HAY STUDY INDEX

INTRODUCTION

CMT STATUS

QA DEGREES FOR CONCURRENT REVIEW

RANDOM QA REVIEW

CATEGORY 1 MTs KNOWLEDGE AND ABILITY REQUIREMENTS

MT CATEGORY 1, LEVELS AND LINE RATES

CATEGORY 1 - LEARNING A NEW SPECIALTY

CATEGORY 2 MTs (ACUTE CARE) KNOWLEDGE AND ABILITY REQUIREMENTS

MT CATEGORY 2 - ACUTE CARE - LEVELS AND LINE RATES

PROGRESSION TO A HIGHER LEVEL

GMTS LINE RATE CHART

GMTS QA REVIEW FORM

GMTS' CHECK LIST OF CRITERIA FOR LEVEL & LINE RATE PROGRESSION

GMTS' CATEGORIES, LEVELS AND LINE RATE COMPENSATION FOR MTs
 (Based upon the Hay Study and adapted for use by GMTS)

INTRODUCTION


The Hay study is survey which looked at the compensation of medical transcriptionists, performed at the request of AAMT. We have adapted and expanded the survey findings for use within GMTS, based upon our client base and the knowledge our MTS must possess to meet or exceed the industry's standard of excellence.
The Hay study indicated that the survey of corporate participants showed an average hourly rate of:

Level 1 MTs 10.54
Level 2 MTs 11.56
Level 3 MTs 13.14

The study notes an approximate line rate paid to MT employees of .07 to .085/line. It was noted that benefits are the most valuable type of broad-based program for employee transcriptionists.

When an MT was paid an hourly wage, plus incentive, the study showed that 100-125 lines per hour (800 to 1000 lines/day) were mandatory before any type of incentive was calculated, and it would be expected that the actual daily average lines produced per hour would be greater. It is interesting to note that 63% of for-profit transcription services are on 100% pay for production.

For GMTS' purposes, we have defined two categories of MTs and three levels within each category. The category is determined by the work type from which each MT receives 66% (2/3) of the daily work assignment. The level within each category is determined by the degree of QA necessary to make the MT's work "client ready".

Category 1 MTs have the knowledge and skills required for the transcription of individual doctor office, clinics, and emergency room work types. Category 2 MTs have the knowledge and skills required for transcribing acute care work types. Requirements for both categories and levels within are discussed elsewhere in these guidelines.

Our production minimums were set at the time we added health insurance benefits and had to set full time requirements in conjunction with Florida State Law. By law at that time, for the size of our business, a full time employee was eligible for benefits at 25 hours.

For the sole purpose of determining eligibility for benefits, our MT minimums were set within a 25-hour week of 1000 lines per day or 5000 lines per work week.

In actuality, a production MT is most often scheduled for a full 40-hour production-based week, with the majority of MTs being capable of transcribing 100" to 150" of dictation per day or more, maintaining an average of 150 lines/hour to 225 lines/hour, or 1200 to 1800 lines and over. This is achieved first with knowledge and "ear" experience and, second, with the use of macros, word expanders, and a good reference library.

We believe our production and compensation criteria is in alignment with the survey for 100% pay for production. (See chart for minutes, lines, line rate and hourly and daily wage.) The industry average of 12 lines/dictated minute was used. Hourly wages were calculated on an 8-hour day.

Correct classification of MTs as employees adds "invisible" compensation, as noted below.

GMTS' benefits package adds an extra .013 to the per line rate:
                                        Payroll taxes
                                        Health insurance (includes vision discount)
                                        PTO
                                        Other (partial to full reimbursement for books, seminars,
                                        CMT exam)

It is possible for a Category 1 or 2 MT to have a different line rate assigned to each account, based on the degree of knowledge and skill required for that account.

"Ear" experience brings to the MT the greatest degree of proficiency and brings to GMTS the greatest degree of flexibility in scheduling coverage for accounts.

