Medical Transcription At Home: Finding the Right Balance

April 14th, 2011

The Medical Transcription work at home trend has gained significant momentum in the past decade or so. It is a production model that has now all but replaced the traditional employment arrangement for medical transcriptionists. Most transcription is now outsourced to large MT service providers who employ hundreds and sometimes even thousands of home based specialists.

The benefits of a medical transcription at home career are obvious and compelling. They include things like:

  • Avoiding tedious commutes
  • Minimizing daycare expenses
  • Eliminating the need for expensive wardrobe upgrades
  • Enjoying the freedom and flexibility of working from home
  • Creating a personalized, comfortable home office environment
  • Finding time for daily life errands during work breaks
  • Having access to your own living areas for comfortable, stress free breaks

 However, as you take stock of the benefits of a home based medical transcription career, it is also wise to maintain some perspective on the potential drawbacks. In my personal experience, the positive benefits of working from home far outweigh the negatives. Nevertheless, it is important to approach any new career opportunity with your eyes open.

Working as a home based transcriptionist can have certain challenges. For example:

  • It requires careful planning to manage your work from home schedule around unexpected family or household emergencies.
  • You may be tempted to schedule parent teacher conferences, shopping, trips to the gym, or other errands during prime production hours.
  • A work at home environment can be distracting if you are not focused and motivated.
  • Well meaning friends, family, and neighbors can assume that because you are home you are available to chat or interact.
  • Friends or family may incorrectly assume that it is o.k. to drop off their kids for you to watch as they run their own errands.
  • Working at home can leave you feeling isolated.

 To succeed in any home based work environment you need to treat your work activities the same way you would treat a real job.  This is definitely true of the medical transcription career.  This means allocating specific chunks of time to uninterrupted MT work to ensure that you consistently meet your production, quality, and turnaround targets. You should plan to schedule breaks, errands, and any other non-work activities around your transcription work. If you allow these non-productive activities to encroach on your transcription time you will find that the stay at home opportunity that looked so appealing will quickly become frustrating, chaotic, and unprofitable - exactly the opposite of your work at home dream.

The time to assert yourself is at the outset of your new career. You should begin by developing a rigid schedule and post it for all to see – particularly family and others who may have a tendency to take your responsibilities lightly. Don’t be timid. Let people know that your top priority must be a commitment to earning a living and fulfilling obligations to your employer. As a medical transcription at home professional, this is never something you should find yourself apologizing for.  As you establish proper boundaries, you will discover that the benefits of a work at home career in medical transcription will far exceed the hassles and drawbacks.  With a little discipline, you will find that you will have the flexibility you desire when you need it most, while still protecting your professional turf.  It will be a win-win-win for you, your family, and your employer.

Posted in medical transcription |

Whither Medical Transcription Growth? MT Growth Drivers for the Coming Decades

April 12th, 2011

Historically medical transcription employment has enjoyed above average growth – surpassing the average growth rate for most occupations.  In recent years, however, technology advances and offshoring trends have contributed to  a moderation of growth in the medical transcription industry.  The question is rightly posed as to what the future holds for the medical transcription and healthcare documentation industry.

The following facts exist:

1. The most recent statistics from the Bureau of Labor Statistics suggest that there are in excess of 105,000 medical transcriptionists currently operating on a full time or part time basis in the United States – this doesn’t count any overseas medical transcription employment.  Some estimates put the count at a figure almost double the 105,000 medical transcriptionist government estimate. The BLS expects the overall industry job growth to continue to keep pace with or exceed that of most other occupations – particularly non-healthcare occupations.

