What does HITECH act have to do with errors in reports?
Posted By: Thought that dealt with privacy issues. nm on 2009-09-24
In Reply to: HITECH ACT for starters - ChiquitaBanana
nm
Complete Discussion Below:  marks the location of current message within thread
The messages you are viewing
are archived/old.
To view latest messages and participate in discussions, select
the boards given in left menu
Other related messages found in our database
I have seen glaring errors too in past reports sm
and yes, they are growing rapidly. I know that I had very little QA when I started (not a full 2 weeks more like a full 2 days). I have always been fast off of QA and I think my longest lasted 2 weeks, but that is me. I am not afraid as I type, but I do watch myself.
Like anywhere, some of the QA people are better than others. I have one at TT who is a real stickler, but she will quote me a page from the BOS so that I can learn what she is talking about. I have had such poor QA over time I really need this at times for some of the minutia and I DO mean minutia. That she is paying such close attention makes me feel I can learn from her (and I have and do) for a long time to come.
I have actually seen far worse errors in old reports from other companies in the past. Not all of us are as capable or as careful as we could be, given time and attention from someone who knows how to teach us. I don't think this is TT's fault, I think this is industry wide. Many MTs just care about the almighty buck and not about the finer points of being an MT. It makes us all look bad, but please don't single out TT as the worst. I have been around far too long not to know that MOST companies have worse problems.
I reported 2 reports with errors and it turned out
that it wasn't done by a TT employee. At least some of the hospitals have their own employees and TT just does overflow. Yet we can see these reports done by non-TT employees. I believe TT hires some of the best MTs I've ever worked with. Other places (especially where I was a hospital employee and also MQ) the quality was very uneven. That is, some MTs were brilliant and some had the English skills of a 4th grader.
HITECH ACT for starters
Have you been keeping up on the laws that are going to start in Feb 2010?
Granted, the excerpt below that I took from the MT Herald speaks of transcriptionists off-shore, it is applicable to transcriptionists ON-SHORE as well.
As you might be knowing that HITECH act has given more teeth to HIPAA with heavy penalties and imprisonment for “willful neglect” and “non-compliance.” The penalties range from $100 to $1,500,000 per calendar year. Apart from these civil penalties, criminal punishments could include imprisonment up to 10 years. All these come into effect from February 18, 2010. Furthermore, HIPAA regulations insist that compliance means “a not do once and forget issue” but an “ongoing dynamic process.” In case of a breach at your end even if you are a medical Transcriptionist offshore, the octopussy hands of HIPAA could narrow down on you through the onshore covered entity/business associate and depending on the intensity and repercussion of the breach and depending on the treaties existing between the US and the offshored country (say like the India-US Extradition Treaty).
Have any MTSOs said anyting about the HITECH Act?
If you think you are micromanaged now, just wait until the HITECH Act (Title XIII of the American Recovery and Reinvestment Act) goes into effect for all MTSOs on February 17, 2010. President Obama signed the Health Information Technology for Economic and Clinical Health (HITECH) Act as part of the Stimulus package on February 17, 2009, and the MTSO requirements go into effect in February of 2010. This concerns Protected Health Information (PHI).
AHDI had a PowerPoint presentation at its Convention (the link is below or search for “HITECH Act MTSO” if it does not work for you). I just picked out some of the highlights as pertains to MTSOs and, ultimately, the MTs that work for them.
http://www.ahdionline.org/portals/0/downloads/ACE09_PowerPoint/ScottEdelstein.pdf
Page 3
Transcription Industry at Crossroads
*Image tarnished
-Transparency
-Accountability
*Relevancy
-EMR
-SR
*Increased regulation
Page 7
New HIPAA
*Before 2/2010 – Does not directly apply MTSOs
*Effective 2/2010 – Applies directly to MTSOs
*Requires healthcare providers to take certain actions when entrusting medical information to vendors (outsource firms, etc.)
