I must have a really lousy account.

It sounds awful, I know.  But you've just got to TRY to get past that uncomfortableness!  If you don't speak up for yourself, no one else will.  Don't sign that contract.  Call them up and tell them you need to raise your line rate.  Raise it a reasonable amount, and stick to your guns!  I know it's scary, but there are a lot of places out there hiring if your current place is going to walk all over you.  Good luck!

you use numerals for all numbers (and the old way is to spell out numbers UNDER 10).  The BOS says to use numerals for ordinals; 10th, 2nd, etc.  BUT, many accounts have their own preferences, so why don't you check to see what yours wants?

My own accounts been doing them for over 4 years, it is just one office person that says anything.  I think that she was having a bad day last week and we about went on a minor screaming match with each other not only over this but some other things.   So will let things calm down, check and double check to see if I can figure things out but without showing me, I am in the dark like I explained to her.  When nothing comes back you think all is great.  

separate folder on Word and I just click on the appropriate folder. I do 4 hospitals in one state and two more, plus a local.

I never have gotten anything mixed up that I know of.

You should never work for only 1 company.  I learned this the hard way.  It's always good to have a backup.

I took a small account a few months ago. 3 docs, I do 2 and 1 has his own MT. She is an employee but we cover for each other for vacations. It is lucky they have that other person and they are flexible when I go away (rarely). Some accounts might expect you to find your own coverage. I have had problems with them not paying on time. It's not their fault, they have a large institutional accounting office over them. But MT is my only income so it has been a problem. Make sure you have a cushion in your checking account or whatever that you can live off of if you don't get paid for a while.

Another option might be an IC position if you can find the right one. I also have an outside contractor position with a local hospital that has employees, but I charge them like a service and they make no demands on my time.

Something to consider is how much time you will spend doing administrative things like billing, recordkeeping, marketing, answering emails, picking up tapes if applicable, traveling for interviews or training if you will be working on their system. I find that stuff eats up a lot of my time.

You might want to consider a 30-day trial period in case you dont like them. My account turned out to have a crappy dial-in system, they expected me to fax every report 1-4 times, and they eat up my time with emails and phone calls - each doc has his own secretary and they have another MT and they all tend to call me for things they don't need to bother me with like I'm an employee. Instead of telling them to find one person to deal with me we agreed I would charge by the hour instead.  I have no problem telling a secretary who calls me at 7p I will take down the info and call her back during business hours unless it is an emergency. It is hard to anticipate those things hence the trial period.

I don't think my account now is any better or any worse than any others.  I have been doing this for over 15 years and basically 2000 lines a day has been my average for the last 9 years and during that time, I have worked in house for 1 hospital and for 4 different agencies. 

I just make good use of a lot of word Expanders and sit down and work and not answer the phones and talk to people and watch TV, etc.

 Boy this sounds just like an account I used to have.  I would go pick up the tapes- “Oh the Dr did not dictate”  or “ Oh the Dr took the tape home”.  They never gave me a list with names.  I was always searching my database for the last names, etc. They did stress tests and never marked the names down so when the machine was running and the Dr would say the name, I would get the first or last name, once again, I would have to search my database.  I did this for about two years and asked about 5X please list everyone that comes in, etc on the list. They would do it for a day and quit, so I just left the name blank and did not care any longer. Obviously, they did not care to get me the information.  Oh yeah, I ever called the Dr 2x and asked her to please help me out and talk to them. It lasted 2 days.  For the tapes, I go so sick of driving and wasting gas, I called 15 minutes before they would leave to make sure there was a tape. I did this for 3 years and decided enough is enough.  I gave my all to the job and did not give 1%. It was not worth it. Some offices have no consideration of the transcriptionist.  They think this is not a "Job"-guess again-It is a job where we barely make money and then they are taking what profit we do make- I would try talking to the Dr and calling before hand.