, and what your practice best adapts to. Look at transcription from all angles before deciding which direction to go.

"If you're looking to retrofit an existing practice, or a transcriptionist is retiring, you could consider getting a service that's used infrequently," Glaser said. "If you're going from room to room seeing patients all day … [then you might] prefer to have a transcriptionist look at the dictation later."

2. Spell out absolutely everything in the contractual terms.

When negotiating with any third-party service, it's important to know exactly what you can expect from it and at what cost. This means taking the time to sit down and negotiate the contract that you need line by line. It can be an arduous task to make sure before signing that the contract includes every last detail, even the seemingly understood ones, but it's well worth it for your practice. You can also use the terms of the contract to hold the company accountable for its performance.

"Build quality metrics into the contract," Slimp said. "The way we see it typically is that it will be a tiered scale, where it will have certain percentages … You want to shoot for 98% accuracy in general, that being for major errors. There will be just typos and things like that. Minor errors are OK, but you want to strive for 98% of charts without major errors."

Slimp said you can enforce the target metrics by negotiating some incentives for when the company delivers exceptional service and penalties for when it demonstrates poor service. Make those quality-control metrics measurable and grounded in statistics that you can easily demonstrate with the transcribed reports you have on record.

3. Make sure you only pay for what you need.

Many vendors pride themselves on flashy features and a lot of optional components. While some of these might be useful for you and your staff, it's worth considering whether you really need all the latest features and frills. If all you need is effective, accurate transcription, then you should only pay for the basic package. Scrutinize the pricing models: Find out if it's a one-time fee or a monthly subscription, and also ask about the frequency and cost of software updates. As always, inquire about the level of support you can expect from the vendor if something goes wrong.

"Some companies can be very expensive and want to give you all the bells and whistles when you only need the basic package," Bishop said. "Find out how much it will cost – is it a one-time price, or do you pay for the software/hardware and then a monthly or yearly fee? Are there upgrades of the software, and if so, are they free, and how often do they upgrade? And if there is a bug or glitch in it, how quickly do they get it fixed?"

4. Make sure the software interfaces with your existing systems.

Any software that you might use, either on your own or in conjunction with a medical transcription service, has to be compatible with your electronic health records (EHR) system and practice management system. In today's increasingly digitized healthcare industry, the ability to generate and share records across platforms – both in your office and other providers' offices – is invaluable. Any software necessary for the transcription process needs to be able to properly communicate with all the electronic aspects of your practice.

"Everything has got to work together," Glaser said. "It's a question you must pose to the vendor when you're buying these things. I've seen some practice management systems with transcription built in … but you have to make sure it can interface with your records system as well."

5. Always check references.

As with any other major purchasing decision, it is important to perform thorough research before buying. Ask for a complete list of the company's references within your specialty, not just a predetermined list of positive reviewers. Find out from other physicians in your field how they use transcription services, what it costs them, and what the quality of their service is. You can also find ample reviews online and look up information on the company with the Better Business Bureau. If there is a dearth of information on a given vendor, that should be a signal that something isn't quite right. There's usually at least some useful information out there on any reputable vendor.

"When outsourcing, make sure you have looked at all the services that the company or transcriptionist is prepared to offer and if they actually do what they say they can," Bishop said. "Get a couple of references, look them up online, and check out the Better Business Bureau … to see how reputable they are."

6. Use your practice's small size as leverage.

If you are a small or even midsize practice, just about any transcription service will be equipped to handle the volume of reports you generate. Unlike large hospital systems, which produce so much dictation that only a large company could handle the workload, smaller practices have the option of using smaller transcription services. You can use this as leverage when considering a transcription service or negotiating a contract. You could go virtually anywhere, so make the company truly win your business.

"[A small practice] will want to use to their advantage that their volume is low enough that almost any service provider could offer them what they need," Slimp said. "Small practices have the option of going anywhere because almost anyone can handle their volume. It's important to know the playing field is really open and to use that competitive advantage as leverage."

7. Focus on getting as short a term as possible.

Finally, do your best to negotiate a short contract, or find a company that offers monthly subscriptions. That way, if the service you partner with ends up being something other than what you expected, you can always go elsewhere at the end of the contracted period. Some companies will try to lock you into a longer contract, but it's best to talk them down to one year or less. Remember, they don't have your business until you sign the contract, and simply refusing to sign on to a multiyear agreement might persuade them to reduce the timeframe. Of course, if you're satisfied with the service, you can always extend the contract in the future. 