2.  The BLS projects medical transcription to post an 11% overall growth over the coming decade.  An expansion of the active medical transcription workforce of 11% would equate to approximately 12,000 new jobs – at a bare minimum.  However, with natural attrition that figure could be far higher.   It is noteworthy to bear in mind that a high percentage of the most seasoned and productive medical transcriptionists will be retiring in coming years – consistent with broader demographic trends seen in the United States.  One of the most important things that the BLS statistics miss is the fact that it takes years of experience for a transcriptionist to achieve a peak level of productive capacity.  In other words, it is not possible to replace the production of a highly productive and efficient retiring MT with the capacity of a single new graduate.  The reality is that the BLS statistics likely underestimate the overall demand for medical transcriptionists in the coming decade.  This is good news for prospective MT’s and harder news for healthcare managers who will continue to struggle to keep up with surging demand and a persistent capacity imbalance.

In addition to the raw statistical projections discussed above, consider the following demographic, legal, political and social trends that will all converge to shape the medical transcription industry over the next several decades – primarily driving demand for healthcare documentation to higher and higher levels – at least until the end of the current baby boom cycle – at least another 25-30 years.

  • A continuously growing population – the population of the United States and the world continues to expand relatively unabated.  This US population growth rate may be significantly understated as a consequence of the rapid growth of undocumented workers entering the country each year.
  • A rapidly aging population attributable to an upcoming and ongoing wave of elderly baby boomers and advances in healthcare treatments designed to extend life spans.
  • Increasing pressure on healthcare systems and processes to continue to extend life spans and provide quality of life to the elderly and other segments of the population.
  • A rapid increase in chronic and age and lifestyle related infirmities requiring acute care and non-acute but continuous care.
  • A significant increase in the quantity of malpractice lawsuits targeted at the healthcare industry and its practitioners. The healthcare industry will continue to respond with more inclusive and detailed medical documentation reports to reduce liability and provide an important legal papertrail.  (Translation: longer reports, more documentation – not less, more reports – not fewer, higher volumes of line counts, etc. etc.)
  • A continuation of the current trend toward medical specialization. This will result in a single patient being seen by multiple specialists instead of a single general practitioner with each visit requiring an additional layer of documentation.
  • An acceleration of the movement toward electronic information documentation as a means of enhancing both the quality of patient care and the accessibility of patient healthcare information.
  • An increasing ability to successfully treat conditions and prolong life in previously terminal patients.

While it is true that some of the projected future demand will be siphoned off by offshoring organizations or mitigated by technology,  it seems clear that the supply-demand conundrum that has existed for many decades will only be accentuated in coming years.  The need for quality medical transcription practitioners should begin to accelerate again after a brief respite.

Posted in medical transcription |

Medical Coding Certification – A Medical Coding Career Requirement

April 11th, 2011

Due to the amount of regulation and scrutiny given to medical coding activities the need for Medical Coding Certification is greater for individuals embarking on a medical coding career compared with many other career fields. An entry level or advanced medical coding certification is typically considered a prerequisite for entry into the medical coding profession.

There are two national organizations that certify medical coders:

1. AHIMA – American Health Information Management Association
2. AAPC – American Association of Professional Coders

Both of these organizations provide a variety of entry level and advanced medical coding certification options. While an entry level medical coding certification will get you started in a medical coding career, in order for a medical coder to advance in the career field, it is usually necessary to gain advanced medical coding certification status. The medical coding certifications offered by both of these organizations are widely recognized and respected in the medical coding industry.  At this point, most medical coding work is still performed by medical coders working in hospitals or clinics. Medical coders work in a professional environment and perform a vital behind the scenes billing support activity.

There is a trend toward outsourcing of medical coding work to third party vendors. As this trend catches on, more medical coding work will be done in homes and it will evolve to become more of a home based career – much like medical transcription is today. As technology continues to evolve and highly secure and remote coding platforms are developed, the outsourcing model will begin to take hold in the industry. However, at this point most medical coding and billing is still performed in hospitals, clinics, and other healthcare facilities.

