HIPAA Compliant Medical Transcription Services.wmv

Is this language what we call English?

I got an application for a job today.  I just don't know what more to say.  Here it is:

"I am xxxx xxxx from the India at Maharashtra. I am working in the Business transcription company as Operation Associate. In the XXXX systems pvt. Leading company in the business transcription. i have been two years experience.

I wish to serve with you...

thanking please send me replay....

Best regards

XXXX XXXX"

I won't blame this candidate.  It is time we think about our education system.  This is just 

an example of what is seen almost every where and every day.  The so called graduates 

not able to even write a decent resume by themselves.

The education institutions are meant for generating a good and capable generation.  It starts right from the politicians (don't know if they really know the meaning and importance of Education).  The educational institutes have the prime interest in profitability.  Lastly, the teachers (with due respect to them).

The politician.  He better be a politician and not interfere in the education as he is never educated enough to decide what students should be taught.   He is normally educated in a field which is not wanted by the society (antisocial activities).

Educational Institutions.  They sure need to see the profitability to survive.  They are restricted by the politicians to recruit according to caste/creed and not by the brain or aptitude or knowledge base.

A teacher is a person who is the main source of how the next generation is going to be.  A teacher should be the highest paid person and the best and/or an authority in the field he teaches.  But the reality is the one who comes in the teaching line is the one who comes in this field as a last alternative.

The parents also need to think.  Their duty is not just to give birth and blame others for not making their child a capable human being.  The child is in the school for only 6-8 hours in a day.  So he is with his parents for a longer period.  The parent's prime need in life is money and not the future of their child.  They live in a world where others are to make their child a good human being because they gave birth to that child.  They teach the teachers how to teach their child.  Not to scold them, not punish them even if they make mistakes, promote them to next level even if the child has not learned enough.  All they want is a Degree embossed on their child's forehead.

The end result?   Obviously what we see above.

Take care before you recruit anybody

I was surprised to get an E-mail today.  Just putting it on the blog for all to know.

This is a Lookout Notice for Medical Transcriptionist named as G Sivarama Krishnan (S/o Gurumurthy). It has come to our attention that he is a professional cheater.

a. He was working in MT firm in Bangalore and has cheated nearly 1 Lakh rupees.

b. He was working in MT company in Vishakapatnam and has cheated for 40,000 rupees.

Please go to this link for a full information about him: https://sites.google.com/site/shivaramakrishnagurumurthy/

He is likely to approach your company for MT job. We request you to co-operate with us to trace this man. Any information about this man can be sent to tracekris@gmail.com

Please forward this email to your friends.

UT36PARM66TK

UT36PARM66TK

WATCH THE WAY YOU APPROACH

You are judged from your approach

Yet another experience I had today.  Had been planning to write about this for a long time.  Once again today, I got very much disturbed with an incident.  A fellow MT approached me for some home based work.  Following is the way the chat proceeded.  It is an ideal conversation to note things you should avoid.

