Becoming an IC with own clients
Posted By: Need to know on 2008-09-01
In Reply to:
How does a person become an IC with their own clients, not working for an MTSO? From what I have read on this board, it seems that is the way to make the most money per line/word/page, etc. so I am thinking about doing this after being an employee for 15 years (with things going downhill now). I would appreciate knowing several things:
1. How do you get the clients.
2. Are there certain types of docs that tend to prefer this situation rather than going to an MTSO?
3. How do you determine what to charge?
4. How can someone get the dictation, type it and return to the doctor without having to pick it up and drop it off?
5. Without QA other than yourself, how does an IC handle blanks? Do doctor's offices tend to get upset with blanks?
6. Is there a particular software system that is better to use when you have your own IC service and want to get work over the Internet and return it over the Internet?
This and any other advice greatly appreciated!
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What happens, is MTSOs coddle the clients and let the clients call all of the shots.
Then the MTs get stuck with account specs that are contradictory and confusing.
It should be simple. When an MTSO is wooing a client, the MTSO should present with a copy of the style guidelines they intend to follow or if it is the BOS, let the client know that. It should be made clear that with the exception of report format, the guidelines are not flexible. Either we use apostrophes or we don't. Don't do it one way for one client and the exact opposite for the other client and then hold the MT responsible when she gets confused as to what account she is typing that day!
the clients were in NY. nm
s
Maybe not your clients, but many are.
Your clients may be behind the times, but many are not. VR has gotten much, much better, and I've spoken with many, many MTSOs who are moving their accounts over.
The average seems to be about 60% to 80% VR and 20% to 40% transcription. There will always be those you cannot put on VR, but it is growing rapidly.
Not all clients DO know--that's just it!
Yes, some clients DO know, and the almighty dollar is the only thing they think of. But some clients DO care, and they don't know their records are going overseas. They would be apalled if they knew. Come to think of it, so would the patients.
not when the clients have the last say
Do not get me wrong. I do not care for it either, but somewhere down the line, the companies will have to suck it up and so will we. Otherwise, we move to a different field. Unfortunately, that is just the way it is.
I'm sure they do tell their clients to sm
hide it from the MTSO, just like the MTSOs hide the fact that their clients' work is being generated by VR.
Do you think clients don't already KNOW about VR? That they are sm
being sold it at every AHIMA conference they go to? Being cold-called by companies doing VR already? That doc don't get info about it at their little retreats and conferences?
It's better to be proactive and have VR sold as part of an MTSO's offering (with MTs doing the editing) than being undercut by other VR-only companies.
do not forget the clients -
They also deserve to be billed correctly. Sad, sad, sad.
IC - FINDING CLIENTS
Do you have to pick up tapes and deliver the hard copies with your accounts? I used to have an account where they would dictate into my Sony system (a special system that allowed docs to dictate from their phones, pause, rewind, make changes, etc), and then I would just e-mail the completed work back at the end of the day for them to print out in the office.
I wonder if the clients are leaving
because they are being sold and that is why I have no work? I can't wait until they make the announcement - then I will know if I need to pack up and leave.
If you are seeking clients, there is not
NM
Are their clients aware?
If I were a client of theirs, I would look for someone else to do my transcription. If I were a patient of this client and if I found out that the client knowingly supports this sort of crap, I'd look for healthcare elsewhere. Heck, docs come a dime a dozen!!!
It all comes down to the customers--that's US!!! The American citizens who trust that our medical records are (1) kept confidential and (2) are done correctly IN THE USA!!!
There should be a way to inform the customers of HIS's clients. First and foremost, we, as customers, as Americans, need to boycott the physicians first--the ones who are sending American money overseas!!! There are PLENTY of other docs out there who support the USA and want to keep the work at home. They'll gladly take my money!
Persnonally, I don't want my medical record entrusted to overseas folks who, for the most part, hate us to begin with. They barely speak a word of English and they certainly do a pathetic job at trascribing. I've seen the damage these folks can do to medical records.
I think that we should boycott MDs who are paying HIS to transcribe for them.
If we don't stand up for ourselves now, what's next????
Too bad they mislead their clients about it
That is what is so rotten about the whole thing, the hospitals think the work is all being done in the US when it is not.
RE Acusis Buy-Out, What About US-Only Clients?
Something does not add up here, because many of the bought-out company's current clients vehemently refuse to work with anyone who outsources. Won't they drop new company outright and have to look for a new MT provider?
But your own clients bring many of your own
x
*Stealing* clients
You can steal things, but you can't *steal* a sentinent being (client) who chooses to go with you because you offer better service/better price or any combination of the two. Said client can walk away from you, too, if you don't deliver. What company does not try to lure clients from a competitor?
If the severance is minimal, you can easily get another job, and you really believe the company would come after you, then maybe foregoing the severance would let you rest easier even if the clause wouldn't stand up in court. If you really believe the company would come after you, do you want to spend time and money in court, even if you win?
stealing clients
I partially agree, but when a person uses insider information about a client's setup, preferences, etc. IMO that is stealing. You're using privileged information in an inappropriate way. So strictly speaking, a person hasn't stolen the client, but they stole the information they needed to get the client's business.