"There are companies – and we still see this – that will want to lock you into a three-, four-, five- or even six-year contract," Slimp said. "But you'll really want to focus on getting as short a term as possible."

 

Frequently Asked Questions About Medical Transcription Services

When choosing a medical transcription service, you should keep several factors in mind. These questions are some of the first things people wonder about medical transcription services, plus some of the most important things you should ask any specific company you're considering.

What are the benefits of a medical transcription service?

Medical transcription services offer an easy and quick way to transcribe audio dictation accurately without using internal resources. Many providers don't want to spend time typing during a clinical encounter, nor do they want to write up audio recordings after the fact. Office staff might need many documents for billing and insurance purposes. Medical transcription companies can reduce the burden of these tasks for just a few cents per line of text, freeing up your practice's staff to take care of more pressing duties.

How can a medical transcription service streamline operations?

One area where medical transcription services can improve your practice's operations is insurance and medical billing. Medical billing can be a complex and time-consuming process, but medical transcription services can optimize your charts for the most efficient billing process. With properly transcribed charts, billing teams can easily code claims and submit them properly with a lower risk of rejection or denial by the payer. Not only does a well-organized chart speed up the submission process, but the lower risk of denial means less denial management for your billing team.

Moreover, medical transcription services can help providers who don't like using EMR systems by directly transcribing audio dictation into the appropriate fields in the EMR. This can save providers hours of transcribing audio from clinical encounters, or save them the distraction of typing while seeing a patient.

What is the quality assurance process for a medical transcription service?

To maintain and improve accuracy rates, a medical transcription service should have a set quality assurance process in place. Ask any service you are considering how it guarantees the accuracy and quality of your transcripts.

Many medical transcription services ensure that transcripts go through at least two people – the transcriptionist and a proofreader. Many go beyond this standard, requiring three or even four sets of eyes to approve transcripts prior to release.

But it's not just the number of people reviewing the documents that matters. You should also inquire about certification requirements, ongoing training and specialty experience. It's important to verify that transcriptionists and senior staff maintain accredited medical transcription certifications and are regularly trained on matters such as HIPAA compliance and AHIMA standards.

What are the available turnaround times for transcribed documents?

Medical transcription services often offer some flexibility in how quickly your documents are turned around, while some only offer next-day delivery. The turnaround you need depends on the nature of your business; some healthcare organizations only need 24- or 48-hour turnarounds, while others sometimes need transcriptions performed in as little as one hour.

Of course, faster turnaround means elevated costs, so you need to build your expectations into your budget. However, it's important when researching companies to confirm whether a medical transcription service offers the turnaround times you require. If you need transcripts returned in less than 24 hours, be sure to inquire about additional costs for that. If you can wait 48 hours for them, see if there is a discount for that.

How can a medical transcription service ensure HIPAA compliance?

It is critical for any medical transcription service to fully comply with the HIPAA privacy laws. Because you are sending the company audio that likely includes sensitive patient information, it needs to not only have the proper technical security infrastructure in place, but also train its staff on the proper handling of protected health information.

Also ask a medical transcription service what encryption it uses on any portals or email inboxes that it uses to transmit sensitive information, either the audio or transcripts. Ask if any information is stored, how it is stored, how it is protected and when it is deleted. Your patients' data is your responsibility, so entrusting an unscrupulous or neglectful third party with it is a breach of confidence. Do your due diligence and make sure that the service you choose takes the proper security measures to prevent a data breach.

Security goes beyond the technical, of course. How is the transcription service's staff trained to handle sensitive data? Are its physical facilities secure? These questions might seem nitpicky, but securing your patients' data is of the utmost importance, in terms of both legal compliance and your own reputation.

Services

Acusis offers a high-quality, accurate transcription service that is easily accessible through a web-based platform. The company uses the highest order of encryption to protect patient information, but it requires a long-term contract. www.acusis.com
DoctorDocs offers 24-hour turnaround and is open for service seven days a week. The company also offers a one-hour "STAT" turnaround for emergencies. No long-term contract is required, and lines of transcription are bought in "blocks." www.doctordocs.com
i-Script's service includes three different turnaround times at different price levels, each of which is reasonably affordable. However, some desirable features – like EHR system integration, electronic signatures and auto-faxing – are not included in i-Script's transcription service. The company puts all transcripts through two layers of oversight before returning them to be signed. www.i-script.net
VIVA Transcription offers next-business-day turnaround and the option to interface with most EHR systems. It maintains a web-based storage system for viewing, editing and signing documents, with the highest level of encryption available. www.vivatranscription.com
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