Stay Away From Nuance Medical Transcription!

Stay Away From Nuance Medical Transcription!

As you probably already know from previous posts, I am a recent graduate of the Medical Transcription course at Everett Community College here in Washington. I finished up the course in 1 year 3 months since I hit a few speed bumps along the way that prevented me from finishing up in the allotted time of 9 months. Regardless of how long it took, I did it, and that is a huge accomplishment for me.

After graduating, I immediately set out the hunt for jobs who hired beginners in the Medical Language Specialist field, and Nuance happened to be the easiest to get the foot in the door with so to speak. They required me to agree to work full-time for the first year since I was entry level and I needed to have a 99.5% accuracy at all times, but they would be lenient with me to allow me to get up to speed since I am a beginner. Since I would be hired as an employee, I qualified for benefits after 90 days too. Everything sounded good and I started training for the work at home MLS position on February 4th, a few weeks before my Vegas vacation. The training was extensive video watching, probably a little too much to consume, which left me confused about the platform I would be working on. I did have live training a couple times, but they basically went over the same thing that we watched in the video and it helped some, but of course, you’re not going to remember everything that you had gone over previously, especially since they didn’t want me to start until after my vacation. So 2 weeks go by, then I have my vacation and start my official start date on March 6th at noon. I did not have any idea I would be starting that day since my supervisor decided to say just jump right in after our phone meeting. That was fine, but I didn’t get much done because I was trying to familiarize myself with the platform, account specifics that doctors require from you and a bunch of other stuff.

The first week was rough, as to be expected. My supervisor requires a weekly phone meeting to see where I am at. She recognized my errors immediately and told me I needed to improve these. For those that don’t know anything about medical transcription/editing, you’re basically listening to a crappy recording of a doctor who talks like an auctioneer or a foreigner or someone sucking on a cough drop or whatever the case may be, and you need to transcribe exactly verbatim. That means if you miss or add any of these when they are not said, “the, an, a, and, etc.” you will get marked off for it, and believe me, it affects your accuracy rating. I had a lot of them because the recordings for the most part sound so garbled, or doctors wouldn’t enunciate correctly, so even though there was a “the” in there for “the patient”, they would say it so close together that you thought they were only saying, patient. I have even added a the in there to make it “the patient” when there wasn’t because I figured that it was more grammatically correct. Don’t ask me why you get dinged for these nonsensical errors because I don’t have a clue. Now don’t get me wrong, I had a few critical errors for not seeing that the patient’s age was incorrect. You would think that the doctor should be penalized for this since he’s the one that spoke the wrong age, but nope, it’s our ass if it’s wrong because we are the ones that have to fix their reports. Critical errors are the highest errors possible, which is a HIPAA (Health Insurance Portability and Accountability Act ) error. We could be sued for these errors. Now do I think that an incorrect age is going to put the patient’s life in jeopardy? Not really. My errors were not huge errors to where the age was a child, but put as an adult; nothing like that that I can see affecting the patient’s outcome with possible medication and whatnot.

Week 2 went by and I still had errors as to be expected because no one is perfect, not even the men and women who have been doing this for 20+ years.

Week 3, my errors were still there but slowly and surely improving from the previous 2 weeks. My supervisor scheduled a meeting with me and HR, more than likely to scare me into trying to do better since she’s evil like that. On the phone meeting, they made an agreement, not me, “THEY”, that I need to have half the errors of week 3 for the next 2 weeks. This means I have very little leeway, even though I am still new at this. Three and a half weeks is not enough time to be perfect at the platform when you have to pend to hospitals, search patient information to make sure it’s correct, make sure the work-type is correct (which I think should be the doctors responsibility), the correct date of service (again, doctors should input this information before they upload it to us, the client) They’re getting paid to see patient’s for like 20 minutes, yet make you wait in the waiting room, and again in the exam room for hours while they come out and speak their reports for us. You wonder what they’re doing, this is what they’re doing, along with visiting with their peers. You hear so much stuff on the recordings that it’s quite humorous. You may be thinking I am a bitter doctor hater, but I assure you I appreciate everything they do for us, I just don’t like how they get ridiculous amounts of money when we’re the ones doing their paperwork for pennies. This job position used to make $20+ an hour, but ever since outsourcing became the norm, they make everyone work for pennies or in my case $9.19 an hour which is the minimum wage in my state. (if I wasn’t an actual employee, I would have only been making $5.40 an hour which is ridiculous.) This is a lot more than some places, so I was grateful for that, but for the amount of work you do, it’s a complete joke. So, half the errors for the next 2 weeks did not seem possible to me. Not to be negative, but I knew that goal was way out of reach with this being my first MLS job.

