Ask me if I am at all surprised to hear there are some issues – and lots of questions and disagreements – with the visible black character “standard” that was concocted by a joint task force a couple years back. In addition to my first post about this at the old MT Exchange site, I posted a followup earlier this year: Visible black character, revisited. In addition, I put a web site dedicated to an explanation of the various methods of billing, including the visible black character.
As I had predicted – there's no method that can't be manipulated.
Whether the issues arise from manipulation or from the fact that the “Joint Task Force on Standards Development” issued a white paper, not a standard, and failed to use actual standard-setting methodology, is debatable. But – I was catching up on my reading and came across For the Record‘s article: “Buyer be Aware.” I'm sending a great big thank you to them for putting this online so everyone can read it.
My first bone of contention in this article is some of the quotes attributed to Dale Kivi, director of business development at FutureNet Technologies.
While many companies such as SPi say they prefer that providers adopt the VBC method, Kivi suggests that a good deal of the resistance has come from transcriptionists themselves. “Whereas HIM directors have been coming up to speed on adopting VBC, the understanding and acceptance at the MT [medical transcriptionist] level has not progressed as rapidly,” he says. “Some transcriptionists are wary of changing because there have already been so many changes to their compensation. They see any change as something that could reduce their pay for the same volume of work. And because the VBC method eliminates payment for spaces, they worry it will eliminate something from their salary as well, which of course it does not.”
Dale, obviously you don't work in the trenches. Let's count the number of MTs who comment on this and tell me that they were asked to convert to the VBC and either (a) didn't get an increase in line rate to compensate for the lost characters, (b) weren't advised that a change to the VBC without a compensatory increase in the rate paid per line would result in reduced pay for more work and/or (c) weren't even advised that their company's line counting software was being changed to the VBC.
And here we have a promotion of the biggest lie perpetuated by those promoting the VBC:
One of the most important benefits of converting to the VBC method is that it allows documents to be easily verifiable. With previous methods, there was room for improper billing practices to take place.
I have to keep beating this drum:
- There are no methods that can't be manipulated
- Unless someone is counting – manually – all the visible black characters (note the importance of the word in bold), this method is no more accurate than any other method that uses software to count the billable units.
The assertion made by Kivi and others is that the VBC is much easier to audit because “what you see is what you pay for.” I would like to know from the industry leaders how many companies are auditing by actually counting the visible characters with no software. Because the bottom line is – the VBC is only more accurate if you actually sit and count each visible character on the document you are auditing and only easier if you were using an abacus to verify your invoices prior to going to the VBC.
Oh – but wait! Read on in the article and you see where the cracks are starting to show in the stressed-out “standard.”
Of course, nothing is ever 100% foolproof, and there are some bones of contention even when using VBCs.
“Headers and footers are one issue,” says Cohen [president of SPi Healthcare]. “Some clients are OK with counting headers and footers across all pages, since they are visual characters, while others may insist on counting the first page only.”
What a surprise – some people want to have their cake and eat it, too! Look, folks – either you pay for all the characters you see on each and every page – or this “standard” starts on that slippery slope to join the calculated line. It seems the demographics are joining the headers and footers on that slippery slope. It doesn't at all surprise me that this issue has come up. There were reasons why the calculated line was abused and those reasons still exist in the industry. Those reasons didn't go anywhere just because a joint committee got together and came up with a new way of counting billable units. At fault are both parties involved in the transaction (you know who you are).
Now here's what I find to be the real kicker in the whole article:
Kivi agrees that it’s important for both parties to be clear about these types of details to avoid the perception that the transcription service is attempting to sneak something under the radar. In that regard, he considers communication to be a key to better billing.
No s***, Sherlock. And if this was the case across the board, there wouldn't be a need for the VBC.
Back to my bottom line: you can use any method of calculating a billable unit as long as it is transparent and verifiable.
Oh yeah – and I'm just never going to understand how any of these people can claim the VBC is easier to verify. I'm begging Kivi or anyone else to explain it to me.