How To Choose The Right Medical Transcription Service For You

Are you looking for a medical transcription service that gets the job done right, done on time, and done your way? It can seem at first that all medical transcription companies look very similar. Be throughout when choosing the right medical transcription service for you, because many do look similar. 

If you go with the wrong company, you could end up spending hours editing and writing to get transcripts you can actually use as part of your patient’s medical chart. Even worse, you may not have any backup if patient files are compromised. 

On the other hand, the right company will deliver a finished transcript that doesn’t require you to do any extra work making edits. In the healthcare industry, your work is already time-consuming as it is.

A good company takes HIPAA compliance seriously to ensure patient file confidentiality, has policies in place in case of a breach, and ensures the company is protected all-around, so you don’t have to worry. 

Which sounds better to you? How do you avoid companies that could put the confidentiality of your patients at risk and cost you valuable time?

In this article, we’ll look at the essential decision factors you must consider when learning how to choose the right medical transcription service for you and your practice, hospital, or surgery center.

Table of Contents

1.               Understanding How Medical Transcription Works

2.               The Going Rate for Medical Transcription 

3.               Security Features for Medical Transcription 

4.               Medical Transcription Accuracy Rates

5.               Medical Transcriptionist Requirements

6.               The Checklist to Ask Your Future Medical Transcription Service Provider

1. Understand How Medical Transcription Services Work

The first step to avoiding winding up with a bad company is knowing how medical transcription works and what steps the company should take through the transcription process to ensure your medical transcripts’ quality and security. 

Note: Always ask the company what steps they follow before sending them your files. 

Step 1: The medical transcription process begins when a medical provider records an audio file of patient-related information. Phones, handheld digital recorders, smartphone apps, or any other digital recording device can be used, assuming they are HIPAA compliant. The medical provider should use a technologically advanced recording device, such as a digital recorder, so that the audio quality is near perfect allowing the transcriptionist to clearly hear and transcribe what was said.

Step 2: Once the dictation is recorded, it’s uploaded to a secure server where medical transcriptionists can download them and start transcribing. Files are reviewed before starting the job to confirm any issues with the audio. 

The reality is that online security risks are always increasing in both a rising number of incidents and cyber attackers’ sophistication. It’s crucial to know that you’re uploading patient data to a secure server, which uses the secure sockets layer protocol (SSL) to protect information from unwanted recipients. Reputable medical transcription companies usually use cryptography or encrypted and decrypted communication at both ends of the uploading process. 

Good transcription companies will announce which kind of secure server they use right on their website. Ditto Transcripts uses secure servers hosted on HIPAA compliant Amazon (AWS) servers and we include this information on our medical transcription info page, so prospective new clients don’t have to ask us as we publicly state where our data is hosted. Transcription companies shouldn’t hide important details like this. 

 Step 3: Medical transcriptionists listen to the files and use foot pedals to control the audio position and speed, replaying the parts of the audio they didn’t quite hear the first time. The medical transcriptionist will create a draft document, using the client’s template, transcribing what they hear. 

Step 4: The same medical transcriptionist will go through the draft and edit/thoroughly proofread the document.

Step 5: Some companies stop at step 4 and send the files back to the client.

how to choose the right medical transcription service for you

At Ditto Transcripts the document is then sent to our QA team for a second pass if needed or to check difficult recording spots. A quick proofread is done again before sending it back to the client.

All members handling PHI must undergo criminal background checks and use protected equipment the entire time working with us. We will offer to show our staff’s criminal background checks to prospective clients as long as they are willing to sign confidentiality agreement.   

Step 6: The last step includes sending the medical transcriptions back to the medical facility. The files must get back to the facility as fast as possible. They are often sent by HL7 secure file transfers directly into an EHR or retrieved from our HIPAA compliant web portal.

2. Know the Going Rate for Medical Transcription 

To choose an in-house medical transcriptionist, or which company to outsource to, you must be aware of the going rate. Below, we list the average rate for both in-house and outsourced options.

If the prices of an in-house medical transcriptionist seem too good to be true, the transcriptionist may lack the required qualifications or experience. Likewise, unbelievably low prices for outsourcing medical transcription could mean getting your files completed under the standard 99% accuracy, done in a foreign country on non-HIPAA compliant servers, or the company will not have enough security measures in place to protect patient data because they aren’t charging enough to pay for the proper protocols.

In-House Medical Transcription Going Rate

Hiring an in-house medical transcriptionist gives you control and convenience. You can train your own employees, ensuring your staff meets your particular standards. If there’s ever an issue, it’s easily solvable by walking over to their office. 

