How the Transcription system works and what are steps involved.
The system works through the Internet. Typically, the various steps would be as follows:

The Physician creates a voice file by speaking through a dictation   platform.
Voice files are sent (uploaded) from the doctor's office to be received   by us. The transfer would depend upon the choice of dictation   platform. If needed, we would provide the necessary guidance in this      regard.
Voice files are received (downloaded) and transcribed by us.
Document files are sent (uploaded) from our office to the doctor's office through the Internet.
Document files are received (downloaded) at the doctor's office.
A printout of the document files is taken for filing and for any other   required use of the doctor/facility.
Files are stored on the computer/backup computer to maintain the   record in electronic form. Also, a backup on a CD could be taken as a   safeguard against possible hard drive crash, data corruption etc. If   needed, we would guide how to maintain records for easy retrieval in   the future. Alternatively, we could maintain the record for the facility   for a small charge and would send you the records as and when   needed. In any case, we would maintain the records at our end for a    month free of charge and would provide copies, if needed.

MSPL commits to the quality standards set by the American Association of Medical Transcription (AAMT) and utilizes the AAMT scoring process of variable point deductions depending on error type. Each type of error is totaled by the number of incidences and deducted from the 100-point beginning. A report with 2 Medical Content errors (1 point each) and 1 Punctuation error (1/4 point) would have 2.25 points deducted from the initial 100 for a final score of 97.75, below the MSPL guarantee of 98.


What are the advantages of outsourcing Medical Transcription to MSPL
India has emerged as the preferred global destination and the hub of IT Enabled Services and offers following advantages:
 A virtual 12-hour time zone difference between India and USA offers   cost and time savings;
Cost due to large availability of low cost manpower;
Quality advantage due to large availability of skilled manpower
 A huge pool of English speaking and computer literate graduate   workforce who can continue to cater to the growing demand of   professionals for IT Enabled Services;
With more than 115 ISO 9000 certified and four SEI Level 5 Software   Companies, India offers the ultimate quality advantage with relatively   less costs;

What would be the dictation platform
There are various options that are explained below:

1.Toll free service: This service can be made available on specific request. Doctors would pick up the phone and dial a toll free number for dictation and the files are automatically transferred by the company using 128-bit SSL encryption

2. Dictation System: There are various companies in the market supplying the dictation system, viz, DVI, Lanier, Crescendo, Winscribe etc. The cost of such a system should fall in the range of USD 5000 to USD 20000 depending on the number of ports, i.e., how many simultaneous users accessing the system. These are all good companies and their systems are widely used in the business and are successful. The option is convenient but high on upfront cost and low on running cost.

3. Hand held recorders: There are various digital recorders available in the market that cost anything between USD 200 to USD 400. The weight of the recorders is between 1 to 1.5 pounds and can be easily carried, allowing the flexibility to dictate. The voice quality is good. The option is convenient and also low on upfront and running cost.

4. Dictating on Computer: There are some shareware and some paid software available in the market whereby you can dictate on your PC. The voice quality is inconsistent, as one has to be careful about the distance of the mouth from the mic. Too far may make the volume very low and too close would make the voice blurred. The option is low on convenience but also has insignificant upfront and running cost.

In our opinion, handheld recorders would be a good choice in the present circumstances.

What is the security of the patient information
The security of the files is an important aspect, especially with new guidelines of HIPAA (Health Insurance Portability and Accountability Act), and as such security features need to be implemented to avoid misuse of patient information at:

a. Doctor's office: The commonly used security features would be restricted access and to authorized personnel only, encryption, firewalls, non disclosure agreement with people authorized to handle the files etc.
b. Transcription Company's office: Same as above.
c. In transit (between the two offices): To save the files from potential hackers and their misuse, one could either encrypt the files for transit by using encryption software or there are internet courier services available whereby the files get encrypted as they are uploaded and decrypted as they are downloaded.

What is the quality assurance procedure followed at our end
At the first level, the transcriptionist would transcribe the file and then would recheck for any errors. At the second level, quality assurance personnel would check for any errors and would produce an exportable product. At the third level, a doctor would randomly check about 25 percent of the files. Also, a doctor and a language specialist are available at all times to sort out problems at all levels.

How to Start
We would need to know what would be the average volume of work per day in terms of number of lines to start with and if everything is smooth how it is going to grow and up to what level. Would we have some choice in determining the timing of increase in work. It would help us in planning the start and scalability need of our facility here.