Clients at fault?
I really think it varies from client to client what is expected as far as unpaid fussing. Some expect the moon and the stars (looking up the ordering physicians on huge databases instead of passing us that demographic). I don't understand why a company would agree to contracts like these with the clients - they know no production will result from it!
TT has just taken on several HUGE clients
That is the reason for the ad
What goes around will come around and eventually your clients
They see that all the other doctors are hardly paying anything per line for it and they'll expect you to adjust your rates accordingly. This is precisely what happened in my area. All the doctors started thinking they should get bargain-basement prices because they could use the threat to send it offshore. So wallow in the green while you have it, at the expense of your offshore workers (and hey, if they're truly so great, why not pay them US rates and really do something really noble to improve their lives?)
You might be helping the economy in third-world countries (they'd starve w/o you?! Get over yourself!) but you are INDEED helping to lower ours here. You can justify and deny that all you want, and frankly, I don't care that you sleep at night. The fact that you are here defending your stance so vehemently tells me you know deep down.
You can also claim there are no good workers here, but you're wrong. We just don't work for MTSOs with your attitude. And guess what? There ARE plenty of doctors that DO care where their work is being done. You might have found a few who don't care (if you truly told them), but that's not par for the course in most places, my dear. Most ESL clients are the most adamant that the work be done here because the US MTs are the only ones who could clean up their grammar!
I can name 5 more on that list who are NOT clients of theirs. nm
nm
Most of the clients don't allow their work
to be sent offshore because of privacy issues, Americanism, etc. The CLIENT decides.
some clients want those apostrophes
The two docs I edit for want those apostrophes there and you can find just as many reference materials that DO include them as don't.
I agree this is nothing that is going to affect patient care, but bottom line - you have to give the client what they want.
MTSOs cannot pay more than they get from clients
If the clients are only paying 10-12 cpl, you cannot expect them to pay you more than 8 or 9.
The only way to get decent pay is to get our own accounts and cut out the MTSO.
Then your MTSO would have NO clients
Overrated you say? If you saw some of the hair-raising mistakes we have to clean up on a daily basis you wouldn't even THINK about doing away with QA because the people you work for wouldn't stay in business.
How about the MTs who are too lazy to look things up and use QA as a reference source. I know I send feedback to the same MT over and over again without seeing any improvement. That is frustrating and a waste of my time.
I was an MT for 35 years before I became a QA person. I had a lot of experience and a lot of knowledge and felt, (very naively I realize now) that I could actually HELP people. But the MTs don't appreciate the help. They just want us to clean up their work and be quiet. If we send feedback we get blasted by the MT instead of being thanked.
I personally got into QA to help people. Boy, have I been disappointed. This is the most thankless and difficult job in the transcription business. Thank you for reinforcing that point.
I am so glad that I have wasted 38 years of my life trying to help people who just want to use me as their whipping boy.
So yeah, do us a favor, get rid of QA. What a waste we are trying to educate and help people. How dare we?
I personally give up. Do your own research and find your own answers. Don't bother me anymore!
It's not KS's VR. It is the clients and they have had that account for sm
several years. The lines are all counted and the rate is the same as my normal rate. The reason is that it takes a lot to edit these reports and they know that. This is not new for KS.
For those that said they do not do VR, they must not in their department or accounts, but there is VR with KS. They have a lot of Powerscribe accounts for radiology and a few VR accounts for HIM already and have for a while now. The pay is good and has not gone down. I am at 9cpl and happy but the VR editing does take as long as straight transcribing.
That 9.9 cpl is what they are charging their clients
I clicked on that link. It's completely an off-shore based company. The 9.9 cents is what they are charging the health care providers. That's only possible if they are paying 1 to 2 cpl for the workers.
So what are you going to do when "your clients" (sm)
So what are you going to do when your clients decide that they want to pay you anymore and go with someone cheaper? It will happen to you, too!
To any visiting clients
The opinions expressed on this board represent only a fraction of the MTs that may be servicing your accounts. As an MT who is proud of the MTSO for which she works, I apologize for the appalling Jerry Springer-like antics of this chat board and wish to assure that most MTs that I work with are thoughtful, hard-working professionals who do know the difference between venting a frustration and turning into an ugly mob of pitchfork-carrying villagers. Though I defend their right to an opinion no matter how churlish and embarrassing it is, I also assure you that there are still MTs working on your dictation who realize that there are live patients who depend upon us. I just thought you needed to hear this.
To any visiting clients
I agree! I appreciate the company I work for and am happy to have a job.
There are 4 new clients starting over the next month....sm
One of which will need 120 transcriptionists. That's whassup! 
If you have your own accounts and clients you can make that much $$$$. nm
x
What your boss charges clients isn't
your business. Your agreement is what you are paid for your services.
Fine, You try telling your clients that and let us
know just how long you stay in business. :)
In other words, you do it first and if you are still in business 5 years from now maybe others will do the same.