Posted in Medical Coding |

Medical Transcription and Healthcare Documentation Industry Publications and Professional Journals

April 8th, 2011

For those contemplating entry into the medical transcription career field and for experienced transcription practitioners alike, there are a number of outstanding publications focused on the medical transcription industry. These publications contain insightful articles about the profession and serve to keep the community up to date on trends affecting the industry. If you are serious about your career you should make it a practice to subscribe to a few of these medical transcription and healthcare documentation publications to stay abreast of changes in the industry. They also offer a great opportunity to network and become aware of job postings and opportunities. Some of the best publications include the following:

Plexus is a bi-monthly publication of AHDI, the Association for Healthcare Documentation Integrity. It’s readership includes medical transcriptionists, healthcare documentation and medical records professionals, business owners, MT employers, and others with an interest in the medical transcription profession. More information can be found at ahdionline.org.

Matrix is another solid bi-monthly publication offered by AHDI. It is focused specifically on the business and technology aspects of the healthcare documentation industry. Information is available at ahdionline.org.

eBrief – formerly known as Vitals is, according to AHDI, “a weekly e-newsletter designed to keep AHDI members and subscribers informed about news and trends in the industry and the strategic direction and initiatives of the association”. Information is available at ahdionline.org.

Advance for Health Information Professionals is a bi-monthly publication offered free of charge to health information professionals. Information can be obtained at health-information.advanceweb.com.

For The Record, is an informative publication for health information professionals. Information can be obtained at fortherecordmag.com.

Journal of the American Health Information Management Association (Journal of AHIMA), is the official publication of AHIMA. Subscription information is available at the AHIMA website ahima.org.

Journal of Healthcare Information Management, According to HIMSS, “JHIM is a quarterly, peer-reviewed journal edited specifically for healthcare information and management systems professionals.” For more information go to: himss.org/asp/publications_jhim.asp.

Posted in Healthcare Documentation, Medical Transcription Resources |

Medical Transcription Management Options and Opportunities

April 7th, 2011

Many practicing and aspiring medical transcriptionists inquire about the potential for career advancement to in the MT industry. This is not only a valid question, but also a great goal. There are plenty of opportunities for advancement in this rapidly growing industry. Good transcription managers are in short supply. The reality is that many practitioners would rather retain the flexibility of being their own boss and doing what they enjoy doing on a production basis. As a result, healthcare providers and MT services often have difficulty attracting qualified transcriptionists to management level roles. Accepting a management level role means giving up a lot of autonomy and flexibility and assuming more responsibility. Many practitioners are reluctant to make this tradeoff.

However, there are many people who thrive on the challenges of working in a faster paced environment and in assuming higher levels of authority and responsibility within an organization. They see the benefits of advancing their career and increasing their long term income potential as well as earning retirement benefits. A medical transcription management position can provide continued upward career mobility and result in a challenging and rewarding career.

There are several options available for anyone considering a career in MT management. The interesting thing to note is that the options continue to grow as technology developments transform the industry.

Manager of Quality Assurance (QA)

A manager of QA does just what the title implies. He or she reviews the transcribed documents that come in from home based transcriptionists; evaluates them against a set of quality criteria; and edits them to ensure they meet the quality standards prescribed by the healthcare provider. QA experts look for errors in spelling, punctuation, and grammar – often using sophisticated tools to assist them in this effort. They also look for important errors in the documents that could lead to misinterpretations of the data by a physician or other health care provider. The QA manager is highly regarded and is integral to the optimal flow of any transcription operation.

Medical Transcription Supervisor

Another important manager is the Medical Transcription Supervisor. MT Supervisors work either for a hospital or an outsourced service provider. The role of the supervisor is to manage a team of transcription professionals. The supervisor is responsible for scheduling, hiring, firing, evaluating, and managing all final reports and workflows and ensuring compliance with turnaround requirements. The supervisor also ensures that all associates are equipped with a full complement of equipment and resources to perform their jobs as efficiently as possible. The transcription supervisor facilitates the development of the MT staff by working with HR and training departments to see that resources are consistently aligned with peak workloads and that all specialty areas are properly staffed to meet turnaround requirements. The supervisor generally reports to a Medical Records Director of a hospital or possibly a director or vice president of a transcription service provider. A supervisor often possesses a CMT (certified medical transcriptionist) credential from an certifying organization such as AHDI(Association for Healthcare Documentation Integrity).