Hiring a full-time in-house medical transcriptionist can easily cost $20-$25/hour or $41-$52K annually. Don’t forget to also include bonuses, promotions, and medical benefits into your budget, which will easily bring the total to $60K or more per person.

Outsourced Medical Transcription Going Rate

Medical transcription typically costs between 7 and 14 cents per line. The industry standard is a 65-character line. In our experience the most expensive is right at 16 cents per line for a STAT file done within an hour.

Outsourcing your medical transcription needs will save your two most valuable resources: money and time. You don’t need to spend time hiring, training, and overseeing staff. You also save big on computers, office space, and other transcription equipment like listening devices and foot pedals, which quickly adds up to 35% of your costs having in-house transcriptionists. You can use those resources for more important things.

Another significant benefit of outsourcing medical transcription is that you are paying for well-trained, experienced, HIPAA compliant transcriptionists, and the best part – they aren’t on your payroll.

A good transcription company hires qualified medical transcriptionists and continually trains them so they meet the highest standards for years to come. 

3. Be Aware of the Security Features for Medical Transcription

Over ten years (2009-2019), there have been 3,054 healthcare data breaches which involved breaches 500 records or more. Those breaches resulted in the theft, loss, exposure, or impermissible disclosure of 230,954,151 healthcare records!

choosing the right medical transcription company

Here are three of the biggest healthcare breaches that have happened so far.

  1. A transportation vendor of the Health Share of Oregon got their laptop stolen, putting the information of 654,000 people at risk. The report did not specify if the laptop was encrypted, but it included contact details, patient names, birth dates, and Medicaid ID numbers. Medicaid had to organize the notification of 654,000 patients. After this, Health Share Oregon updated its annual audit process with its contractors as well as improved workforce training.
  • Florida Orthopedic Institute, a healthcare provider based in Florida, reported a breach in April 2020. The Office of Civil Rights (OCR) breach portal estimates the incident affected 640,000 individuals. The information breached contained appointment times, diagnosis codes, insurance plan identification numbers, payment amounts, and more. According to the WFLA, there’s a $99 million dollar lawsuit.
  • In June, it was reported that a third-party vendor, Central Files, improperly disposed of patient records. The breach included records from Elite Emergency Physicians and St. Johns Health System, resulting in the exposure of 550,000 patients’ data. Central Files had been hired by a host of providers to destroy certain records. The records were later discovered at a dump site in “poor condition, showing signs of moisture damage, mold and rodent infestation, and damage from being mixed with trash and other debris.”

It’s vital to choose a medical transcription service that does everything in its power to keep data safe. 

In order to protect data effectively, medical transcription companies must be HIPAA (Health Insurance Portability and Accountability Act) compliant. 

What is HIPAA?

HIPAA is the Health Insurance Portability and Accountability Act. It sets a standard across the USA for patient data protection. There’s an umbrella of regulatory standards companies must follow to keep PHI (protected health information) safe. All healthcare facilities, including hospitals, medical clinics, and doctor offices, must choose HIPAA-compliant transcription services. Otherwise, they face violating laws and possible lawsuits from mishandled information on the transcriptionist’s end. 

What are the HIPAA Security Requirements?

The HIPAA security requirements cover every aspect of data protection, including administrative, physical, and technical safeguards. 

  • Designated security official
  • Security management system
  • Identity workforce access needs
  • Restricted information access
  • Security awareness training
  • Security incident procedures
  • Contingency plan
  • Evaluations and improvements
  • Third-party contracts
  • Physical facility access controls
  • Strict workstation use 
  • Technical workstation security
  • Auxiliary device and media controls 
  • Audit access control lists
  • Breach audit trail and reporting 
  • Ability to recover and restore
  • Person or entity authentication 
  • Transmission security 

Below is an example of an audit trail required by HIPAA.

medical transcription audit trail

The audit trail tells HIPAA officials the entire history of a medical report from inception, including who opens it, edits it, sends it, and deletes it.

Following the HIPAA requirements makes it virtually impossible for hackers to breach your data. The trouble comes when transcription companies don’t take HIPAA security measures seriously, resulting in serious HIPAA violations. 

Are Off-Shore Medical Transcription Companies Required to Follow the HIPAA Regulations?

Off-shore medical transcription services present medical facilities with some attractive benefits. 

“There are many benefits of working with off-shore transcription providers, including economic, service-level adherence, access to advanced technology, and access to industry professionals with generally more experience than what you might find in a traditional hospital transcription environment,” says Christopher Foley, CEO and founder of the global medical transcription and technology services company, Clinical Documentation Integrity LLC. “These companies utilize the latest technologies, process controls, medical research resources, and quality assurance techniques to ensure their clients receive the highest level of service possible.”

