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Billing/Counting Lines in Medical Transcription

Billing, which is quite the most important task in medical transcription is itself quite a huge task, not because it is difficult but because of lack of any standardized format for billing process. This till date has remained a mystery. It is supposedly one of the controversial, misunderstood, misused, and abused concepts in the industry. Though everyone does complain about it, still the fuzziness surrounding this issue still carries on. However, over the past few years, there has been a general consensus among industry players, which in coming years will pave the way for standardization. Before proceeding with understanding this billing cycle and process, lets get familiar with basic definitions provided by AAMT.

1. Gross Character: Any letter, number, symbol or function key necessary for the final appearance and content of a document, including the space bar, carriage return, underscore, bold, and any character contained within a macro, header or footer.

2. Net Character: Printed characters only. Note: to convert to Gross Characters multiply Net Characters by 1.2

3. Net Line: A defined line length that includes a predetermined number of gross characters (55, 60, 65, 70, 75, etc.).

4. Gross Line: Any printed line that has one or more characters. (To convert Gross Lines to Net Lines multiply Gross Lines by .70).

5. Keystroke: Each stroke of a key is counted - including the space bar, carriage return, underscore, bold, etc. Note: macros become an issue here - technically, if a macro requires three keystrokes, then for billing purposes, three keystrokes would be billed.

6. Net Word: A net word is defined as five (5) alpha/numeric characters plus one(1) space for a total of six (6) characters.

7. Recorded Minute: One recorded minute of dictation is equal to an average of 777 gross characters for Medical Records dictation (including ER) and an average of 782 gross characters for Physician Practices dictation.

General Methodology for Accounting: The most accepted system in the industry is to bill transcribed reports on the number of lines, which is usually a 65-keystroke line. In other language, all characters with spaces divided by 65 gives the total number of lines in the document. Though some clients do bill on the basis of all characters without spaces divided by 65. However, still billing per page is still in accordance at some places where majority of reports are very concise and short. Anyhow, it remains in the repertoire of the client and the transcription provider as to how best they can negotiate with each other.

After a successful negotiation, comes the most difficult task of counting the number of characters and lines in each document. But thanks to information technology, a variety of softwares are available in the market to reduce this taxing task to a question of minutes.

These include:

Speed cent – Developed by Spinet global solutions, tailor made as per requirements.

Abacus - Sorcerer Software,

MedPen - Emmaus MedPen

MP Count - Emmaus MedPen

Slycount II (WordPerfect) - Sylvan Software

Slycount IV (MS Word) - Sylvan Software

WP Count - Productive Performance, Inc.

In addition, the widely used document processing software, Microsoft Word and Word Perfect each have their own built-in line counting utility - which may prove adequate depending on your application. However, the best programs provide all the options of including or excluding spaces, carriage returns, headers, footers, transcriptionist ID, etc. This allows for optimal flexibility in tracking and billing line counts.


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