Page 8
Business Associate Rules
*General Rule: Covered Entity may not disclose PHI to a business associate without “satisfactory assurance” that the PHI will be appropriately safeguarded
*Satisfactory assurance requires a written contract with specific provisions
*If Covered Entity learns of breach of privacy provisions of contract, it must take reasonable steps: cure breach, terminate or report conduct to HHS
MY COMMENT: If you are an employee or IC working for an MTSO, they will be in your computer constantly to upgrade security, make sure you have the latest anti-virus software, and make sure you are not accidently saving any “unauthorized” information.
Page 9
*Business Associates directly subject to HIPAA (new)
*Business Associates include MTSOs, HIEs, RHIOs, HER/PHR vendors
Page 10
MTSO Safeguards to Look For
*Secured data center
*Audit trail for access
*Automatic document destruction
*Control over home-based personnel
MY COMMENT: “Control over home-based personnel.” What the heck could that mean?
Page 13
New Security Obligations for MTSOs
*Implement written policies and procedures to address each administrative, technical and physical safeguard standard
*Implement a security awareness and training program for workforce members
*Designate a security official
*Conduct an “accurate and thorough” security risk analysis
MY COMMENT: “Security awareness and training program” and “security official.” Are they going to install Spyware and track every keystroke we make and every website we visit?
Page 15
Restrictions on Sale of PHI
*HITECH Act prohibits MTSOs from directly or indirectly receiving remuneration in exchange for any PHI
*Exceptions for –
- Remuneration paid by Covered Entity to Business Associate related to Business Associate’s services
MY COMMENT: “…prohibits MTSOs from … receiving remuneration.” They would not feel the need to put this restriction in if there had not been questionable sale or reimbursement for PHI information in the past. Better believe, thought, that EVERY MTSO will start charging for demographic information if they can, but will NOT pay the MTs for inserting that information.
Page 21
HIPAA Risks of Medical Transcription Systems
*Computerization enables storage of large amounts of data in small spaces.
*Networked information is accessible from anywhere at any time.
*New databases and different types of data sets are more easily created.
*Information is easily gathered, exchanged and transmitted.
Page 22
Enforcing Patient Privacy Overseas
*Injunction difficulties
*Damage award enforcement
*Jurisdiction issues
*Foreign attorneys
*Applicable law issues
Page 23
*EU Privacy Directive (10/24/95)
*Canadian Privacy Law (4/00)
*New Zealand Privacy Act
*Australian Health Privacy Guidelines (1/02)
*Argentina Health Privacy Law (10/00)
*India – No formal data privacy laws
*Other Countries
- Chile, Mexico, Paraguay, Peru, Brazil
MY COMMENT: India currently has no formal data privacy law and probably does not plan to have one soon. That could open up a whole new can of worms for the MTSOs who off-shore there. Will they stop using Indian MTs or simply move the headquarters to India and, thus, not have to deal with any of these regulations? Food for thought!!!
Page 31
Anti-kickback Statute
Scenarios
*HIM Director and his family receive an all-expense paid trip to India
*Paying hospital administrator a “consulting fee” to recommend MTSO
*Providing free PDA or laptop to Director of Medical Records
MY COMMENT: “consulting fee” Must be happening already or they would not specifically prohibit it. Wonder how that will affect current contracts between hospitals and MTSOs. There could be a major shakeup. Some MTSOs may lose and some may gain. Unfortunately, those that lose cannot continue giving work to employees with no hospital contracts.
Page 33
False Claims Act (FCA)
*Applies to any person or company that directly bills a Federal healthcare program (e.g., hospitals, ASCs, imaging center, nursing homes, physician offices)
*Also applies to Subcontractors that indirectly bill a Federal healthcare program (e.g., MTSOs, billing companies, coding companies, medical device companies, pharmaceutical companies)
Page 35
*Hospital pays Transcription Company/Subcontractor with Federal money.
*Thus, False Claims Act applies to Transcription Company/Subcontractor.
Page 36
Definition of “False Claim”
*A claim which the billing person or company actually knows to be false.
*A claim, the accuracy of which was deliberately ignored by the person or company making the claim.
*A claim, the accuracy of which was recklessly disregarded by the person or company making the claim.