If a Category 2 MT is requested by GMTS to be "on-call" to cover a Category 1 account, that MT retains her higher line rate.

If a Category 2 MT requests more than 33% (1/3) of his/her workload be from a Category 1 account, that MT is paid at the appropriate Category 1 line rate.

As the time and expense of training for acute care is immense, that MT may lose the opportunity to maintain and/or increase the skills gained at the Category 2 level. The decision may be made to have that MT remain at a Category 1 level.

Distribution of the workload is at the discretion of GMTS' owner/operations staff.

CMT Status


CMT - for the year 2000 and 2001

For Category 1 MTs with GMTS, CMTs will receive .0025/line more that non-CMTs in MT level 2 with QA degree 2 and MT level 3, QA degree of 1, contingent upon consistently meeting all the criteria for knowledge/skills necessary in those levels.

If you have received your CMT while a full time employee with GMTS in the years before 1999, are currently a full time employee of GMTS, and are currently licensed as a CMT for the year 2000, we will retroactively pay the second 50% for passing the CMT examination.

For the years 2000 and 2001, GMTS will reimburse 100% of the cost of the CMT examination upon written receipt of notification of passing both parts of the test, for those MTs who are full time employees of GMTS at the time of passing and who intend to fulfill the obligation of six months continual full time employment with GMTS after attaining the CMT certification.

As the CMT classification is defined as an entry-level certification in our industry, it will have no bearing with regard to line rate or levels of MTs in Category 2, acute care transcription.

MTs in both Category 1 and 2 are encouraged to take advantage of this offer for reimbursement, as GMTS views achieving the title of CMT as one form of a commitment to continuing education, which is a benefit to each MT and to GMTS as a whole.

QA DEGREES FOR CONCURRENT REVIEW


NOTE: (difficult/ESL dictators are reviewed at greater length regardless of the level of the MT)

Rule of thumb: The lower the degree of QA, the higher compensation can be offered.

5 - Full review with voice

4 - Heavy -
  •         Full read
  •         Listen to critical areas: Diagnosis, lab data/diagnostic findings,
            medications, allergies
  •         Listen to blanks, indicated areas
3- Medium
  •         Light read; focus on diagnosis, lab data/diagnostic findings, medications,
            allergies
  •         Listen to blanks, indicated areas
2- Light
  •         Listen to blank, indicated areas.
1-         Problem log only or when more than 2 blanks per report.

Feedback of specific editing changes is provided by phone, fax, email or DropChute.

RANDOM QA REVIEW


A bi-weekly to monthly random QA review of a percentage of reports for all transcriptionists is performed, combining both read-only and audio comparison. The GMTS QA form is used to monitor overall quality, to define areas for continuing education and as an indication to upgrade levels. Feedback is provided by fax, email or DropChute.

Inquiries regarding errors, point values assessed, reference discrepancies should be brought to the attention of GMTS owner/operations staff for clarification. These may be returned to the QA staff for reply.

CATEGORY 1 MTs KNOWLEDGE AND ABILITY REQUIREMENTS:

(From the Hay Study, adapted for GMTS use)

(Entry Level)
Level 1: Basic knowledge of medical terminology, anatomy and physiology, disease processes, signs and symptoms of the specialty (most often single dictator) AND the reference materials for research/verification.
Knowledge of transcription guidelines as outlined in the GMTS Style Guidelines.
Ability to operate PC, software, dictation/transcription/other equipment as necessary for the transcription of the account.
Ability to work under pressure with time constraints, consistently meeting TAT deadlines.
Ability to concentrate.
Excellent listening skills.
Knowledge of and ability to apply the legal aspects of our industry in the personal work environment (i.e. confidentiality and upcoming HIPAA requirements)
(Intermediate)
Level 2: Experienced and in-depth knowledge of medical terminology, anatomy and physiology, disease processes, signs and symptoms of the specialty/specialties (multiple dictators) AND the reference materials for research/verification.
Knowledge of transcription guidelines as outlined in the GMTS Style Guidelines.
Ability to operate PC, software, dictation/transcription/other equipment as necessary for the transcription of the account, and to troubleshoot as necessary.
Ability to work under pressure with time constraints while maintaining the integrity of the dictated content of the report. Consistently meeting TAT deadlines.
Ability to concentrate and remain detail oriented with a variety of formats.
Excellent listening skills.
Knowledge of and ability to apply the legal aspects of our industry in the personal work environment (i.e. confidentiality and upcoming HIPAA requirements)
CMT preferred.


