Healthcare Leadership and Innovation

Transcription Reconcilation Responsiblity?

  • 1.  Transcription Reconcilation Responsiblity?

    Posted 10-25-2018 16:32
    Can anyone share who is responsible to reconcile reports against scheduled patients in physician offices?  We have an office that some providers use Dragon and/or templates while others dictate or do a combo depending.  I am getting pushback saying it should be the responsibility of the transcriptionist (in-house and service) to make sure we have a report in the system for all patients on the schedule.

    In my 25 years in hospitals and physician offices, I have never had a transcription company perform this clerical function, but rather someone in each individual office and/or physician with open encounters.  The only exceptions were in-office transcriptionists, a very small personally owned company or large system with a separate clerical support team.  I would think qualified transcriptionists should spend their time transcribing vs. tracking down why a report is missing against a schedule that does not indicate no-shows, APP's vs. physicians seeing patient, etc..  At this point, our two transcription companies do not offer this service either, so not sure if any do?

    Please share your workflow.
      Thank you!


    Susan Chamberlain, MSCTE, RHIA, CDIP, CCS-P
    Network Director of Him Services


  • 2.  RE: Transcription Reconcilation Responsiblity?

    Posted 10-26-2018 06:43
    Hello Susan,

    Reconcilation of patients is the responsibility of a designated office staff member not the  transcription service.  You may not find a service that will perform this task.   In the hospital setting this is done by HIM Chart Ansalysts, not a service.  In the office setting it's the person who reviews the chart for completion.

    The transcription service is only responsible for reconciling reports already dictated in the system, but awaiting transcription.

    The only was I can see transcriptionist assign this responsibility is if he/she is employed by the provider and thats part of their job role.

    Good luck.

    Haimwattie R. Pariag, RHIA, CHP, CHTS-PW
    Sr. Revenue Management Consultant
    Trinity Health

  • 3.  RE: Transcription Reconcilation Responsiblity?

    Posted 10-26-2018 08:20
    ​While not a formal procedure, our office coders can tell us who does not have a report for the day they are coding.   While they are coding, they compare their "work list" with the schedule.   If there is a patient who was seen but does not have a report, they alert the provider's office with a carbon copy to the clinic manager.   It seems to work pretty efficiently.   Good luck!

    Jean Uhlenkamp
    Clinical Documentation Improvement Specialist
    St. Anthony Regional Hospital

  • 4.  RE: Transcription Reconcilation Responsiblity?

    Posted 10-26-2018 09:27
    ​I don't see this as the responsibility of the transcriptionist.  Their responsibility is to transcribe the reports that are dictated to them.  I see this more as the responsibility of whomever is doing the billing for the office/clinic.  They should be verifying that they have the appropriate documentation to support what is being charged.  When they identify a visit for which documentation is not present, they should pend the account from billing until the documentation is completed by the physician or appropriate provider.

    Shelley Hurst
    Administrative Director, Him

  • 5.  RE: Transcription Reconcilation Responsiblity?

    Posted 10-26-2018 12:18

    Deficiency management is the responsibility of an organization and the organization decides where they spend the money to complete the task. Traditionally, this type of deficiency tracking is seen at the individual physician office (where they have the best handle on no-shows and cancellations, for example) or in the HIM department. No matter where it is completed – the facility as a whole is committing staffing hours and money on this necessary function.


    I managed transcription for over 10 years and never had a transcriptionist do this kind of thing but if my facility wanted us to handle it, then I would have either 1) gotten approval to add and hire a clerical support person to do the work or 2) assigned it to the transcriptionists and then modified their required 'lines per hour' on performance appraisals. This work would reduce the volume that the transcription staff produces obviously. Again, there is a cost associated with deficiency checking, and the facility needs to decide where they want to spend it.


    If the facility wants an outside transcription agency to do this clerical function – then again, it will cost them because the outside company will produce less transcription having their staff do the work, or add on 'clerical billable hours' or some such thing.  Again, there will be a cost to the facility to complete deficiency checking. They need to decide where it can best be done and where they will spend the money to get it done.


    Denise VanFleet, MS, RHIA |Program Coordinator, HIM BS Program; Assistant Professor

    Rasmussen College - National Online

    Office: 630-366-2938