Week 4 was much better. I had half the errors as the previous weeks, but my supervisor didn’t care because I already failed her 2-week requirement. Our phone meeting consisted of her being quite angry about FIESA not working correctly so she could check QC’s grades for me. I mentioned that one QC person, in particular, kept dinging me for the same thing over and over and there were about 10 in that report. She immediately fixed those once she saw them, but that still didn’t give me any leeway for the job as she said it’s up to HR if I get to stick around or not, which was a new phone meeting scheduled for next week.

Week 5, I am doing markedly better and had half the errors of week 4. My accuracy was even 98.6%. But, since I failed their goal, it didn’t matter. They didn’t see me as improving up to their speeds or standards. I was improving slowly but surely each week and they didn’t give me a chance. My supervisor complained to HR, otherwise, none of this would have taken place because they’re all scatterbrained for the most part anyways. Most people don’t even clock in on days they’re supposed to and HR/payroll doesn’t care. So basically this goes to show that my words stand correct.

HR was on the conference call and told me sorry, they had to let me go because my errors were consistent. My supervisor was lying to her saying I had more errors than what FIESA was stating, but I wasn’t going to sit there and argue with them because I want a company who is actually willing to work with their employees and give them all the possible help they need in order to succeed.

Had I known that this job would not be a place that I could learn to grow, I probably wouldn’t have wasted my time. Hell, I wasn’t even given a 90 day probation period to get up to speed; whereas if I was given one, I feel like I would have been way more familiar with everything and could have improved drastically.

…you live and you learn I guess.

For anyone trying to do Medical Transcription as a career, I honestly hope reading this makes you avoid it like the plague. Each company outsources to other countries because they work for less. Big dogs are being let go because they make too much money, and they over hire new graduates because they know they probably won’t last long enough to make it anyways. So let this be a warning to you. I wished I had someone telling me that this was a dying field before I went to school for it. BTW, if you’re currently in school, don’t bother listening to them say that you SHOULD or NEED to get certified or registered. This is just a ploy to give money to AHDI, the people who started the certification process. No MT job asks for it or makes it a requirement according to numerous people on the MTStars forum board, so don’t waste your hundreds of dollars testing for it!

Hospitals are letting go of their MLS workers and being bought out by bigwig companies like Nuance and M*Modal. Just know, that if you do decide to work for any of these companies, you will not be able to financially support yourself on your own. If you’re a supplemental income and you don’t mind working for minimum wage, then go for it. You might have better luck than I since there are millions of different accounts to work on and different supervisors to work for!

I just wish you good luck, because you’re going to need it.

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Vegas: Day 3 – Moving to Mandalay Bay!

As most of you know, if you follow my blog, I got the 2 night stay in a great room suite at Mandalay Bay for free by participating in the MyVegas Facebook App. I was kind of dreading check in because I heard of other people being charged the resort fee even though it’s supposed to be entirely comped. I waited in line, with 2 suitcases, 1 bag and extra crap that we had our booze and mixers in since my husband had to go find a bathroom. It was actually annoying to move all of them as the line would move every 10 seconds when a person would go up to the many counter options. Thankfully, this nice guy behind me would help me each time so I didn’t have to grab everything every time. LOL

Finally, it was our turn and the check-in process couldn’t have been any smoother. No resort fee, 100% comped. When she asked us if we wanted a room near the elevator or at the end of the hall, I wasn’t thinking about how long of a walk it would be from the elevator or how others not near the elevator were probably fuddyduddys, but decided to choose away from the elevator, which ended up being a huge mistake!! We were at the very end, and I mean the very end of this mile-long hallway of rooms. At least we know we’re burning off calories just to get back to our room to get necessities like booze, but it was painstaking every time. We got all situated, and I was actually contemplating asking for another room closer to the elevator but didn’t want to go downstairs and wait in that long ass line again for another 15 minutes so we decided to suck it up since it was what we initially agreed on. Never again though, that’s for sure!!