(Advanced)
Level 3: Experienced and expert knowledge of medical terminology, anatomy and physiology, disease processes, signs and symptoms of the specialty (or specialties) AND the reference materials for research/verification. Is able to assist others in distinguishing difficult/ESL dictation and clarifying the usage of medical terms.
In-depth knowledge of transcription guidelines as outlined in the GMTS Style Guidelines.
Ability to operate PC, software, dictation/transcription/other equipment as necessary for the transcription of the account, and to troubleshoot as necessary.
Ability to work under pressure with time constraints while maintaining the integrity of the dictated content of the report. Consistently meeting TAT deadlines.
Ability to concentrate and remain detail oriented with a variety of formats.
Excellent listening skills.
Knowledge of and ability to apply the legal aspects of our industry in the personal work environment (i.e. confidentiality and HIPAA requirements).
CMT preferred.


MT CATEGORY 1, LEVELS AND LINE RATES


Line rates and resulting hourly rates are based on median standards for production
as noted in the GMTS chart. See chart for low, median and high standards.

*QA Percent is based on the criteria in the GMTS QA form

Category 1 - Individual physician offices, clinics, emergency room

Level 1 -                         Entry Level

QA degree                     5, 4

QA Percent                    95% (before editing) consistently

Knowledge/ability:          Entry level to intermediate

Line rate range:             (before moving to an increased line rate, all requirements
                                        must be met and a measurable increase in skill
                                        level demonstrated)
                                        .0600
                                        .0625

Level 2 - Intermediate
QA degree 3, 2
QA Percent 98.5% + consistently
Knowledge/ability: intermediate to advanced
Line rate range. (before moving to an increased line rate, all requirements must be met and measurable increase in skill level demonstrated)
.0633
.0650
CMT rate: .0675 (probationary 0.666)
Probationary
line rate for
new specialties: 		1 step below current line rate (one month review)

Level 3 - Advanced
QA degree 1
QA Percent 98.5% +
Knowledge/ability: Advanced
Line rate range: (before moving to an increased line rate, all requirements must be met and measurable increase in skill level demonstrated)
.0675
.0700
CMT: .0700 -0.725 highest rate offered in Category 1
Probationary
line rate for
new specialties: 		no change (QA level 2; reviewed weekly for any difficulties or need to change the QA level/line rate)

CATEGORY 1 - LEARNING A NEW SPECIALTY


For an MT at level 2, QA degree 3, regarding transcribing for a specialty (new account) in which the MT has limited previous experience, the MT level is not decreased and the probationary line rate and review schedule is noted on page 9 and 10.

In acquiring the knowledge and skills needed for an unfamiliar specialty/account, the most critical element for determining the movement between levels and line rates is the degree of QA necessary.

At the end of the probationary period, the degree of QA necessary will be reviewed for the new specialty/account.

If the degree of QA can be decreased to the minimum for the MT's level, the line rate can be increased from the probationary line rate to the appropriate line rate.

For an MT at level 3, QA degree 1, there is no change in line rate, even though the degree of QA performed is greater. This is reviewed weekly to identify any problems that would constitute a higher degree of QA and a corresponding line rate.

The probationary period can be extended for an additional interval if necessary.

The MT's level, QA degree and line rates remain unchanged on the MT's regularly scheduled familiar accounts, as long as the requirements for being at that level continue to be met.