Medical Transcription Trainer

Another important management function is that of medical transcription trainer. MT trainers will train transcriptionists on new account types and specialty areas. Account specific information will vary from client to client and each practitioner will require training on the account specifics, turnaround requirements, and special instructions relating to each account they service. A trainer will be responsible for developing the talent pool of the organization’s staff and will work closely with the MT supervisor to ensure that the staff is optimally deployed for maximum effectiveness in meeting the production needs of the department or organization. Cross training is also an essential function of the trainer. It is imperative that all members of a staff are capable of shifting their focus at a moment’s notice to accommodate an urgent need resulting from either a new client startup or the absence of one or more key transcriptionists. A trainer may also monitor and recommend continuing education training opportunities to associates throughout the year.

Medical Transcription Recruiter

The medical transcription recruiter is increasingly one of the most important managers in an organization. Their job is to continually develop and replenish the base of talent within an organization. The recruiter is constantly searching the country for qualified transcriptionists to add to department or company staff. Recruiters run ads, conduct interviews, and work with other managers to forecast future hiring needs. They are also responsible for identifying opportunities to increase retention among existing associates.

Medical Records Director

The Medical Records Director is typically a credentialed medical records specialist who oversees all aspects of the medical record production and archiving process. The director will typically manage all transcription and coding supervisors and sometimes the billing functions of a healthcare organization. A director will work with the MT supervisor to ensure that all documents are transcribed in accordance with contract requirements and that records are made available in a timely and professional manner to the healthcare professionals that need them. The secure electronic storage and delivery of records is a key function of the director. This individual will need to continually search out best practices and evaluate new and innovative technologies to ensure that the department operates at peak productive capacity. The health and well being of thousands of patients depends on the quality production and timely dissemination of health record information. The director is also responsible to ensure that all processes, documentation, workflows, relationships, and systems are HIPAA compliant. A director may possess one or more credentials or designations from a certifying organization such as AHDI, AHIMA, or AAPC. Credentials such as RHIA, RHIT, CCS, CPC, and CMT demonstrate a long term commitment to the profession and are evidence of the expertise developed by the director over the years.

Voice Recognition Medical Transcription Specialist

The relatively recent emergence of voice recognition specialists and supervisors is a good example of how new career opportunities are created in response to significant technology advancements in the industry. These are position that were not even on the radar screen a decade ago. As voice recognition technology gains a foothold in the industry, more and more of the MT workflow is going to be processed through a speech recognition engine. This will in no way eliminate the need for transcription, but this technology will transform the role of a growing subset of the workforce in the coming years. An increasing number of MT’s will use a speech recognition processed document as a starting point for their transcription activities. Speech recognition produced documents generally require significant editing. This editing process will be performed by practitioners whose role will change from traditional transcriptionist to medical language editor. The technology behind voice recognition processing is sufficiently different from the traditional process that voice recognition supervisors may also be required to manage these new activities.

Posted in Medical Transcription Management |

Avoiding Financial Catastrophe

April 5th, 2011

The best way to avoid financial catastrophe is to eliminate debt and spend within your means. Debt elimination may mean downsizing or getting rid of some things. Take a hard look around you.

Then take this quick financial self-assessment:

  • Do you have one or more expensive cars with high payments each month?
  • Are you living in a house that is really more expensive than you can afford?
  • Are you eating out frequently?
  • Do you have expensive cell phone plans for everyone in the family?
  • Is your cable TV plan loaded up with premium movie channels?
  • Do you carry credit cards that you use indiscriminately?

The first question to ask is: Are any of these things a matter of life and death?

Certainly we all need to eat and we all need basic shelter and transportation, but almost all of us fall into the trap of rationalizing the purchase of items that far exceed the requirement of satisfying the basic need.