Suddenly, without notice or introduction got an IM:
xxxx: HI
xxxx: Good afternoon
I said: hi
xxxx: One of my friends gave me ur idregarding medical transcription
xxxx: Sir do u outsource work
I said: yes, we do
*** approach without introducing who (he/she) was ***
xxxx: at what time the files are given
I said: mail me your details to X_X_X_X_X or fill up the details at http://outsourcedmtservices.com/career.php and I shall get back to you in my free time (clear but polite enough for a person to know that I was busy)
xxxx: Sir i will forwrd my CV to u
I said: yes pls (that was quite a polite answer from my side and I hope you will agree)
I said: who gave you this ID?
xxxx: Sir i was working in XXXXXXX
xxxx: and one my colllegues gave me
xxxx: and i am in search of work now
I said: colleague?  Who?
xxxx: xxxx
I said: k
then what followed was:
xxxx: can i send through messenger my CV
I said: no, enter the room through a proper door not through windows
xxxx: ok no problem
xxxx: thanx a lot
xxxx: http://outsourcedmtservices.com/career.php  on this right?
I said: sorry about it, but I don't like people jumping in through windows
xxxx: no problem sir
xxxx: a mistake is a mistake
I said: sure is
Please note that I am the employer and I am telling the proper way I wanted things to come with a cool head till now.  But what followed was ........
xxxx:  i will email u on this id yahoo messenger id
Session Close
This means right in the first visit I was given the impression that I was dealing with someone who will behave his/her own way and not the way the employer wants
after 8 mins another IM hit me 
Session Start:
xxxx: sorry to disturb u again sir ...i have sent u my CV ..thanks
I said: k
Session Close
After a gap of about 1 hour again one IM hit me (after telling initially i was busy, it certainly was getting difficult now to maintain my mood)
Session Start :
xxxx: Sir can i talk to u for 2 mins
I said: what is it
xxxx: Sir for end to end what is the rates u offer
I said: one question follows the other, and that follows the next
I said: that is why I reply in my free time so that things are explained in one go
xxxx: which time is preferable
It was this time that I decided to talk crudely in a language which I hoped he/she would understand
xxxx: that all i have given u in detail u dint receive my email yet
I said: yes, so you want everything right now
I said: I get the feeling that you have employed me and I am answerable when you wish
xxxx: u r misunderstanding
xxxx: i know u were in Mapro
I said: no
I said: that is a wrong info you have
I said: you expect me to satisfy all your querries at the click of a button as though I have no other work than that
xxxx: I have worked for many people many big companies still working but even the boss of that comany does not reply so rudely anyways...
xxxx: if u dont want me to ask ok
xxxx: thanks for spending so much time
xxxx: 2 minutes
see the nature, I am not supposed to feel offended and I am not supposed to lose my sense even if the applicant keeps nagging me even after telling him nicely.  But when I speak bluntly then I become rude.
So fellow colleagues think about it.  Please give a thought and keep your approach so that the other person should like you and not hate you.
It is very rightly said IF YOU GIVE REPECT THEN YOU ARE BOUND TO GET RESPECT.
To be frank, it was almost like a terrorist attack.  Some terrorist just breaks into my privacy (room) without knocking, without introducing himself and then he is the boss of my room not me, and I am supposed to do as he wants me to and that I do not have any choice.

Summary of Healthcare Bill Passed in US - 2010

On March 21, the House passed the Senate bill, originally passed by the Senate in December. The bill was then sent to the President for his signature. Immediately after that vote was taken, the House passed changes to the Senate passed bill known the "Budget Reconciliation" bill (H.R.4872) by a vote of 220 to 211. The Senate will now consider this package of changes this week, which will shape the final outcome of the healthcare reform program.
This healthcare bill is a comprehensive overhaul bill that increases coverage to 94% of Americans and makes sweeping changes to our current healthcare system. There are new provisions in the bill for both individuals and employers. Although the bill is comprehensive, we address the changes that will affect small employers and their employees.
Individual Requirements:
The bill requires all U.S. citizens to obtain the minimum essential coverage or pay a penalty of $95 in 2014, $325 in 2015, $695 in 2016 and $750 in 2017 and indexed thereafter. There will be a penalty cap of $2,250 per family.
Exemptions to the penalty will be granted for financial hardship, religious objections, and those with income below the tax filing threshold (in 2009 the threshold for taxpayers under age 65 was $9,350 for singles and $18,700 for couples).
Beginning in 2018, there will be a 40% excise tax on individual high-cost health plans costing more than $10,200 for individuals and $27,500 for families.
Employer Requirements:
Employers under 50 employees:
Exempt from required coverage and penalties.
Employers more than 50 employees who do not offer coverage:
Employers with over 50 employees that do not offer healthcare coverage will be required to pay a fee of $2000 per total number of full-time employees if they have at least one full-time employee receiving a tax credit for premium assistance. There is a transition provision that exempts 30 employees from the total number of full-time employees for purposes of this calculation.
Employers with over 50 employees who offer healthcare coverage:
Employers with over 50 employees who offer healthcare coverage must pay at least 60% of their employees’ premiums or employee premiums payments cannot exceed 9.5% or more of their income to avoid fees. Fees may be imposed at the rate of $3,000 per employee who receives a tax credit for premium assistance.
How does an employee qualify for a premium assistance?
• An individual is eligible to receive a tax credit for premium assistance if their employer pays less than 60% of the premium cost or if the employee share of the premium exceeds 9.5% of their income.
Employers more than 200 employees:
Employers with 200 or more employees will be required to automatically enroll new full-time employees in coverage.
Insurance Market Reforms:
Beginning in 2014, the bill puts in place reforms to the current small group insurance market and changes the way insurers determine eligibility. In addition, there will be a “market shift” to pool the self-employed, non-profits and small businesses into the same group under new marketplaces called exchanges.
These market reforms include:

• Individuals and small businesses will be guaranteed health coverage and will have the ability to renew coverage annually
• Prohibits insurers from basing eligibility on: pre-existing conditions, health status, medical condition, claims experience, receipt of health care, medical history, genetic information, disability, and evidence of insurability
• Prohibits lifetime or annual limits on benefits
• Prohibits deductibles greater than $2,000 for individuals and $4,000 for families
• Requires insurers to expend no less than 85% on medical coverage
• Coverage for non-dependent children up to age 26

What’s in it for Small Business?
New Marketplaces to Shop for Healthcare Coverage:
By 2014, all 50 states will be required to establish state-based exchanges. These state-based exchanges, or marketplaces will be offered to employees of small businesses, the self-employed and individuals.
These pools will be run by states. States may form regional exchanges or allow more than one exchange to operate in a state.
These state-based exchanges will also include private insurance plans, multi-state health plans, and Consumer Operated and Oriented Plans (CO-OPs). There will be no public option, however, each state exchange will be required to offer at least two multi-state health plans negotiated by Office of Personnel Management (OPM). CO-OPs are non-profit, member driven and owned health insurance issuers that will offer plans through the exchanges.
Small Business Eligibility for the Exchanges:
Individuals, the self-employed and small businesses up to 100 full-time employees will be eligible to obtain coverage through state exchanges. However, before 2016, a state may limit pool to businesses up to 50 employees. Beginning in 2017, the state exchanges will expand to small businesses more than 100 employees.
It is important to note that small employers eligible to obtain coverage in an exchange who grow beyond the employee limit will continue to be treated as a small employer and eligible to participate in their qualified health plan until the employer decides not to enroll in that plan.
Benefits Under the Exchanges:
The exchanges will include private insurers that offer four benefit categories of qualified health plans. The four levels of coverage for benefits will be: bronze, silver, gold and platinum.
• Benefit levels include:
Bronze plan covers 60% of the benefit costs of the plan
Silver plan covers 70% of the benefit costs of the plan
Gold plan covers 80% of the benefit costs of the plan
Platinum plan covers 90% of the benefit costs of the plan
• All insurance plans in the exchanges must include these services: ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, including behavioral health treatment, prescription drugs, rehabilitative and habilitative services and devices, laboratory services, preventive and wellness services and chronic disease management, and pediatric services, including oral and vision care.
Increased Coverage Options:

The bill will establish simple cafeteria plans to allow small employers and the self-employed to offer tax-free benefits.
Employers who offer insurance but not through the exchanges will be required to offer “free choice vouchers” to employees to purchase coverage through the exchanges.
Assistance to Small Businesses to Reduce Coverage Costs: Tax Credits
The bill contains small business tax credits to help offset the cost of providing healthcare coverage to employees.
Starting in 2010, a three-year small business tax credit will be available to businesses up to 25 employees and average wages below $50,000. The full tax credit, 35% of the employer’s contribution toward the employee’s health insurance premium, would be available to small businesses with 10 or fewer employees with average wages below $25,000. Employers must contribute at least 50% of the total premium cost to be eligible for a tax credit.
In 2014, a tax credit will be available to businesses up to 25 employees and average wages below $50,000 who purchase health coverage for their employees through state exchanges. The maximum allowable tax credit will increase to 50% of the employer’s contribution, if the employer contributes at least 50% of the total premium cost.
The employer would cover the premium costs for their employees during the year and receive the tax credit at the end of the year when filing income taxes.
These small business tax credits will be applicable to tax exempt small businesses, 501(c)(3)s (i.e. charitable organizations), but the maximum credit will be limited to 25% of the employer’s contribution toward the employee’s health insurance premium in 2010-2013, and will increase to 35% in 2014.

Basic Rules of Transcription

Basic Rules of Transcription

I. Spacing With Punctuation Marks

Do Not Type a Space ...