Entry level MTs (level 1) in Category 1 are not eligible for a probationary rate, as the highest degree of QA is being performed daily on all work.


CATEGORY 2 MTs (ACUTE CARE) KNOWLEDGE AND ABILITY
REQUIREMENTS:


GMTS requires an expertise above true entry level for the first level of acute care transcription. As such, level 1 acute care is available for those MTS who can demonstrate an intermediate level of knowledge and skills.

(Intermediate)
Level 1: Experienced and in-depth knowledge of medical terminology, anatomy and physiology, disease processes, signs and symptoms of the specialty (or specialties) AND the reference materials for research/verification. Expected to demonstrate skills requiring a maximum QA level of 3, except on rare occasions. In depth tracking of progress.
May be specialized in 2 of the 7 work types of acute care, including history and physicals, operative notes, procedure notes (including cardiology) , consultations, discharge summaries, radiology and pathology, and have a working knowledge of 3 others.
Knowledge of transcription guidelines as outlined in the GMTS Style Guidelines.
Ability to operate PC, software, dictation/transcription/other equipment as necessary for the transcription of the account, and to troubleshoot as necessary.
Ability to work under pressure with time constraints while maintaining the integrity of the dictated content of the report. Consistently meeting TAT deadlines.
Ability to concentrate and remain detail oriented with a variety of formats.
Excellent listening skills.
Knowledge of and ability to apply the legal aspects of our industry in the personal work environment (i.e. confidentiality and HIPAA requirements)
CMT preferred to show level of knowledge and ear experience.
(Advanced)
Level 2: Experienced and expert knowledge of medical terminology, anatomy and physiology, disease processes, signs and symptoms of the specialty (or specialties) AND the reference materials for research/verification. Is proficient in the ability to discern and edit difficult/ESL dictation to maintain accuracy and clarity.
Must be proficient in transcribing 4 of the 7 work types, including history and physicals, operative notes, procedure notes (including cardiology) , consultations, discharge summaries, radiology and pathology, and have a working knowledge of the other 3.
In-depth knowledge of transcription guidelines as outlined in the GMTS Style Guidelines.
Ability to operate PC, software, dictation/transcription/other equipment as necessary for the transcription of the account, and to troubleshoot as necessary.
Ability to work under pressure with time constraints while maintaining the integrity of the dictated content of the report. Consistently meeting TAT deadlines.
Ability to concentrate and remain detail oriented with a variety of formats.
Excellent listening skills.
Knowledge of and ability to apply the legal aspects of our industry in the personal work environment (i.e. confidentiality and HIPAA requirements)

(Master)
Level 3:
(by test) 		Experienced and expert knowledge of medical terminology, anatomy and physiology, disease processes, signs and symptoms of the specialty (or specialties) AND the reference materials for research/verification. Is proficient in the ability to discern and edit difficult/ESL dictation to maintain accuracy and clarity.
Is able to assist others in distinguishing difficult/ESL dictation and clarifying the usage of medical terms.
Must be proficient in transcribing all 7 work types, including history and physicals, operative and procedure notes (including cardiology) , consultations, discharge summaries, radiology and pathology.
In-depth knowledge of transcription guidelines as outlined in the GMTS Style Guidelines.
Ability to operate PC, software, dictation/transcription/other equipment as necessary for the transcription of the account, and to troubleshoot as necessary.
Ability to work under pressure with time constraints while maintaining the integrity of the dictated content of the report. Consistently meeting TAT deadlines.
Ability to concentrate and remain detail oriented with a variety of formats.
Excellent listening skills.
Knowledge of and ability to apply the legal aspects of our industry in the personal work environment (i.e. confidentiality and HIPAA requirements).
Achieved by passage of a GMTS' knowledge and skills test.