*ADVICE – Check and double-check the accuracy of a bill for services prior to presenting it to your customers.
MY COMMENT: ICs are going to have their bills scrutinized to death.
Page 37
False Claims Act
Scenarios
*MTSO submits invoices with inflated line counts to hospital
*Ambiguous line definitions
*HIM Director fails to independently verify line counts
*MTSO bills for STAT when normal TAT was requested
MY COMMENT: “Ambiguous line definitions.” Sounds like the perfect time for MTSOs to say: “Sorry, due to government regulations, we are being FORCED to pay by VBC.” Or ICs that work for MTSOs may become extinct because the MTSO does not want to pay their billing company to double and triple check IC submissions.
Page 38
Penalties
*Between $5,500 and $11,000 per claim, plus 3 times the amount of damages sustained by the Government for each claim.
*The penalties can add up very quickly.
Page 39
Qui Tam Provisions of the FCA
The qui tam provisions of the FCA allow private persons, called “relators,” (a.k.a. whistleblowers) to bring civil false claims actions on behalf of the government.
Page 42
Other Legal Issues
*Labor issues
-Employees v. independent contractors
*Tax
*Healthcare reform
MY COMMENT: “Employees v. independent contractors.” Again, it sounds like IC positions may be in jeopardy.
Hope I am interpreting these changes wrong, but I have a feeling there are going to be some major changes in the Medical Transcription business in the next 12 months. Of course, they will never tell their employees what they are planning until they decide to fire all of us.
How to you interpret this information?
where they 35 comparable reports - or 35 short and 35 long reports? nm
x
Typing ER reports and radiologogy reports
are completely different with regards to pay. For typing regular reports, that is a very fine line rate. For typing radiology reports, it would be horrid.
Errors
Yes, they do deduct for MAJOR errors that affect patient care, not for minor mistakes. If you don't make major mistakes that you should make anyway, you don't get deducted. Duh.
more errors
that should read, major mistakes that you should NOT make anyway. duh. LOL!
errors
Well putting an 'a' or 'an' out of place IS an error, right? That's not nitpicking, it's QA!
There are errors in your posting
and whether or not it is only a law enforcement agency who can provide certain information with good reason...there are companies who can provide any information about you that you would rather be kept from public view without good reason.
Plus, how much will they deduct for errors? (nm)
v
Your'e right, the errors have been corrected.
It was written in a fit of passion after just learning that I lost my job, excuse me. I hope you are never put in this position and don't ever get emotional about losing your job. I am sure you can walk on water also.
Not sure about QA deducting for errors.
Not to toot my own horn, but my QA scores are pretty high so that's never been an issue. The time off isn't technically acrued like on a weekly basis or per hours worked, but you don't just get 2 weeks to take off a month after you're hired, if that makes sense. I'm not sure but I think you might be able to take 1 week after 6 months, something like that. I don't recall how the sick and personal time are allowed to be used in the first year, since I've been there almost 4 years. I'm certain a recruiter would be happy to answer questions along those lines for you, although I'm glad to help with anything else from my general perspective as a current employee.
Docking for errors
 Run for the hills. I think this is absolutely terrible. Tell them to take a hike and leave.
no backup on errors
With some of my QA feedback they are telling me it's wrong because it doesn't match the instructions for the client. The problem is, when checking the client instructions there is nothing in there about what they are counting me off for. For example: we are no longer to separate laboratory data or x-rays into their own category but to combine them with the ER course. I didn't do that because I didn't know that and I got counted off for it, but there was nothing in instructions regarding this. One QA said no big deal, another QA person counted off. I have tried to document and make notes to my supervisor about it, but all it gets me is more grief from the QA because apparently they are being told about it and angrier at me because I said something. I am not perfect and I have made mistakes they have pointed out, but some things I should not be and the QA should also be able to realize they are human as well and can make mistakes. I do QA at my FT job so I know how it all works, but it has to go both ways.