The second question to ask is: How can I get out from under these excessive or unnecessary expenses and right size my financial obligations?

The answer in some cases may be surprisingly simple.

  • Cancel the cable.
  • Stop eating out.
  • Eliminate or cut back on your cell phone plans.
  • Cut up your credit cards.

The answer in other cases may require more work. Like most people you have probably taken on debt and other financial obligations that are not easy to get out of.  You may have to work harder to eliminate some of these other things from your life.

Put your house up for sale and move into a less expensive one. In the current economy this may be more difficult than you would like it to be, but it is often doable. If you owe more than the house is worth then you may need to visit with your bank about accepting a short sale offer. Make sure that your agreement is one that doesn’t put you on the hook for any deficit in the future. Many banks are willing to accept short sale prices (an amount less than what is owed) and call it good. Others may accept the price but want you to be obligated to the difference. This is not a good outcome for you. Be careful to ask about this.  Either way, you will want to get out from under the burden of financial debt associated with our extravagant and excessive house payment.  Some creditors will also allow you to restructure your loan and make interest only payments or otherwise reduce your monthly outgo, at least for a time while you are trying to sell the house.

Put your cars up for sale. Again, you may find that you owe more than they are worth. It may mean another trip to the bank to explain your situation and ask them to work with you. They may restructure your loan or allow you to turn the car back in.  The key is to get rid of these enormous financial burdens and then replace them with something sensible. Maybe a smaller, reliable, used car that gets good gas mileage and doesn’t come with a huge payment. If you can pay cash for a used car that would be the best possible thing.

Just get out there and do it. Gaining control of your financial future starts with making ONE good financial decision – no matter how small. You will be surprised at how much better you feel just by calling the cable company and cancelling the cable. It may not mean that much to your bottom line but it is the start of a new financial path that will lead to financial peace of mind and an ability to live within your means into the future.

Posted in Personal Finance |

The Advisability of Mandatory Certification and Credentialing for Medical Transcriptionists

April 2nd, 2011

There is a mandatory credentialing movement afoot which would require all medical transcriptionists to become certified.  To be certain, mandatory healthcare credentialing is not without precendent.  Many health occupations require mandatory certification and credentialing.  There is certainly a rationale for mandatory credentialing among medical transcriptionists given the sensitive nature of the documents they work with on a daily basis.  However, it is not clear that a mandatory medical transcriptionist certification requirement would result in an increase in the level of competency of medical transcriptionists or an improvement in patient care.

Medical transcriptionists represent the front lines of the health documentation process.  In partnership with the dictating physician, they are the final gatekeepers for the medical record.  And while the physician has final say and responsibility over the content of the medical record document, in reality, the medical transcriptionist is often the last person to participate in the production and final modification of a patient record.  As a consequence, the influence of the medical transcriptionist in the development of the patient health record, and the need for competency, cannot be overstated.

The effective safeguarding of vital, confidential patient information demands a rigorous training, oversight, and ideally credentialing process for medical records documentation specialists.  AHDI (The Association for Healthcare Documentation Integrity), serves as the primary gatekeeper for industry credentialing for medical transcriptionists and medical language editors.  AHDI has aggressively promoted the CMT (Certified Medical Transcriptionist) credential, augmenting the exam substantially in recent years with significant foreign-physician dictation and speech-recognition components. Additionally, recognizing the need to attract new talent to a high growth industry, AHDI has rolled out the RMT (Registered Medical Transcriptionist) exam, which is targeted primarily to the entry level medical transcriptionist.

Impact and Influence of the Medical Transcriptionist on the Final Quality of the Patient Medical Record

How important is the medical transciptionist to the integrity and accuracy of the patient medical record? Quite simply, the medical transcriptionist is fundamental to the final patient record outcome.