There are clients out there who do not agree with "offshoring" and want only USA and will pay
That is all I have to say about the issue as this frustrates me to no end. USA all the way or bust!
No, they have just brought several new clients on and are hiring a
bunch of new transcriptionists for them.
If you're contacting clients ...
maybe they'd be interested in the following.
Extortion threat to patients' records
Clients not informed of India staff's breach
http://www.sfgate.com/cgi-bin/article.cgi?file=/c/a/2004/04/02/MNGI75VIEB1.DTL
You don't think the clients aren't aware of where
their transcription is being sent? My doctor (a major health system in Michigan) bragged about how cost effective it was for them to send their dictation to India, until he realized I was an MT. The bottom line is the almighty dollar.
Your clients can use any zip - unzip software they want...
MPTools creates standard zip files, so you clients don't need MPTools to unzip the reports. They can use anything they want.
I was told that they use ChartScript, or at least 1 of their clients does. Do they use
s
Not many people have control over their clients!
If you are in an overflow situation, where you have people who work for the hospital and who work for a service - the people in the hospital get the work first.
The options that a company has is to only take full outsource contracts, but sometimes that is not feasible.
It is frustrating for all concerned.
I think the Plan is that those clients will have a choice of - sm
either Indian or US transcription. Still, I think some of them will not trust their records to a company that at least in their minds might, just MIGHT, either purposely or accidentally send some of their dictation to India. And that could result in a legal problem for that client. Look at how WE are all reacting to the word India when we were told this was the bulk of this company's makeup. (In fact, where this company started.) We've all been stung either directly or indirectly by this outsourcing problem, and have seen a lot of dishonesty in this business so far. So of COURSE we're not going to trust them, as we've seen too many other MTs lose jobs because they can't work for 3rd-world-wages and still live in the United States. So I think you are right, and although the main part of the plan to be hybrid and contain both Indian & US transcription sounds pretty good, I think that even if it's an honest, workable plan, it's gonna take a long time to convince both the clients AND the US MTs who transcribe for them that this will work.
Key word here is 'current clients'
So, then as a member of management, would you say that 'future' clients will have the same USA-based requirements?
Most people on the board know to take comments posted here with a large grain of salt.
I'd like to see a copy of a letter sent to clients ...
The letter would explain to the client/doctors that MTs work from homes all over the country and we may not know the names of streets, towns, landmarks in their communities. The letter would explain how docs and MTs could both save time if the doc would move his/her lips when speaking, and would speak at a reasonable volume and pace -- not super-fast, and not stop and go while shuffling papers and talking on cell phones. The letter would describe (in a sweet, informative way, of course) that MTs are real human beings and that dictation is not transcribed by magical machines on the other end of the phone line. And then, I'd like to hear all the docs say, Thank you at the end of their dictations and say, If there's anything that I can do to improve my dictation technique, please let me know, and actually mean it!
yea and just wait until the clients find
out that they are not using the US staff that they claimed they would be using on their accounts.
You get what you pay for; I've gotten someof my best clients
hunters' come crawling back on their knees after they found out what you DON'T get when you go with the lowest bidder: QUALITY.
While it is true clients can set forth when the work is available
This particular ad stated these are straight shifts and not flexible. That is a no-no in IC, IMO. They can say when work is available but can't dictate what hours you work, period.
Clients want to pay less; MTSO decides how - cm
to make it cost the client less.
These are the same players who in the 1990s had a profitable MTSO and sold it to MQ. It was a now what happens? reality for everyone left behind. I think the only thing different this time around is that they are still trying to line their pockets even more before they do it again, before their own retirement.
If they did it before, it's delusional to think they have any conscious about NOT doing it again. They want us to be loyal to them, but I see history being repeated, albeit by ripping off the bandage more slowly, so I ask, why?
Some clients (in ALL types of business) are so bad that
*
To any visiting clients - the opinions SM
you are seeing come from years of being treated badly by the companies you sign transcription contracts with.
We are treated like indentured servants. Every year, our benefits disappear or cost much more. Every year, we are not only not given any kind of a raise in pay, but we are forced to accept pay CUTS with little to no notice given by our employers.
Part of the responsibility for this mess is in your lap also - for demanding that services provided to you come cheaply. Would you demand that your own employees suddenly be paid 1/3 less for a portion of their jobs? What would happen if you did?
If you're feeling really bold, why don't you experiment with that concept? Ask your nurses to be paid 1/3 less for the portion of their job that requires paperwork, for example. They aren't providing direct patient care, so that portion of the job should cost you less, right?
Tell all of your employees that you will no longer offer direct deposit for their paychecks. Then tell them that they have to pay $25 to have their checks FedExed to them or depend on snail mail for free. How well do you think that would go over?
Just a slice of what we MTs have to accept every day.
Trying out the VR systems sold to clients..sm
with false promises, demanding from MTs to achieve
600 lines per hour with a pay of 3 cpl,
does this not strike you as being used as a 'guinea p*g'?
Equal to the Indian MTs?
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