They do not charge you with errors while
on 100% QA so the score always shows 100%, They do make corrections in your reports if needed, but they don't count against you. Once you are released from 100% QA (I was released my second day, some still on 100% for much longer) they only QA 3% so most reports where only blanks are filled in your QA score will show at 100%, but it doesn't mean your monthly QA score is 100%.
Errors and omissions
nm
Errors have to be weighted, some
errors are bigger than others -- i.e. wrong medication transcribed or total phrases left out versus a word misspelled or the wrong punctuation, BIG DIFFERENCE that could be very detrimental to a patient if that report is the only one another doctor is referring to.
Did you catch the errors after you sent it
Or did the company call them to your attention?
You can always correct the errors and resend it, asking them to disregard the first submission if you caught the errors.
formula for check sent for errors on DQS
did anyone from MQ call to ask how their check amount for the errors in calculations on DQS work was derived at? i sent an email to the payroll dept in our region when I first got the check and she responded by telling me that she had sent it on to corporate and that they would get back to her on how to handle this. i get a call today from corporate and i was given an incomplete explanation -- IMAGINE THAT!! I was told that the average that they had obtained after taking a sampling of reports and coming up with the average was not going to be furnished by MQ to the MT. i requested from that person to find out for me why. it's my money and i want to be able to see how they came up with that figure. Why shouldn't I be able to have that info as it pertains to me and my money so that I can take my own number of lines and multiply it and come with hopefully the same figure. Need I explain that?? oh, and i was told that I was the only MT that had requested that information -- that all the other MTs who had questions about the check were satisfied with the answers that were told them. i told this person that i was tired of being told that I "was the only one" who had the problem and that no one else had brought it up. they try to make you feel like you're the only who has brought up such a thing and act like you're being out of line for doing so.
verbatim should NOT mean putting in errors: SM
As a QA, this is how I pass on the guidelines (and verbatim is usually requested by the client, NOT QA!):
Verbatim means: Transcribe what the physician says but correct obvious punctuation, spelling, and grammar errors - like "there is 3 moles."
Headings and exams are transcribed when and as dictated, not adding in headings, not changing PHYSICAL EXAMINATION: to OBJECTIVE:, "rearranging" the report, or changing an exam dictated in paragraph to block format.
You do not add additional words to clipped sentences in clinical notes. If the doc says "A 56-year-old patient," you don't transcribe "This is a 56-year-old patient."
If the doc says right leg in one place and left leg in another, a blank is left and it goes to the clinic for resolution.
If a medication is spelled and you can't verify it, it is blanked and goes to QA. If we can't verify it, it goes to the clinic for resolution.
Verbatim should NEVER mean transcribing errors like have been described here, at least IMO.
How do you keep from making small errors
Alright Transcriptionists, I need some advice. I am fairly new to the transcription world, less than a year. What I wanted to know is how do you stop messing up the little words, the non-medical words. Arrgh. It is not constant on my part, but every once in a while I cannot tell the difference of what the doctor is trying to say, but it makes sense either way I type it. Examples on words: on, in, of the, a, to (not any one combination of these words) I Google it and get just as many hits for one as the other.
I have no problem with my medical transcription, its those English 1-2 letter words. Sometimes I feel like I spend more time trying to figure that out than anything else in a report. 
Thanks for advice.
you don't make errors doing MT work with
i cannot believe that
every human makes errors.....
we get paid low enough as it is
They might dock your pay for errors. I'd ask if interviewing. nm
s
I know someone only getting 7 cpl for experience here, and I think they dock you for errors, but
s
keyboard sticking .. thus the errors!!
My apologies .. I am going to buy a modem and will get a new keyboard as well .. probably need an eye appt. too!!
Errors kill people
Most companies don't dock for simple errors, they dock for repeated major errors. You said you were a nurse, what would have happened if you gave a medication the patient was allergic to? It's the same with this job. ONE simple error can cause serious harm and to have a flippant attitude about it is extremely sad. What if that were your parent, grandparent, or child in that bad and the attitude of the person causing harm was oops.
They do not dock for errors. NEVER been cheated out of $$!!!!!
nm
Agree with below...too many errors were made
nm
Punctuation errors, not spelling
Didn't see spelling mistakes, but plenty of grammar/punctuation errors.