• following a period with an abbreviation
• following a period used as a decimal point
• between quotation marks and the quoted material
• before or after a hyphen
• before or after a slash
• before or after a dash
• between a number and percent sign
• between parentheses and the enclosed material
• between any word and the punctuation following it.
• between the number and the colon used to indicate a dilute solution or ratio.
• on either side of the colon when expressing the time of day
• before an apostrophe
• before or after a comma used within numbers
• before or after an ampersand in abbreviations, e.g., C&S
• on either side of the colon when expressing ratios e.g. 1:1
• after the closing parenthesis if another mark of punctuation follows

Type One Space...

• between words
• after a comma
• after a semicolon
• after a period following an initial
• after the closing parenthesis
• on each side of the x in an expression of dimension, e.g. 4 x 4

Type Two Spaces...

• after punctuation at the end of a sentence
• after a colon except when expressing time or a dilution ratio

II. Numbers

• Spell out WHOLE numbers zero through nine, use numerals for 10 and above (this may change in the near future as the AAMT is trying to standardize using numerals only. When the next edition of the AAMT Book of Style is published, you can probably expect new guidelines.
• Use numerals when numbers are directly used with symbols.
• Use numerals when expressing ages.
• If it is an approximate age, spell it out.
• Use numerals to express size and measurements.
• Use numerals for everything metric. Centimeters, millimeters, liters, etc.
• Use numerals in all expressions pertaining to drugs - this includes strength, dosage and directions. Z-PAK 2 daily on day 1, then 1 daily on days 2-5.
• Spell out and hyphenate fractions standing alone. He drank one-half a gallon of apple juice.
• Use numerals to express mixed fractions. 1 1/2 years.
• Use commas only if there are 5 or more digits when expressing numbers. e.g. 10,000, 4000.
• Use numerals when expressing vital statistics including height, weight, blood pressure, pulse and respiration.
• Substitute a hyphen for the word "to". He is to take 1-2 tablets of Tylenol every 4-6 hours p.r.n.
• Leave a space between numerals and measurements unless they form a compound modifier. It is 6 cm below the ...... It is 1200 ml....... A 4-cm nevus....... A 2 x 2-mm lesion.......
• Always use 0 in front of the decimal point if the number is not a whole number. 0.75 mg
• Use decimal fractions with metric measurements. 1.5 cm
• Use mixed fractions with English system measurements. 1 1/2 inch
• Use numerals for: Ages, units of measure, vital statistics, lab values and in other instances where it is important to communicate clearly the number referenced. Examples: 4 inches, 3-year-old. She has three dogs who have eight fleas each. A total of 7 basal cell carcinomas removed from his left arm. (7 for clarity)

• Do not start a sentence using a number. Spell out the number or recast the sentence.
• Dictated as: 10 milligrams of Reglan was administered stat. Transcribe as: Reglan 10 mg was administered stat.
• Exception - It is acceptable to begin a sentence with a date. Example - 2000 is going to be a prosperous year.

• Plurals - do not use an apostrophe to form plural numbers.
• 4 x 4s
• She was in her 20s or twenties (this is acceptable because it is not a definite number).
• She was born in the 1970s.

• Series of numbers - Use numerals if at least one is greater than nine or if there is a mixed or decimal fraction.
• Example - Jeff has 1 job, 1 place of employment and 18 hours a day to do the work.

• Cranial nerves - Preferred: Roman numerals I-XII
• Diabetes type 1 and type 2, not Roman numerals I and II - this was recently standardized by the American Diabetes Association.
• Apgar scores - Use numerals for ratings and spell out numbers relating to minutes. Rationale - to draw attention to the scores. Example: The Apgar scores were 6 and 9 at one and five minutes. Apgar is not an acronym.

• Time Examples
• 8:30 a.m. - morning
• 8:30 p.m. - evening
• noon, not 12:00 noon
• midnight, not 12:00 midnight or 12 'o'clock or 12:00 p.m.

III. Measurements

• Spell out all nonmetric measurements. Feet, inches, pounds, ounces, yards, grain, dram, etc.
• Exceptions:
• Use tsp for teaspoon
• Use tbsp for tablespoon
• Abbreviate all metric measurements.