Are the slight benefits worth the risk when choosing the right medical transcription company? 

In 2012, a jury awarded a family $140 million because a woman received a lethal dose of medicine due to an off-shore [AF1] transcriptionist’s error. Thomas Hospital, Alabama, was held accountable for the woman’s death.  

The list of off-shore medical services provided to the US is pretty extensive, often including medical transcription, radiology readings, billing, and clinical decision support. 

In the case of a data breach, under HIPAA Omnibus, the Department of Health and Human Services’ ability to take action against off-shore HIPAA violations falls into a grey area. 

“It’s a mess. There’s lots of uncertainty,” says Kirk Nahra, a privacy and security attorney at law firm, Wiley Rein LLP. “HIPAA doesn’t say a word about off-shore. But a BA is a BA.”

Other than HIPAA Compliance, What Should a Company do to Protect Data?

It’s always nice when companies go above and beyond to gain customer trust and keep confidentiality under control.

At Ditto Transcripts LLC, we make the protection of data a habit in our office. As an example, here are some extra features we offer.

We have detailed reporting and tracking features that include:

  • Monitoring of any modification to PHI across file services to detect breaches
  • Tracking and monitoring of any changes to access rights and file server permissions to identify anomalies
  • Auditing and reporting of data access to PHI to prevent unauthorized changes
  • Utilizing customizable, built-in capabilities for alerts to audit file/folder-related activities regularly
  • Detecting and responding to mass access with customizable, automated responses

Aside from detailed reporting and tracking, we have:

·        Individually defined user access levels

·        Individual user names, passwords, and PINs

·        Scaled network redundancy

·        Virtual private network

·        Dedicated data centers

·        SSL 256-bit secure encryption

·        Secure FTP (SFTP) servers 

If clients have any questions, we are happy to provide proof to make clients or prospective clients feel at ease. 

4. Consider Medical Transcription Accuracy Rates

Medical transcription accuracy rates have been studied often. However, a study by Oxford Academy explains accuracy rates are all over the charts. The confusion is mostly because not all errors are equal. Mistaking there for their may not endanger the patient. On the other hand, a numerical error within a dosage can mean life or death.

AHDI developed a recommended quality-scoring framework.

how to choose the right medical transcription service for you

Here’s how it works:

  • All transcribed documents start with a score of 100. Points are then deducted to get a final score. 
  • There are three error categories: critical (3-point deduction), noncritical (1-point deduction), feedback, and educational opportunities (no points deducted). 
  • If the same error is presented throughout the document, it’s only counted once. 

A score of 98 or better is considered a pass. A report containing one critical error is subject to failure since it’s a 3-point deduction and would obviously be a 97 and a failing score. One or two minor errors results in a pass, even if the mistakes are made several times. 

Taking AHDI’s system into consideration, the USA’s minimum average medical transcription accuracy rate is 98%. 

What can Make Medical Transcription Accuracy Rates Suffer? 

Several factors can affect a transcriptionist’s accuracy rates. 

Firstly, when hiring off-shore transcriptionists, you usually don’t get paired with a native English speaker. While a non-native English speaker can be successful, transcription is the pinnacle of listening skills. The medical providers sometimes sputter, use slang or jargon, advanced medical language, and sometimes don’t provide any additional medical context assuming the transcriptionist will know what they actually mean. There may be many words that are not in the transcriptionist’s vocabulary because they haven’t encountered them yet in their experience. 

Secondly, medical transcription companies who pay their transcriptionists an hourly rate are on a tight timeline to get as much done as possible per hour. If a transcription company pays $20.00/hour, then the company is going to want that person to produce $50 or more worth of completed medical transcription. On top of that, most transcriptionists are expected to spend time editing and doing general administrative stuff like submitting the file to the company’s system. An audio file that’s heavy with medical terminology naturally takes longer to transcribe, and transcriptionists naturally don’t want to work time they aren’t being paid for. 

Lastly, in medical practices, transcription often falls under administrative duties. For the best medical transcription accuracy rates, the transcriber needs to be extremely focused and patient. Physicians coming out of a long shift understandably might have trouble focusing on all of their dictation like one would hope they would, which can affect the audio quality.  Poor audio quality with an untrained administrative assistant doing the transcription can be a recipe for disaster. 

How to Get the Best Medical Transcription Accuracy Rates

With the number of medical transcription services that can be found online, it can be tricky to identify which companies have the key factors that ensure accuracy rates. Many people blindly choose the least expensive service and move on with their day. This could cause problems that could be avoided by creating a simple checklist of what to look for. 