High producers have most errors ?? sm
I beg to differ on that one. Some may, but I have been the highest producer everywhere I've been. I have also been proud to maintain 100% accuracy at more than 1 place of employment while consisting producing 300 lines per hour. An excellent MT has a good ear, knows anatomy and physiology and has to look up very little and also uses their Expander to their benefit.
MTs who produce high volume but have many critical errors need reprimanded and watched closely. A good QA team and company wouldn't put up with an MT like that for long it would cost the company money in penalties in the long run if garbage was sent to the clients.
I went and looked; it looks like the page has some errors
I think the submit button must be down there on the right, barely visible and you can't read the writing on it.
I didn't use the online application; I faxed my resume in with a cover letter when I applied to them and got good results with that. If you have a fax available, I'd definitely recommend that approach.
It just sure looks to me like that page has web formatting errors or something.
I usually don't point out spelling errors but the one
x
Transam still charge for errors?
Does Transam still charge MTs for errors? They use to.
Transform charges for errors
HUGE 2nd on that one! I see errors that really scare me.
x
Wow, nothing urks me more than seeing errors on a website! sm
It is HIPPA or HIPAA? Do they even know what that is? Is it CONVIENCE or convenience?
I hate that I cannot even read articles without editing anymore! Sorry don't know anything about them but did check out their website.
I see errors on my OWN medical records and
so, are heads going to roll because of that? Someone typed in I had hypotension when it is really hypertension, someone said I had MRA done because of abdominal pain, never was abdominal pain. My mother was sent some wrong medication from the drug store and you think anything has come out of this?
It's one unit now and they no longer dock for errors. NM
x
Docking pay for errors is totally ridiculous!
With the way these doctors dictate (and some of them are really horrible), MTs don't deserve getting docked for errors. By docking for errors, you're forcing MTs to try and guess at things, which is much, much worse than leaving a blank. I'd never work for any company who docks pay for errors - NEVER. It's got to be the most absurd thing I've ever heard of in my life!!
Do they still dock for errors and how much? I will never work for a company that does that.
Not because I do not strive for high quality but that errors can be subjective. QA says it should be this way and docks me but maybe another QA would agree with me. So, who is right? That kind of thing. Nope not for me. I also wonder how much these companies end up cheating you out of money because they get the same price by the client, just they have docked your pay, thus more in their pocket. Whose to say they are not picky on purpose.
Would you work for a company that docked for errors?
If you make an error in a report, you don't get paid for the whole report.
Would you work for this company?
Only if it also docked doctors for dictation errors
HA HA
Further away you get from primary source, more chance for errors
But can you explain what you mean by true QA editing? Isn't all editing of VR true editing? Or are you QA'ing what has already been edited? Sorry - clear as mud I know. Hope you get what I mean.
laptop point and click errors
Think I'll go to law school and get rich on the point and click errors in medical reports. My doctor just joined those ranks and when I went in for check, he wanted me to get on an antibiotic, and I agreed. He pointed and clicked to his laptop, sent it to the pharmacist electronically and when I picked up my prescription it was for a seizure medication and not an antibiotic. They both start with a k. I thought the pharmacist made a mistake, but no turned out it was the doctor and his point and click was wrong. He was really upset when I took it back to his office for correction. More and more of this will be happening. Check your meds before taking.
Friend works there and says pay is often late. They may dock for errors, too. Need to ask. nm
s
They were docking for errors and still using a DOS program last year. Can anyone update this? nm
s
You are kidding, right? This is just riddled with grammatical and spelling errors!!! nm
The above poster is right. There are a few spelling errors so maybe that is the quality issue that
the MTSO is bothered by. I'm not an expert and this is not being negative, just an observation. Maybe it all goes with concentration, being tired, burn out and everything in between. I have been so exhausted at times that I could barely remember how to spell my name. You need to slow down and this is a from a former 60-80 hours a week worker. It is not worth it.
Like I said, this was when I interviewed in 2005. REpeated errors got your pay docked, not
s
|