While every attempt is made to create a completely verbatim medical transcript, the reality is that medical transcriptionists are called upon to continuously render judgments with regards to sometimes ambiguous or marginally intelligible dictation. Not infrequently, a trained medical transcriptionist will catch physician dictation errors, which must be corrected and brought to the attention of the physician.  Judgments are made based on the context of the dictation. Where a medical transcriptionist is unclear or where there is clear ambiguity, the physician will be called upon to clarify. Protecting the accuracy of the patient record along with the confidentiality of that record are two of the most important objectives in the medical records production process.  However, a third and not far distant objective is speed and efficiency. Successful patient outcomes quite frequently and literally require extremely rapid turnaround of patient documentation.  As a consequence, medical records departments are continuously managing the tradeoffs between the pressure to meet turnarounds and the need to maintain a high and uncompromised level of quality.  Expert quality control oversight systems are critical to simultaneously achieving these frequently conflicting objectives.

Clearly, it is imperative that medical transcriptionists, quality control specialists, and their managers and supervisors be fully trained, competent and ideally, credentialed.  The profession requires an exacting level of knowledge and training to protect the accuracy of patient records.  Errors in the medical records process, whether the fault of the dictating physician or the medical transcription unit, are unacceptable and highly risky.  A 2004 medical records error analysis study conducted by AHDI (then AAMT) concluded that 63% of the errors discovered in the study were determined to be critical in nature – having the potential to negatively affect the health and safety of the patient.

The Case for and Against a Medical Transcription Certification and Credentialing Requirement

AHDI has long argued, and recently more emphatically, that the medical transcription industry would be better served with a fully credentialed staff of certified medical transcriptionists. They insist that little would be lost and a great deal would be gained with mandatory certification of medical transcriptionists.  While a credentialed staff would certainly bring a minimum level of standardization and a demonstration of competency, the call for a fully credentialed medical transcription workforce is not without its problems.

For starters, the vast majority of active medical transcriptionists are currently uncredentialed.  Requiring these seasoned professionals to take time from their careers to meet the certification study, testing, and continuing education requirements would not be costless, particularly from an efficiency standpoint.  Taking your highest volume producers out of the production process for any period of time would have a measurable negative influence on an industry already burdened by capacity constraints.  Additionally, there is the cost of credentialing and certification and cost of periodically  renewing the medical transcription certification for tens of thousands of transcriptionists – which would not be inconsequential.

Of course, if a case could be made that the credentialing process would reduce the medical record error rate attributable to medical transcriptionists in a meaningful way, the costs and tradeoffs of medical transcriptionist certification may prove to have a good return.  However, there has been little evidence presented that would suggest if and to what extent such a quality improvement would occur.  It is an issue that will almost certainly continue to be pressed and that merits additional analysis.

Posted in Medical Transcription Certification |

7 Simple Laws for Financial Success and Peace of Mind

April 1st, 2011

In these tumultuous times, it is easy to fall into a financial tailspin.  However, with a little thought and perseverance, we can avoid the devastating mistakes that can result in years of financial misery. Here are 7 suggestions that almost anyone can achieve.  Following these 7 simple financial laws will allow you sleep at night and avoid financial calamity.

1. Spend Less Than You Make. This is the most fundamental and important of all of the seven laws. If you can not or will not abide by this law then please read no further. It doesn’t matter if you earn $1,000 per month or $20,000 per month. You can always live beyond your means. Conversely, you can almost always live within your means, no matter how modest.  If you can’t live on $3,000 per month without overspending your budget every month then you won’t be able to do it at higher levels of income either. This is a fact. Because the true measure of financial success begins and ends with the ability to generate a surplus each and every month. End of story.  For more help on making this happen read on.

