In response to the article "MTs: RAC & Role" by Cheryl McEvoy in the September 2009 issue of ADVANCE, I would like to share the input of one certified medical transcriptionist (CMT) with 20 years experience.

Having worked both in-house and with outsource companies, as well as having done some in-house billing prior to becoming a full-time MT, I agree the recovery audit contractor (RAC) program is not something MTs nationwide would "know much about," as transcription and coding have been separate entities for at least my entire career to date. And that's for a reason. MTs are trained to perform transcription and are paid accordingly. Unless I am missing somewhere in the article that MTs will be reimbursed substantially for their efforts serving as "gatekeepers for specificity," I find Tim Keogh's position preposterous.

Although I would agree with Keogh's statement, "Given proper education on what information is needed to code a procedure, MTs can identify cases that need more detail . they could flag documents that do not have sufficient information ." because it would be beneficial in the process of a facility receiving correct reimbursement, I wonder on whose dime that proper education would be received and on whose dime the extra efforts to flag a report and make those notations would it be.

Working for an outsource company, as I believe the majority of MTs do, we are paid by the line. We do not get paid any extra when we are taking the time to make a side note and flag a report for quality assurance. As far as I know, there are no outsource companies who pay by the hour, so getting that "proper education" sounds like it's on my dime. And my dime indeed. I have not had a raise in my line rate in the past 7 years. Not even a cost-of-living raise.

 Every time I have inquired where that initially promised raise was, the answer has been, "we are not giving increases at this time." Just this past month I tried once again and was given the excuse about "the economy." I would be willing to bet there are no other health care providers or employees who are still working for what they were earning 7 years ago. I have been one of the top quality producers for my company, working nearly every weekend. By virtue of the fact that the cost of living has certainly increased over the past 7 years but my wages have not, I work 15-hour days to make up for that difference. Not exactly the healthy answer, but the only way to make a living in this profession.

My suggestion would be first an overhaul of the payment structure for MTs and CMTs, including a set salary or hourly rate for education, and please do not insult me with that "$10 an hour" basic rate I have heard from some companies that pay for your first day of training with them.

If the medical document plays such an important role in determining the correct coding, please consider reimbursing respectfully that professional who is creating the document.

Denise Murphy, CMT
Via e-mail