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I am a small MTSO and also IC'd for another company a couple of years ago and something similar happened to me.  However it was probably a little different as I did the pick-up and deliveries although I was an IC for the company.  When she did not bill the clinics so that I could not get paid, I knew the clinics and so I went to them and told them that after a certain date I would not be doing their sevice because I was not being paid -- a little different than your story but you can also let the clinics know how that service is being run.  Again, only after you write your calm, fact filled letter.  But if someone threatened my business with anything like that - going to my accounts -- they would be paid within 24 hours.   Reputation is what counts in this business.   But again, just write to them calmly and with the facts asking them to prove that you had signed a contract, then giving them 48 hours to produce such contract or send you a check for your services or you will see them in court.   Again, I would threaten to go to their accounts to let them know how they run their business but only as a last resort.  But just do it, write them you deserve your money.   Was there problems prior to quitting and that is why you just left suddenly -- I know this leaves them in a lurch but if they were a crummy company they probably deserved it.  Also if you did not sign a contract stating you would not go after any account you worked on for two years go for the accounts. 

my hospital's TAT is between 24 and 48 hours depending on type of report.  When I worked in-house, it was from 2 to 48 hours, with Op notes/HP having a 2 hour TAT.   I think it varies a bit between hospitals, but as a general rule most reports are no greater than 24 hours. Sometimes discharge summaries have a longer TAT, such as 48 hours.   I don't have any experience with VA hospitals, but they probably aren't much different.  

I am an IC for a small MTSO.  I have a deduction taken from my invoice every pay period for renting Transnet equipment.  My foot pedal broke and I asked urgently Monday morning for a replacement foot pedal to be Fed Exed to me - work was on the system and needed to get done.  Well, after many many phone calls and e-mails I got the replacement foot pedal via Fed Ex (they shipped on Friday) on Saturday morning.  So I worked all weekend to get caught up on a whole week's worth of work.  Got my invoice yesterday (late - the MTSO has rescheduled their payment schedule as they are not getting promptly paid by their clients - the ICs had to accept the new payment schedule or quit).  There was a deduction for $40.13 for delivery fee for the foot pedal.  The Accounts manager says that "many memos" have been sent out that ICs are responsible for delivery fees.  Huh?  I looked over the memo I received about Transnet rentals and it said our invoice deduction covers maintenance costs for faulty equipment, etc. (the MTSO had originally said I would be billed for a new foot pedal - then I brought up the memo on rentals that covers faulty equipment and that got dropped pretty quickly).  I told the Accts manager that postage is the MTSOs expense, just like it is my IC expense to return the faulty equipment to the MTSO.  I also mentioned that the MTSO pays for phone charges to fax stuff to ICs; likewise the ICs pay for their phone charges for faxing to the MTSO.

What would you do?  I am so fed up with this MTSO...I don't make that much money on Transnet anyway (most of my lines are from microtapes) that I am tempted to just tell her to take all of my doctors on Transnet and quit doing these willy nilly deductions without my approval or knowledge.  This is the third time the Accts manager has taken "deductions" from my invoice without telling me - the last time was for Chicago taxes on rental equipment (totally illegal according to Cook County govn't) - that took 2 weeks to get straightened out!  Arrggghhh!!!

if an MT is directly contacting my client and I would appreciate the tip that I could follow up on.  A good MTSO will be able to handle the situation in a way that would not result in you being in the middle.  Perhaps the MTSO could approach the MT and simply say that the client said that they were contacted by one of the staff about whatever the topic may have been and to no longer make direct contact with the client. 

I wouldn't necessarily say it's none of your business considering that the job you hold is your bread and butter and if your coworker says something to the MTSOs client that could jeapordize the MTSO/client relationship, that COULD affect you, so I believe you have grounds to speak up.

I am a small MTSO that has two part-time IC's and can only pay them 0.85 cpl to 0.9 but because of the account they can make $45 an hour.  Again, I stress to me it is what I can make an hour.  But it is a psych account, I pick up tapes, meet the gals, and then they have 3 days to do the reports which are long, 10-12 pages but I developed so many templates that they can do them about 60 to 75 minutes.  They E-mail to me and I E-mail the reports to the docs.  We pick up on Thurs, and they have to have to me by 10 on Tues.  My other accounts they sometimes help me with but again I can only pay .85 to 9.  Again though they can make $25 an hour which I don't feel is bad pay.  I just cannot charge the docs more than I do at 11.5 to 12 cpl.  They pay on time, never a bounced check and appreciate what we do so I feel we all benefit.   Also they have been loyal to me and my psych account has been with me for over 16 years.   See what you make per hour. 