Once the work is about to start, we would be requiring the following information also.
1. The list of the physicians connected to the hospital/clinic.
2. The list of the physicians frequently referred.
3. The list of the departments in the facility.
4. Yellow pages/zip codes of the area. (we can also buy ourselves)
5. Patient schedules.
6. Sample files for all the physicians for all work types so that we can read and prepare notes
7. A document addressing all format-related issues, e.g.,
a. What should be the spacing between the paragraphs
b. How do we transcribe Allergies, i.e., in bold, CAPITAL BOLD, underlined, or as simple text.
c. Any physician-specific instructions
8. A list containing the names of the restaurants, entertainment spots, road maps etc. if possible. (we can also buy these ourselves)

Start using Macro Transcription Services

Why use Macro Transcription and Billing Services
Assured Quality Standards complying US benchmarks

We use a six point quality check and a multi-tier quality assurance system in order to ensure that your documents are transcribed accurately and quickly. Our standard quality policy is derived from the AAMT policy and we deliver an accuracy rating of 98. MSPL guarantees quality levels of 98 or better for transcription accuracy. In addition, we warrant:
 Transcription documents will contain all required components and   information including Headers, Footers, and Dictation body.
Transcription reports will have the proper structure, format, content,   spelling and grammar.
Transcribed reports will accurately reflect the meaning intended by the   dictator, yet may be interpreted and edited by the transcriptionist in   accordance with particular client requirements.
Transcribed reports will be created according to AAMT's Book of Style,   unless client has specified differently.

MSPL commits to the quality standards set by the American Association of Medical Transcription (AAMT) and utilizes the AAMT scoring process of variable point deductions depending on error type. Each type of error is totaled by the number of incidences and deducted from the 100-point beginning. A report with 2 Medical Content errors (1 point each) and 1 Punctuation error (1/4 point) would have 2.25 points deducted from the initial 100 for a final score of 97.75, below the MSPL guarantee of 98.


Quality Assurance Procedures

MSPLincludes quality assurance editing as part of the contracted line fee. For new clients, 100% of jobs are fully edited by our knowledgeable QA editors until grades of 98 and higher are consistently achieved on all report types. Our experience shows that two weeks of 100% editing are usually sufficient to achieve dependable, 98% results. Grammar, punctuation and medical terminology are included in QA editing. Account Specialists verify formatting and report types. MacroScribe® software features include:

1) Bookmarking the location of voice file questions
2) Listening options for QA editors and
3) English language, medical and pharmaceutical spellcheckers to assist the accuracy of our transcriptionists and QA editors.

Cost Advantage
India has emerged as the preferred global destination and the hub of IT Enabled Services due to large availability of skilled and cheap manpower and leveraging this advantage MSPL can deliver an average savings of 30% over other transcription strategies. Our technology and outsourcing model gives you incredible efficiencies compared to US based solutions. Also you can make huge savings on your capital expenditure on setting your own transcription facilities.

All our billing is standardized with AAMT standard of 65 characters per line. Alternative billing standards can be decided upon depending on volume and type of the transcription work.

Turnaround Time Advantage
Having our production facilities in India we have a virtual time difference of 12 hours, leveraging this advantage the receipt of transcribed reports will adhere to contracted turnaround times which are always less that 24 hours and can be made available faster for critical reports.

Safety and Security of Data.
MSPL has developed its infrastructure, hardware and software architecture with security as a primary requirement. Redundancy has been engineered across all systems and products to ensure 100% uptime. MSPL's backup methodology includes daily full backups of all ASP servers. Our complete security systems and routines have been reviewed and engineered by industry consultants as well as MSPL staff. Security systems and procedures involve many areas including:

Physical security to computer room and it contents
Server security and administrator rights
Network security and firewalls
Web Security, encryption and access limitations
Disaster prevention and recovery


HIPAA
MSPL was specifically designed and engineered to meet the rigid standards of HIPAA compliance. We have built-in controls for security and auditing. Start with dictation, we audit who listens, transcribes, edits, views and signs. Printing and faxing audit trail details include user ID, workstation location, printer ID, time and date. With in-house transcriptionists all working on the same platform, transcription managers have unprecedented audit and user control. Finally, a system that recognizes your need to know and automatically creates the history of each transaction so audit reports of your staff and MSPL's staff are on-line and ready.

Security safeguards include VPN, triple DES Internet encryption, redundant system architecture and ASP center security for servers, networks, firewalls and computer room entrance. Disaster prevention and recovery is ensured.




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