We then decided to make ourselves a drink since it was about 4 pm and then made our way to the tram to Luxor so that we could go pick up our free carrot top tickets for this evenings show that I also got from MyVegas. Another painless process, except he couldn’t find me in their computer system at first and asked if I had a confirmation slip. As soon as I start pulling up my email, he says oh here it is, then asked how I got front row. Well, sir, it’s because I booked it months in advance. Said my thank you’s and walked away, which was just at the right time because a couple of our other friends just got out of the bodies exhibit right across the way. They were headed to Walmart to get booze though, so we didn’t hang out for too long.

After that, we just walk around and then eventually head to New York New York to use up my $75 credit to one of their restaurants and decided upon Chin Chin for some Chinese food. The food was decent, but they didn’t give you much on a family-style platter for the price. Also, do not order drinks here. They are like $13 a piece for one of those small, slender style glasses that they usually serve you when you’re walking around the casino. I about shit my pants when I saw it. I should have said something but I didn’t want them to spit on my food. You couldn’t even taste the booze either, I mean how could any booze fit in it when its topped with ice and mixer? Stupid Vegas, stop ripping people off with your ridiculous prices on booze and your tiny ass glasses. Now you understand why we go to Walmart to get stocked up all the time. But, since I had the credit, I had to spend it on something.

After we were all nice and full, we ran back to our room to drop off a few leftovers we had and grab a drink since it was almost time for Carrot Top. They actually allow you to bring in your own drinks and I thought that was cool since most of the shows don’t. Now if you haven’t seen Carrot Top and you plan to, I won’t ruin his skits for you, although I’m pretty sure he changes it up quite often, so people will continue to come back. When you walk in the venue, you pretty much see animals getting it on on the screen inside. So if you find that offensive, you probably shouldn’t be going to see him anyways. My husband was getting a little buzzed and usually, that means he’s loud. He kept drawing attention to himself but Carrot Top was probably like ignore the drunk, obnoxious guy. But when Carrot Top asked if there were any fellow redheads in the audience, of course, my husband raises my hand for me and then his immediate focus is on me and so is everyone else in the audience. Good thing I couldn’t see them since I was in the front row, but the people next to me were all staring so I knew everyone else probably was too. If you know me, you know I hate being the center of attention. Anyways he asked me a question about if I knew redheads were a dying race. I knew, but I acted confused. lol

About mid-show, he gets out his crown royal and plastic cups and starts pouring and giving to random people. I think he avoided us because my husband was already feeling good. You drunk dick, thanks! 

After the show, Carrot Top came up to the front row and shook everyone’s hand. He told me he liked my top, probably because I had cleavage going on. Why else would a man say he liked my shirt, hmm?

A friend of mine mentioned how gross he was and to avoid the roid juice he squirts from his nips, but actually, I think he toned the roids down a bit since he wasn’t so abnormally bulky in weird sections of his body anymore. He looked completely normal, besides the facelift and plastic surgery. He denies it, but I know it’s been done.

So now we started heading downstairs to get back on the tram but stumble upon a karaoke bar in the Luxor. I figured we might as well use our CT tickets to get a buy one get one free drink since it mentioned that inside of the venue. We did that, and the drinks were exceptionally well, and 2 for $11 is not bad considering all of the other places we’ve been ripped off by at this point.