2.  Know Where Your Money is Going. To achieve true financial success you need to know where virtually every penny is going each month. This may seem like a tedious and stingy mentality. The reality is that if you are like most households, you fritter away hundreds of dollars each month that you are completely unaware of. At the end of the month you scratch your head and wonder where it all went. After all, it was just a few dollars here and a few dollars there.  Guess what? By the end of the month it adds up to real money. By knowing exactly where each dollar is going, you are in a position to take control of your day to day financial decisions. Cut back on those discretionary expenditures that suck up large amounts of money without your realizing it. They are sabotaging your ability to comply with Rule #1 above. You must get to the point where you bring your spending in line with your income and generate a surplus for investment. This is the ultimate financial magic bullet.

3.  Pay Yourself First. Taking some money off the top of your paycheck and squirreling it away into a safe investment each pay period is the surest way to get ahead. When the money comes out before you see it (and more importantly before you get the chance to spend it),  you are forced to live on a modestly lower income. One of my favorite tricks is to put a larger portion of each raise I receive into this automatic savings plan because again, it is new money – money you will not miss if you (and your spouse) never see it. Automatic 401K deductions work nicely for this. It helps if there is a matching feature attached to your employers plan. You should always get in the habit of maxing out the matching options offered by your employers. This is free money and a quick way to increase your nest egg.

4.  Limit Yourself to One Credit Card and Pay off the Entire Balance Each Month. This is absolutely critical to your financial solvency. Maintaining a hoard of credit cards increases the likelihood that you will begin to max out all of the balances and find yourself in a highly leveraged financial situation.  A credit card should ONLY be used as a convenience – not as a loan vehicle.  Consumer debt is the enemy of financial freedom.

5.  Pay Cash for Everything Except Your Home. Even Cars? Yes! Especially cars! This may sound like a heresy, but if you begin by purchasing a modest used car for $3,000-$4,000 and then sock away the money you would have put into a car payment into a special account just for auto expense, you will be surprised at how quickly you will be able to save enough to buy a nicer car.  Oh and don’t trade in your used one. Either keep it or sell it yourself,  you will get a lot more for it than a dealer will ever give you.

6.  DO NOT TAKE OUT A SECOND MORTGAGE ON YOUR HOME! This practice has been the kiss of death for millions of Americans. This is a great time to buy a cheap home. There are abundant foreclosures and short sales for record low prices.  In many cases these homes are selling for far less than it would cost to replace it. You can do the math but it won’t be long before the prices will go back up to at least replacement value. It is a no brainer to buy now if you DON’T OVERDO IT.  Like our car example above, buy something you can afford NOW. Don’t take on a burdensome debt (if you are wondering if you can afford a particular home, refer back to Law #1!!).   With interest rates at historic lows, you should be able to get into a home purchase for about what you would pay for rent. You get instant equity, a tax deduction, and a home of your own. Over time you will pay down your loan and end up with a free and clear home!! Now that is the ultimate Freedom and still a big part of the American dream. And it is totally within your reach.  Just resist the temptation to EVER add a second mortgage to your home.  This will cripple you for life!

7. Establish an Emergency Fund. This is one of the things that will bring you the most peace of mind as you navigate through an uncertain economic environment. Having three to six months worth of income set aside in a safe interest bearing account will do wonders for your stress levels, peace of mind and overall financial and emotional well being.  This will obviously not come overnight, but it can be done if you set an aggressive goal to add to an account a little each paycheck.

There you have it. This is not rocket science. Most people who get into financial distress (which includes almost everyone at one time or another) do not realize that these very simple financial laws are so easy to follow. It just takes a little resolve to set yourself apart from the crowd.  Good luck!

Posted in Personal Finance |

Introduction to Medical Coding

March 28th, 2011

Medical coding is the process of assigning standardized numerical codes to patient health care charts. This coded information is used to ensure that insurance companies, government organizations, such as Medicare, and patients alike all receive accurate billing statements for health services performed. Medical coders perform the work of converting diagnostic and procedural information into simplified numerical codes that can be electronically processed for payment by third party payers – Insurance companies and Medicare, for example.