MT CATEGORY 2 - ACUTE CARE - LEVELS AND LINE RATES
Level 1 - (Intermediate)
QA degree 3 (rarely 4)
QA Percent 97% + consistently
Knowledge/ability: Intermediate progressing to advanced
Line rate: (before moving to an increased line rate, all requirements must be met and measurable increase in skill level demonstrated)
.0750
.0766
Probationary
line rate 		.0750

Level 2 - (Advanced)
QA degree 2, 1
QA Percent 98.5% +
Knowledge/ability: Advanced
Line rate: (before moving to an increased line rate, a scheduled review must be performed)
.0775
.0800
Probationary: No change (QA level 2; reviewed weekly for any line rate difficulties or need to change the QA level/line rate)

Level 3 - Master (achieved by testing only - see below)
QA degree 1
QA Percent 98.5% +
Knowledge/ability: Master
Line rate: .0825 (minimum)
Probationary
line rate 		no change (QA level 2; reviewed weekly for any difficulties or need to change the QA level/line rate)

PROGRESSION TO A HIGHER LEVEL

(Scheduled review per account)

To progress to a higher level, except Category 2, Master:

An MT can request in writing a 30-day scheduled review to raise to a higher level within the category or a higher line rate within the same level. For an MT whose accounts who are "unscheduled" or "occasional" (less than 2 times a week), a minimum of 5 sets of work must be reviewed during a 5-week period of time.

A QA review will be performed at least twice weekly. All work reviewed must be at 98.5+ or higher before QA review and the MT must consistently meet all the GMTS knowledge, skill and procedure requirements at the current level in order to progress.

A point system will be used and tracking for this period of time will be kept on "GMTS' Check List for Level & Line Rate Progression."

Once an MT is at the highest level in Category 1 (CMT, advanced) an increase in line rate can come about in two ways: 1. Continuing on in knowledge and "ear" experience into Category 2. 2. An increased line rate charged to the client.

GMTS' quality review staff may recommend an MT be raised to a higher level in a Category, based on the degree of accuracy, and the degree of QA necessary to make the work "client-ready".

To progress from Category 2, advanced, to Master:

The progression from Category 2, advanced acute care MT to Master MT is by a GMTS administered test, currently being prepared by Susan Dooley, Department Chairperson of Health Information and Human Resources at Seminole Community College, Sanford, Florida.

The test will be appropriate for medical editors/QA reviewers and MTs, and consist of transcription and editing skills of various work types with ESL/difficult dictation, medication and laboratory data knowledge, context-oriented sound-alike usage and the use of transcription style guidelines and computer literacy.

The test of knowledge and skills is graded against the GMTS QA form. All references and resources may be used to achieve a minimum passing score of 98.5%+.

The GMTS QA form and the knowledge, skills and procedure check list is contained herein.

*A requested review is limited to no more than one every six months.

**The number of reviews that can be processed at any one time will be at the discretion of GMTS.

***Constant compliance with knowledge, skill and quality requirements is expected to remain at the highest level acheived.


GMTS LINE RATE CHART


*Employer benefits package adds an additional .013 to the line rate

Low-100"/1200 lines/day                     Median-125"/1500 lines/day     High-150"/1800 lines/day
Rate           Hr           Day               Hr           Day                 Hr                     Day          
.0600 9.00 72.0011.25 90.0013.50 108.00
.06259.3875.0011.7293.75*14.06112.50
                                                          (Hay levels 1 &2)         (Hay levels 1,2,3)
.06339.5075.9611.8794.9514.24113.94
.06509.7578.0012.1997.5014.63117.00
.06669.9979.9212.4999.9014.99119.88
.067510.1381.0012.66101.2515.19121.50
.070010.5084.00*13.13105.0015.75126.00
(Hay level 1)                                   (Hay level 3)
.072510.8887.0013.59108.7516.31130.50
.073311.0087.9613.74109.9516.49131.94
.07511.2590.0014.06112.5016.88135.00
.076611.4991.9214.36114.9017.24137.88
.077511.6393.00*14.53116.2517.44139.50
(Hay level 2)
.080012.0096.0015.00120.0018.00144.00
.082512.3899.0015.47123.7518.56148.50
.083312.5099.9615.62124.9518.74149.94
.08512.75102.0015.94127.5019.13153.00
.086612.99103.9216.24129.9019.50155.99
.087513.13105.00*16.41131.2519.69157.50
(Hay level 3)
.090013.50108.0016.88135.0020.25162.00

