“When it comes to establishing realistic turnaround-time (TATs), clearly defined expectations are crucial.” That’s the mantra of Elizabeth S. Roop’s article in the November 22 edition of For the Record Magazine. Her article discusses the importance for medical transcription service organizations (MTSOs) to achieve an appropriate balance between speed, quality and consistency with their TAT service-level agreements.

Ms. Roop points out a number of things for medical providers to consider when contracting with an outsourced medical transcription vendor, namely:

1. High quality, ability to meet TATs and affordability are all pieces of the same triangle. Skimping on any of the three will affect the triangle’s properties. For example, if a hospital demands an MTSO have produce high quality and high speed records, then it must be willing to pay a high premium for those services.
2. Be sure to take into account any unique medical facility characteristics (i.e. type of records, frequency, required skill levels,  etc.).
3. Prepare and negotiate ahead of time to handle staffing fluctuations and possible overflow situations. Two scenarios where volume fluctuations are hard for MTSOs absorb are: (1) When a hospital chooses to outsource all of its medical transcription, leaving no in-house staff to pick up the slack; and (2) When a hospital uses an MTSO to supplement in-house overflow. (NOTE: Keep in mind, in either of these situations, an MTSOs cash flow can dramatically change. Receivables can take longer to come in even though the work levels are increasing. One way to counter this situation is to use a medical transcription factoring firm.)
4. Busy clinicians can also alter turnaround times. It’s important for medical facilities to establish proactive relationships with their clinicians to help avoid nasty surprises and ensure that clinicians are aware of how the quality and timeliness of their dictation impacts the speed with which they receive reports.

In addition to the author’s suggestions, medical transcription industry experts suggest the following tips on how to manage TAT:

1. Establish whether medical transcription work can be outsourced offshore and make any necessary accommodations to ensure TAT can be met if it will not be.
2. Clearly define penalties for nonperformance  as well as any “cure” period during which service can be brought back up to par. Also consider specific rewards for outstanding performance.
3. Conduct due diligence, including checking MTSO references with case mix and TATs similar to what will be expected.
4. Select an MTSO appropriately sized for the expected demand and ensure it has the resources to handle fluctuations.