The process of medical coding requires an attention to detail to ensure accuracy of billing records. Because of the large dollar amounts involved, coding is a highly regulated and tightly supervised activity. Coding is also subject to frequent and rigorous audits to ensure accuracy in the billing process as there are literally billions of dollars at stake. In many ways, medical coding is a much more scrutinized activity than, say the transcription of patient records.

Medical Coding work is typically performed in hospitals or clinics, although we are beginning to see some of these coding and billing jobs migrate to work at home positions. Medical coders generally begin with a transcribed patient health record and transform procedures and diagnoses etc. into numerical codes. This takes a great deal of expertise in medical terminology and a fluency with relevant codes. Of course this requires formal training. Billing specialists takes the coded output produced by the coder and submit it for reimbursement to insurance companies, Medicare, or directly to the patient. Many times a single person will perform both the coding and the billing functions. This is particularly true in smaller clinical settings. In large, high volume health care operations, coding and billing are often organized into separate functional areas. Of the two, coding specialists generally enjoy a higher income and require more specialized training.

Medical coders are in high demand and the opportunities in the career field of health records documentation are outstanding. Coders work in hospitals and clinics and for other health care providers across the country. They play a vital role in the health information management cycle.

Increasingly, the health information management industry is taking advantage of the rapid advances in online coding technology. More and more, the work is performed online over the internet. As online coding catches on as a concept, we will likely see many of the positions that have traditionally been offered exclusively in hospitals and other health care settings begin to migrate to home based jobs. The work at home employee model has worked very well for the transcription industry and will also likely begin to gain traction in the coding industry as online coding becomes more prevalent.

Posted in Medical Coding |

The Rocky Road to ICD-10 Medical Code Implementation

March 27th, 2011

The US healthcare industry has been grappling for too many years now with the implementation of ICD-10 medical codes. The new ICD-10 code set promises to improve the classification of the massive and growing reservoir of health information and to bring the United States up to the international standard for healthcare documentation.

There is no question that the US is lagging significantly in this vital health information area. Most other developed countries have long since adopted and implemented the new standards. The need for an upgrade to the current system was identified formally in the early 1990’s when the National Committee on Vital and Health Statisics affirmed that the current code structure was “broken”. The numerous delays in implementation since that time can be traced to a handful of short-sighted economic and political considerations. Regardless of the cause, the US healthcare system can ill afford additional delays. The quality and integrity of health data in the US has been declining for several decades now.

The deterioration of health data can be blamed in large measure on the fact that the US has simply outgrown the ICD-9 medical coding system. While ICD-9 served the industry adequately for a number of years, the growth in medical procedures, treatments, diagnoses and technology have surpassed its limited adaptive capability. The universe of available ICD-9 codes is rapidly dwindling and certain code sets are becoming oversubscribed. This is resulting in tremendous inefficiency and is calling into question the integrity and completeness of the data delivered through the system. As the risk of compromised patient care increases, the need for change is becoming more obvious.

Advantages of the ICD-10 Medical Code Classification System

Implementation of the ICD-10 medical code set will confer a number of significant advantages on the industry. These include:

  1. Greater specificity and accuracy in healthcare documentation
  2. Reduction in manual intervention arising from the limited descriptive capability of the existing code set
  3. Increased level of detail in the final health record
  4. Improvement in care decisions with elevated data quality
  5. Reduction in errors and quality assurance activities
  6. Reduction in reimbursement holdups due to inadequate information or clarity
  7. Increased productivity of coding practitioners as automation becomes more applicable throughout the entire process
  8. Increased compatibility with other global health information systems
  9. Improved patient outcomes

Conclusion

While there are certainly some compelling economic costs associated with full adoption and implementation of the ICD-10 code set, the costs of non-adoption are growing every day and threaten to dwarf real implementation costs. Additionally, the negative impact on patient care will increase exponentially as the existing data model becomes less stable. The evidence for successful implementation is readily available. Virtually every other major developed country in the world has successfully adopted ICD-10. The time for discussion and analysis is past. The time for bold action and implementation is here.

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