GMTS QA REVIEW FORM


QUALITY ASSESSMENT REVIEW FORM             REVIEWED BY:
DATE:                   MT:                                       LOG NAME:
TOTAL REPORTS:         TOTAL LINES:                     % QUALITY:

It is the MT's responsibility to maintain 100% accuracy on:
  1. All required log information and patient/dictator information on all report pages
  2. Client report format
  3. Spellcheck performed on every report and the log
If any of the above require revision by clerical staff/ proofreader, $0.005 deduction will taken from MT's line rate for ALL reports contained in this log.

Reason: If even one report is deficient in the above 3 items, it is necessary ALL reports be checked. If log information is inaccurate or incomplete, time is spent in researching and revising. This is a non-budgeted time expense and additionally may result in penalties for noncompliance in turnaround time.

Compliance for turnaround time does not allow sufficient time to return work to the MT.

Was the $0.005 reduction taken on this log? Yes_____ No_____

BLANKS ARE NOT INCLUDED IN THE CALCULATIONS FOR ACCURACY
(NOTE: Excessive blanks may indicate experience level is insufficient for this account.)
Expectation of 98.5% + accuracy average to be maintained on this set of reports.

  1. Omitted/incorrect significant contextual English/medical term/drug or dosage
    Occurrences (5pt each):_______________________________________
    Total error value:________
  2. Macro error/macro expander error/incorrect editing of a "routine"
    Occurrences (5pt each):_______________________________________
    Total error value:_______
  3. Editing error affecting meaning
    Occurrences (5pt each):_______________________________________
    Total error value:_______
  4. Editing error not affecting meaning/spelling error:
    Occurrences (3pt each):_______________________________________
    Total error value:_______
  5. Subject/verb, gender, race context agreement:
    Occurrences (3pt each):_______________________________________
    Total error value:_______
  6. GMTS Style Guide error - FYI - 0 pts deducted as of 7/15/99
    ______________________________________________
    ______________________________________________

Errors #1-#3: _____ x 5 = _____ Errors #4-#5: _____ x 3 = _______
Total error point: ______

Total error points divided by line count, subtracted from 100 =

Accuracy ratio for this set of reports: ______
(see feedback sheet or fax'd report for specifics)

GMTS' CHECK LIST OF CRITERIA FOR LEVEL & LINE RATE PROGRESSION

Name:
Current Category:_____Current Level:_____Current Line Rate:_____For Account:_____
Reviewed by:
Date Requested:_____Date Began:_____Date Completed:_____

Progressed: Yes____ No_____Total Points_____

On Completion: Category_____Level_____Line rate_____Account_____

*Any increase in line rate will be effective the beginning of the next work week for the specific account noted above.

Point system: 10 pt each. Points Possible: 880. Needed: 858

Date/Log Name        ________________ ________________ ____ ____
MetMetMetMetMetMetMetMetMetMet
Y/NY/NY/NY/NY/NY/NY/NY/NY/NY/N
Format correct _________________________________________

Deadline met _______________________________________

Job #s correct
on log ____________________________________________

Reports saved
correctly _____________________________________________

Pt info correct
on all pages ___________________________________________

QA < 98.5+ ___________________________________________

Line count correct _________________________________________

Style guidelines
followed _______________________________________________

Resources used __________________________________________

Spellchecked ____________________________________________

blanks noted
correctly on log ____________________________________________




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Gilbert Medical Transcription Service
405 Douglas Avenue
Suite 2205
Altamonte Springs, Florida 32714
(407) 260-2409 (voice) - (407) 260-7034 (fax)