Visible black character – cracks in the concrete

vbc_crackedAsk me if I am at all surprised to hear there are some issues – and lots of questions and disagreements – with the visible black characterstandard” 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.

Do tell!

“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.

Internet marketers and medical transcription

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9 thoughts on “Visible black character – cracks in the concrete”

  1. “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.”

    Anyone with half a brain can count the lines in a document with all characters including spaces, and then count using VBC only, and see the difference. If paid at the same rate, how can ANYONE say the MT is not losing money, when they are only being paid for 3/4 (or whatever) of what they type?! Those spaces do NOT get their by themselves, and its ridiculous not to pay for them.

  2. Isn’t it fun that nearly 15 years later of my first online venture, and they still haven’t figured out how to rip off a client or MT without getting caught? Because seriously, if an MT is being paid and not knowing how their pay is counted, ummm, why are they working? And if clients have not yet figured out to just stop blindly trusting someone with regard to billables and know they NEED to verify, well then they are deserving of huge billables 🙂

    And Jules, I’m not sure how counting VBC would work. Does that count erasing mistakes I make and retype? Does it count when the doc says no change that?

    Sorry, end of day, very tired and very curious.

  3. I totally agree with you Julie. Spaces contribute at least 15% of any report content, and they do not get there by themselves as ‘FarAwayDeb’ said, the space key does not strike by itself. So if anybody want to adopt VBC, increase the pay by such agreeable percentage. I have been through accounts that were niggard with such tactics but had no option to drop such accounts that don’t care for true human effort. Else,YouHaveToTypeLikeThisForSuchAccounts.

  4. I think those institutions that prefer the VBC just like the illusion that they can see what they are paying for. I doubt they’d ever manually check it, but they think they can if they want to, thus they think the MTSO can’t cheat them. Could these institutions be ones that were messed over by MQ and their line counting fiasco/lawsuit a few years back? I have no problem with VBC in theory as long as compensation made up for the “invisible” keystrokes. Headers, footers, etc. are another complicated issue and not one that is exclusive to VBC.

  5. Julie,

    I appreciate your passion for this subject, even though your post could be seen as an attack on me professionally. I’ve been through the line counting wars and have thick skin, so no problem…

    Like any article that combines random quotes from multiple sources, the story spun in the referenced article can be easily disassembled and made to look out of touch with what MT’s face in regard to volume measurements.

    For a more comprehensive look, may I suggest you look in the For the Record transcription article archives (a tab on the main menu bar). Included is a complete article I wrote on the cost, quality and TAT recommended standards as promoted by AHIMA, MTIA and AHDI. The article (submitted as a 5,000 + word white paper) was broken into two sections: How Well Do You Measure Up and New Transcription Measures give Transcription a Jolt. In the article, the details of the justification for VBC counting are provided as well as a conversion chart to show equivalent rates for the various counting methods. To that end, we and your fellow bloggers are in complete agreement, if you change the counting method, you must convert the compensation rate.

    As far as auditability goes, the VBC method is the most consistent approach by far as it can easily be validated with Microsoft Word or just about any other word processing software. The only issue to watch for is that in Word, the characters in the header and footer are not considered in the “characters without spaces” or any other option under the Tools menu bar Word Count function.

    On the other hand, if you think it doesn’t matter which counting method you use because they all can be equally manipulated, you must not have be aware of the class action lawsuits settled against MedQuist (won by the buyers, lost by the MT’s).

    And although I am not an MT, I have been in the industry for more than 10 years and spent the first ten years of my life as a technical writer, often compensated by production. I’ve strongly lobbied on behalf of the MT’s both in DC with the AHDI Advocacy Days as well as in the numerous articles I’ve written and had published in various magazines over the years.

    Ask around in the industry … anyone who knows me will tell you, I am not the enemy on volume measurement and fair comepnsation for MT’s. In fact, the opposite may be true as I received top honors a few years back when MTIA recognized me as promoting billing ethics and integrity better than anyone else in the industry.


  6. Absolutely nothing personal intended, Dale. I’m just calling BS when I see it.

    I am well aware of the Medquist lawsuit and indeed you will find a blog post here about it. I call BS again as to your conclusions.

    As far as MTIA, AHDI and irregularities, let me just point out – MTIA was advocating the BMP and MedQuist was a participant in the BMP program at the same time the “billing irregularities” were happening. So – color me not impressed by any of it. I call BS again.

    I know your heart is in the right place. We’ll just have to disagree on the finer points here.

  7. Hello sir, if only visible characters are used to measure the linecount, think how the report will look if no spaces are provided. All these measures are taken in order to silently reduce the income of the peoples who work hard.

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