• Use F for Fahrenheit IF accompanied by the symbol for degree. 98.6�F
• Spell out Fahrenheit IF degree is spelled out. 98.6 degrees Fahrenheit.
• Use C for Celsius IF accompanied by the symbol for degree. 36�C
• Spell out Celsius IF degree is spelled out. 36 degrees Celsius.

• In tables and technical documents:
• Use ft or ' for feet
• Use " for inches
• Use yd for yard
• Use pt for pint
• Use oz for ounce
• Use fl oz for fluid ounce

Abbreviate most unusual units of measure when accompanied by numerals

Dictated as	Transcribed as
0.8 centimeters squared	0.8 sq cm
22 milligram of mercury	22 mmHg
3.0 liters per minute	3.0 L/min
40 millimeters per hour	40 mm/h
8 grams percent	8 gm%

IV. Symbols

• Spell out a symbol when used alone (with no number).
• Use symbols when they are used with numbers

Common Symbols

Dictated as	Transcribed as
Four to five	4-5
Number 3 0	#3-0
Twenty-twenty vision	20/20
BP 120 over 80	120/80
Grade two over six	2/6
A positive	A+
Three point five centimeters	3.5 cm
Point five centimeters	0.5 cm

V. Capitalization

Capitalize...

• Abbreviations when the words they represent are capitalized
• The first word following a colon if it begins a complete sentence or is part of an outline entry
• Most abbreviations of English words
• The first letter of chemical elements
• The names of the days of the week, months, holidays, historic events and religious festivals
• The names of specific departments or sections in the institution only when the institution name is included
• The names of diseases that include proper nouns, eponyms or genus names
• The trade or brand names of drugs
• A quote when it is a complete sentence
• The names of races, peoples, religions and languages. Black, as a race designation would be capitalized, however client preferences may differ.

Do Not Capitalize...

• The spelled out names of the chemical elements
• The seasons of the year
• The common names of diseases
• The names of viruses unless they include a proper noun
• Generic drug names
• The common noun following the brand name. Example - Tylenol tablets
• The names of medical or surgical specialties
• Designations based on skin color, like "a tall white man."

VI. Hyphenation
These prefixes do not require the use of a connecting hyphen in compound terms:

ante	intra	semi
anti	micro	sub
bi	mid	super
co	non	supra
contra	over	trans
counter	pre	tri
de	post	ultra
extra	pro	un
infra	pseudo	under
inter	re	weight

Examples - antecubital not ante-cubitalAlso Correct - antithesis, bitemporal, counterproductive, defibrillated, extrapyramidal, infraumbilical, interpersonal, intracranial, microhematuria, midline, nontender, nondistended, nonfocal, nonspecific, noncontributory, noncompliance, nonicteric, nonsmall, overestimate, overweight, preoperative, postoperative, posttraumatic, pseudogout, semicircular, sublingual, superimposed, supramammary, transvaginal, ultraviolet, underweight, weightbearing.

Do use a hyphen with prefixes ending in a or i and a base word beginning with the same letter. Example - anti-inflammatory.
Do use a hyphen when compounded with the prefix self.
Example - self-administered, self-monitored.
For Clarification - Use a hyphen after a prefix if not using a hyphen would change the meaning of the word. Examples - re-cover (to cover again) versus recover (regain)

VII. Cancer Classifications

• Stage and grade - do not capitalize either one if it does not begin a sentence.
• Use Roman numerals for cancer stages.
• Use Arabic numerals for cancer grades.
• For clarity, use capital letters or arabic suffixes without spaces or hyphens.

Here are some examples:
stage 0
stage I stage IA
stage II stage IIA
grade 1
grade 2
grade 3

VIII. Drug Terminology

• If dictated q.day - transcribe q.d.
• If dictated q. four hours - transcribed as q.4h. not q. 4 hours.
• When referring to drugs including strength, dosage and directions - Use Arabic numerals only. Example - The patient was prescribed penicillin 500 mg t.i.d. for 5 days.
• If there is no whole number, always add a 0 in front of the decimal point for clarity - this is a general rule when transcribing numbers, not just medications. Example - Dictated as Synthroid point 75 mg a day. Transcribe as Synthroid 0.75 mg q.d.
• Be aware that some drugs are commonly dictated in either milligrams or micrograms. Example - Synthroid 0.05 mg or Synthroid 50 mcg.