That is my Saturday 2 cents worth for the day.  If any typo's cannot find my glasses so sorry if there are.   Patti

I'm a student MT, and I'm curious as to what the difference is between a MTSO and a Sole Proprietor working as an IC from home? Right now I am writing a business plan as part of my MT Program, and I am trying to sort this all out.

Also, I saw a post below talking about digital dictation and paying for FTP site service, is this an expense necessary for ICs or only MTSOs with employees? How does an IC usually download digital files from the client?

I've been a Transcriptionist since 1990, starting out transcribing tapes into my IBM Selectric from home so I could raise my then 4-year-old daughter as a single parent.  The industry has been very good to me and I'm very proud of the fact that I was able to make a good living in as an MT all these years.  And as I said, I used to be opposed to outsourcing - at least until I really started looking at it, asking around, talking with people.

Outsourcing transcription work isn't any different from bringing in people from Belize and Honduras to clean hotel rooms - Americans don't want to clean toilets either, not any more than they want to work overnight typing.  The companies who do not outsource will go out of business for several reasons, all of which are OUR fault -

1.  People don't want to work overnight or weekends but it's a 24/7 business.
2.  The quality of new transcriptionists coming out of school is, for the most part, horrendous as is their work ethic.  In order for it to be cost-effective to train newbies, companies will have to make sure they're up to speed quickly and most trainees aren't willing to do that because the schools have told them they can make a ton of money right out of school, even though they aren't qualified to type a prescription, let alone a legal document.
3.  MTSOs still have to provide quality work for a lower price than the next guy to their hospitals; it's not that they don't care about the quality, it's that the hospitals are squeezing them for lower costs, just like everybody else, wanting to get more for less.
4.  The offshore folks are willing to work and work hard.  Yes, the MTSOs have to spend more time reviewing the work, but at least the work is getting done within turnaround.

Now, we all have a decision to make.  Me?  My decision is to work when the work is there, not when it's convenient for me and do my very best to make sure my quality is better than anyone else so the company won't be able to say that I didn't do what I had to do to stop the need for offshoring.

What about you?  I don't post to these forums often because I'm too busy working.  Seems like you all have a lot of idle time with your hands to post here - maybe you should work more and then there'd be less to offshore.

I used to be MTSO of my own company and in my best year I made almost 6 figures (gross).  I had 6 MTs subcontracting for me.  I paid them 2/3 of what I made as I felt they were worth it but I still worked 7 days a week, 12 hours a day with no vacations and worked every holiday.  When we did our taxes that year I made $30,000, divide that by the number of hours I worked and it was minimum wage. For that money I could have stayed in corporate America, had paid time off and weekends off.  I should have gone back to school then. It ruined my health, I had to have surgery, closed the business.  8 years later, I keep making less and less.  The company I work for just lost our acct to someone cheaper and the hospital did not even give her notice.  We are done tomorrow.  I go back to college in January. I've had enough.

Personally, I would not hire anyone unless they could transcribe the hardest dictator I had. And that is at LEAST two years of acute care experience.

I think the expression is, "burned once, twice shy." 

it takes a lifetime ++ to know it all.  The medical field is far too vast for anyone to ever know it all.  One can be in this business for 25 to 30 years and still not know it all.  I do believe, however, that a successful MT will do what he/she does best.  I know a lady who has been doing op notes for 30+ years, and she is very successful; but when it comes to the off-the-beaten path of op notes, she would have to stop and do some research.  I also have a relative who has been in the business since 1965, doing a wide variety of clinic notes, and you couldn't out clinic her, no way!!!  She has recently gotten into procedure notes - does them like a charm! 

On another note, these 2 ladies have done the good, the bad, and the ugly, but they have had enough sense and experience to stay away from those places that dish up nothing but the ugly and ugliest.  We all know they're out there, and there is no living to be made on that stuff!

that the people who answered my ads for help were people I would not have transcribing my work.  I found very FEW good MTs over the years.  The fact is, there are a few cream of the crop and a lot of duds.  Computers/spellcheck/Google searches have made it easier for not so good MTs to be able to fudge and get by.  You used to have to KNOW the stuff or it was abundantly evident.