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understanding cost

Understanding Medical Transcription Costs

Whether you are having your medical documentation transcribed by an in-office employee, independent contractor, or a medical transcription service need to be aware of all that is involved so that you can get the most for your dollar.

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In-house employee: The costs of compensation (up to and including overtime), benefits, payroll taxes, workers' compensation coverage, sick/vacation time, office space, human resource support personnel, dictation / transcription equipment, technical support personnel, printers, paper and supplies can be very expensive. Often, productivity is not measured and less than optimal. Turnaround time is significantly compromised by low productivity, sick and/or vacation days, significantly raising your total cost of medical transcription.

Item Description Cost (USD/Year)
Salary Current Avg Salary of an MT 30,000
Benefits Medical, Life Ins, 401K, Overtime pay, Professional training and tution reimbursement costs 8,000
Real Estate Office Space, phone and power expenses 3,000
Medical Transcription Equipment PC, Printers, Foot pedals, dictation equipment, Software upgrades, Hardware Maintenance and Internet Connection 2,000
Management Cost of support personnel to manage benefits, manage computers and cost of supervisors. 5,000
  Cost of In-house Employee 48,000

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Item Description Line Count
Lines Per Day An Avg MT will produce an avg of 1000 65-character lines per day depending on the skill level of the MT. 1,000
Lines Per Year 240 work days Excluding all vacation, sick and national holidays and not calculating any downtime. 240,000
  Cost per Line (Cost of In-house Employee / Lines Per Year) 0.2

Independent contractor: The costs associated to employment are eliminated; however, due to the labor status, laws preventing control (scheduling, amount of work produced, etc.) of the individual become inhibiting factors. Independent contractors often perform based upon their needs, not yours! Dictation / Transcription equipment, printers, paper, remote access costs are still needed for the process.

Medical Transcription Service Company: All employment costs are eliminated. Depending upon your current technological platforms, the costs associated with dictation / transcription equipment and remote access may also be eliminated by using the Medical Transcription Service Provider’s infrastructure. The Cost is typically based upon several modalities of measurement which may include the number of reports, minutes, and/or lines produced. Understanding the measurements used in calculating your cost is the key to success in this scenario.

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PAGE: The definition is self-explanatory. Each page of finished medical transcription counts as a billing unit. Variables that affect billing by the page include margins, font selections, and justification. In addition, a problem arises where one page may have a few lines on it while another one could be completely full. This result in poor correlation between the amount of medical transcription produced and the amount billed.

REPORT: The definition is self-explanatory. The total pages contained in one report of finished medical transcription counts as one billing unit. Variables that affect billing by report include margins, font selections, and justification. While the charge is a flat rate, the result is a poor correlation between the amount of medical transcription produced and the amount billed.

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MINUTE: The definition is every minute that the dictator spends dictating is a billing unit. While in theory this seems like a great idea because a minute of dictation is easy to define, there are a couple of problems that result from this. Different dictation systems produce different dictation times for the same dictation. This is because of the start and stop timers begin and end in different places on different dictation systems. Lastly, because authors dictate at different speeds, the same amount of dictation can produce very different amounts of medical transcription. All too often, dictators are interrupted while recording, conversing with co-workers, increasing the dictation time.

GROSS LINES: Gross lines are also known as "visual line count". Every line on a page that has text counts as a "line" and every blank line (typically, but no always) does not. Variables that affect gross lines include font sizes, character styles, margin widths, justification, and format. Most people tend to like counting by the gross line because of its relative simplicity. However, there is no reliable method for directly comparing different gross line counts between reports that do not use the same fonts and margin widths. Gross lines are directly related to the type of formatting that is done. If an MT uses a lot of indents or tabs in formatting the report, the gross line count will go up without a corresponding increase in the number of characters typed (savvy MT’s know how to "goose" their line counts by formatting this way). Also, sometimes gross line counts include "blank" lines (although most commonly it is assumed that blank lines are not included).

CHARACTER LINES: A character line usually consists of adding up the number of characters you physically see on a printed page and then dividing the total character count by some quantity, 45, 50, 55, 60, or 65. Most of the time spaces (spacebar) are counted as a character as well as carriage returns (breaks). Years ago, the American Association for Medical Transcription defined a line as "any letter, number, symbol, or function key necessary for the final appearance and content of a document." This definition created a world wind of variation by many vendors, looking for ways to count every single keystroke generated by the MT, including keystrokes to run macros, spell check, and open up word processing programs. AAMT has since changed it's endorsement of the type of line and maintains that it is just a "recommendation." Character lines as a method of measure continue to be a better measurement of productivity as long as it is verifiable, definable, consistent, and is a fair and honest representation of the charge for services rendered.

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       TransDyne 2009