Visible Black Characters (VBC) In Medical Transcription Billing

Article excerpted from by Julianne Weight

At the heart of transcription billing practices is what we call a billable unit. A billable unit can be any unit of measure agreed upon between the client and the vendor, to include but not be limited to:

Recorded minutes: The number of recorded minutes as reported by a dictation system or (in the case of digital hand held recorders) the job file information.

ASCII characters: In transcription, the reference is to ASCII* printable characters.

Characters: A 65-character line is nothing more than characters divided by 65 to obtain a “line.” The “visible black character line” is nothing more than counted characters that excludes those that cannot be viewed by the naked eye.

Gross Line: A gross line is defined as any number of characters taking up one line of type, regardless of the font or length.

Gross Page: A page containing any text as it would be printed on a printer.

There is no such thing as a “standard” rate or what some refer to as a “going rate.” If you’re at a facility that contracts for outsourced transcription services, nobody can tell you if what you’re paying  for transcription is reasonable, fair or otherwise equitable. The requirements from facility to facility are too different for that. A colleague at another facility in your same town may tell you their line rate is much less than yours and you need to renegotiate it, but unless you share details of the contract and both facilities operate on the exact same terms, you aren’t making an apples-to-apples comparison. Your billing rate may be very reasonable for the services you’re getting. You may read in a publication that “nobody should pay more than $0.XX per line” for transcription – but that ignores the details of what the client requires and the definition of a billable unit. Statements like this have contributed to ongoing issues with contracted rates and billable units.

Likewise, if you’re an outsourced medical transcription service, you have to determine for yourself what rate to charge and whether or not you can make money at that rate. Medical transcription service owners frequently hear rumors about the “going rate,” either from other transcription service owners or from prospective clients. Unless you know how that rate is calculated and what services are included in that price, it would be irresponsible to base your own pricing for services on whatever you’ve heard or been told.

If you are a medical transcriptionist working on production, it’s up to you to make sure you understand how production pay is calculated and how it is reported back to you. The company you work for has a responsibility to assist you in doing that, but they do not have to pay you by the same unit of measure they bill the client. With privacy and security requirements in the medical documentation industry, it’s becoming more and more difficult for transcriptionists to independently verify their production. Therefore, it’s even more important for a medical transcriptionist to understand how the units are calculated and compensated.

There are three factors in transcription: price, quality and turnaround. Regardless of what a transcription service may promise, it is only possible to deliver two of the three. If the price is low, quality and/or turnaround is impacted. The higher the price, the better the turnaround and quality.

It would also be irresponsible of us to entertain a discussion of what constitutes an “average billing rate” for transcription services across the United States. What we can do is help facilities determine is whether what they’re being billed is congruent with the contract and whether they are actually getting the services outlined in the contract.