IX. Lab Test Punctuation Guidelines

• Use commas to separate multiple related test results. Here are some examples:
• Creatinine 1.2, BUN 42, phosphorus 4.3.
• WBC 12.4 with 72 segs, 9 lymphs.
• CBC reveals an RBC count of 10.2, WBC 6.8, platelets 220,000, reticulocyte count 1 with 3 monos, 1 eos and 0 basos.
• Electrolytes reveal a serum sodium of 138, potassium 4.0, chloride 100 and glucose of 80.
• Use periods to separate unrelated laboratory test results. For example,
• Potassium 3.7. TSH 1.0. Albumin 4.0.

X. Miscellaneous

• Keep logically connected items on the same line. Drug doses, names, dates, sets, etc. Examples:
• Lopressor 100 mg. Keep all 3 items on the same line.
• Dr. Fred Farnsworth. Keep the doctors title and full name on the same line.
• January 14, 2000. Keep the entire date on the same line.
• 100 pounds. Keep both words on the same line.
• 5 inches. Same rule.

Names

• Names with junior or senior attached. Use a comma before and a period after the abbreviation or use neither.
• Example - Jeramiah Johnson, Jr. or Jeramiah Johnson Jr
• Incorrect - Jeramiah Johnson Jr.
• Names with ordinals. Do not use comma between name and ordinal.
• Example - Bernie Schwartz III
• Incorrect - Bernie Schwartz, III

XI. Report Section Notes

History of Present Illness - Mainly in present tense, but mixed tense may be appropriate.

Past Medical History - Use past tense.

Allergies

• Allergies are typed either ALL CAPITAL LETTERS or bold font depending on client preference. Example - If the allergy is dictated pcn, type PENICILLIN.
• If the patient has no allergies use the phrase, "No known drug allergies."

Medications

• Transcribe in continuous paragraph format, even when the doctor numbers the medications. Example: Penicillin 500 mg t.i.d. for 5 days, levothyroxine 0.75 mg q.d. and Lopressor 50 mg b.i.d.
• Capitalize brand name medications. DO NOT capitalize generic medications.
• Use Latin drug abbreviations. Example - if dictated every day - transcribe q.d. If dictated every four hours - transcribe q.4h. not q. 4 h.
• Don't mix Latin and English terminology. Example: If dictated q. day - transcribe q.d. NOT q. day.
• When referring to strength, dosage and directions - Use Arabic numerals only.
• If there is no whole number, add a zero in front of the decimal point for clarity. This is a general rule when transcribing numbers, not just medications. Example: Dictated as Synthroid point 75 milligrams a day. Transcribe Synthroid 0.75 mg q.d.

Physical Examination

• Transcribe in present tense in ALL of the major report formats.
• Vital Signs - Should look like this: Temperature 98.0, BP 140/80, pulse 76 and regular, respirations 16.

Assessment/Diagnosis/Impression

• Typed entirely in upper case.
• No abbreviated medical terminology. Type the entire term or phrase. Example - If the doctor dictates CAD, type coronary artery disease.
• Numbers follow the same rules for any section of the transcript. Example - A 31-YEAR-OLD FEMALE. 5 MG.
• Abbreviate units of measure, e.g. MG, MM, CM, etc.
• The title Doctor is written out, not abbreviated.

Verb tenses

• Use past tense:
• In the past history of a report
• In discharge summaries EXCEPT for the History of Present Illness and the Physical Examination sections.
• When discussing expired patients

• Use present tense:
• To describe the physical examination
• Use the correct verb tense to communicate the appropriate time of the action. Even if the dictator inadvertently changes tense during the dictation.

XII. Things to check when proofreading a document

• Fill in blanks or make notes
• Consistent pronouns - he or she?
• Consistent tense - was or is?
• Consistent left and right alignment
• Singulars versus plurals - sclera or sclerae?
• Headings - Are they labeled properly?
• Sound-Alikes
• Unnecessary awkward repetitions
• No abbreviations in diagnoses or procedures
• Drugs correctly capitalized
• Formatting, headings and indentations
• Proper use of hyphens
• Dates
• Complete sentences
• Punctuation

Reference from ww.mtdaily.com