To find the best accuracy rates, consider the following points in your checklist: 

  • Based 100% in the USA
  • Native English speakers 
  • Pay per 65 character line (industry standard)
  • Personalized transcription (you are matched with an industry specialist)
  • Accuracy rates guaranteed
  • Free trial offered 
transcription accuracy checklist

Most transcription companies openly mention these points on their website. If one of the points is missing, make sure to follow up before sending your files.

What Should You Do if They Don’t Deliver the Promised Accuracy Rate?

A promise is everything a company stands for. It’s the unique statement of what separates the company from its rivals and what makes it worthy of your consideration. 

If a medical transcription service does not follow through on their promised accuracy rate, they should immediately give you a refund. 

If you initially signed a contract with the company, they should cancel the contract with no strings attached. 

A medical transcription service’s customer review page can give you an idea if the company is reliable or not. Search for Google, Facebook, and website reviews. 

5. Investigate Medical Transcriptionist Requirements

As far as education, the minimum requirement for a medical transcriptionist is graduation from a medical transcription certificate program. A certificate program qualifies transcriptionists for most entry-level medical transcription work. Some employers prefer hiring transcriptionists that have an associate’s degree for working in areas needing specialized knowledge. 

Medical Transcription Certificate Programs

Medical transcriptionist certificate programs usually last 90 days and are offered through vocational schools and online courses.

Something to be aware of is that these schools often don’t have an internship, which can be vital for a transcriptionist’s skill development. Another flag is that not all certificate programs are accredited. The accreditation can be necessary if the transcriptionist chooses to pursue an optional professional certification in the future. 

Having a professional certification allows transcriptionists to declare themselves as certified medical transcriptionists. Learn how to become a medical transcriptionist here.

Medical Transcription Degree Programs

Associate degree programs typically take two years to complete. Transcriptionists can also take these programs at vocational schools and community colleges across the country. Most of these programs offer internships where transcriptionists get hands-on experience and will help grow their skill sets even more. Again, accredited programs are essential for transcriptionists who want to become certified. 

Professional Medical Transcription Certification Options

Note that it’s not required by law to be a certified medical transcriptionist. However, many medical transcriptionists take the opportunity because it opens employment doors. The AHDI (Association for Healthcare Documentation Integrity) offers two different professional certifications for medical transcriptionists:

·        The Registered Medical Transcriptionist (RMT)

This certification is for newly graduated medical transcriptionists with less than two years of experience. 

·        The Certified Medical Transcriptionist (CMT)

Medical transcriptionists who have their RMT certification and more than two years of experience can get their CMT certification. 

The two professional certifications are there to distinguish the abilities of a transcriptionist. While RMTs can transcribe basic medical files, CMTs’ duties often require transcription of advanced medical vocabulary and other demanding types of files. 

The level of certification transcriptionists have is undoubtedly a factor to consider when handing your audio files to a transcription company. If your files are tricky, make sure the company has appropriate transcriptionists for the job. 

6. Create a Checklist of Questions to Ask Your Medical Transcription Service Provider

When people want to learn more about a business’s reputation, where do they go first? 

Their online reviews.

While reviews are a great place to start, relying solely on them can be deceiving. You don’t know where those reviews came from, and if there is nothing but outstanding reviews, is it genuine?

Before making a final decision, don’t rely on company claims and reviews. Dig a little deeper by asking questions.

Here are some of the questions to ask your potential medical transcription provider:

1. Is the service truly an American company with real offices in the US and not just a PO box, or a division of a foreign company operating in the US?                                                                   

2. Do they run criminal record checks on all staff with access to your data? Are they willing to share the criminal record reports upon request?

3. Do they have general and cyber liability insurance policies they can include you on?

4. Can you call them and speak with someone on the phone who is in the US?

5. Is the procedure easy if you’re not satisfied with the work?

6. Can they prove their HIPAA compliance?

Choosing a company that believes in transparency and ethical business practices will save you from jumping through hoops to find the great company you were looking for in the first place. 

Ask as many questions as you can. Through this, you could gain a life-long medical transcription service that delivers your reports at the highest standards every single time. Interested in learning more about the best type of transcription jobs? Click here.


Are you ready to choose the right medical transcription company for your needs? Remember to consider every point in this article and avoid companies that could potentially cost you hours of editing and putting your patients’ confidentiality at risk.

Here at Ditto Transcripts, we are a 100% American medical transcription service that can answer all of your questions without hesitation or half-truths or non-answers. We created this business intending to give clients a finished product right away that fits all of the client’s needs. Contact us to see how we can work together.

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