My husband is a karaoke freak and likes to make a fool of himself, especially when he’s drunk. I, even when drunk, like to sit back and laugh at him and not get up there because one, I know I can’t sing, and two, I don’t like being the center of attention as previously mentioned. He always begs me to sing love shack with him, but that song is like the most played out song at a karaoke bar. I tell him, I’ll sing with him at home. Sometimes, I wish I would just let go and be outgoing but it’s kind of hard. Anyways, he’s having trouble finding a song, so I pick something that I know he’ll be good at with his personality. He loves Billy Idol, and he can do him decently, I think anyway, and so he chose “Dancing With Myself”. I got out the video camera when he did it just so he can see and hear what he sounds like. He got so embarrassed and told me I am not to post that on Facebook. I so desperately wanted to since he was grabbing his body like he was making out with himself. He’s a funny fella. So we text our friends to come on down and join in the fun, they do, but after Don’s done singing, we all move along back to our room. We started heading towards the tram and they shut it down at 11 pm. This is Vegas people, why is it shut down at 11? JEEZ!!! So now we have to walk all the way through the Luxor, through the Mandalay Bay Shoppes and finally an hour later get to our room.

We start pouring drinks for everyone, which is 10 people in our Great Room Suite. Remember when I said we chose the end of the hallway? Yeah, well about an hour after being in the room and listening to some 2pac on their iPod docking station, we get a knock on the door. It’s security telling us they got noise complaints, which I didn’t think we were being very loud, but I guess when you have 10 people talking it may seem that way. We were dancing, drinking, playing poker and listening to some music. Didn’t think that would have alarmed anyone. But, I think the convention people were right next to us like I said, so they complained. The security guy told us this was our first warning, if we get 2 more, we’re getting kicked out. So obviously we didn’t want to get kicked out, so we headed out of the room and downstairs and to Excalibur. Six of them randomly disappeared, so now it was 4 of us left. We played some slots a little bit then decided to call it a night too. After all, it was probably pushing 4-5 a.m and we needed some sleep.

Until next time.

Vegas: Day 2

We didn’t really have any plans laid out while we were downtown besides a nice dinner at The Flame Steakhouse in El Cortez at 6:30pm today. We did a little bit of gambling and walking around on Fremont, but didn’t really win anything.For brunch, we decided to go to Mandalay Bay at the Border Grill to meet up with another couple that hadn’t come downtown to hang out yet. When we got there, they mentioned that they weren’t serving brunch anymore because they couldn’t keep up with the orders. Well, I should have known that the MyVegas Facebook group was there that day, because they planned a meet around the time we were visiting, and there’s a free brunch reward for the Border Grill on the MyVegas Facebook app game. The couple that we met up with had the reward, so the waiters made an exception for them, but I didn’t get it so I didn’t want to spend $30 on the meal plus whatever for a drink. I stuck with a grilled caliente chicken torte. Let’s just say I wasn’t very satisfied with it, but it filled the tummy and will definitely make a turd.

So after we ate, the 2 other couples decided they were going to go check out Shark Reef, but the night before we had already said we would go with the other 2 couples and decided to wait it out as we had free passes too.

We walked around Mandalay Bay to get a feel for the hotel since we would be moving our stuff and staying there on Monday. We gambled a little bit, but I wasn’t having very good luck, especially with the machines that I normally like to play which are the double diamond deluxe .25 machines. After walking around and losing a little bit of money we decided we had enough and wanted to get back downtown. I was so full and just wanted to go take a nap or do a little gambling downtown again.

We head to the El Cortez since that’s our favorite spot to lose a little money. I wasn’t having luck there either, what is this shit? Supposed to have the loosest slots in Vegas and I’m not even winning a 1.00. We go back to our hotel and try to make plans with the others. They asked what we were doing for dinner, so we mentioned the Flame Steakhouse and so they all wanted to go. It took about 3 calls before the hostess there got our reservations correct with the right amount of people we specified. Plus, we bumped dinner up to 8 pm since we were completely stuffed from earlier this afternoon. That’s the bad thing about Vegas. You can eat one meal and be completely stuffed, because you’re drinking, walking, and retaining water so you feel bloated most of the time. We probably ate 2 meals a day because of this.

We arrive at the steakhouse and the hostess can’t find our reservations. WHAT!? We called like 3 times to make sure they were correct and now they’re no where to be found? Wow, they need to rehire some new staff, preferably not foreigners. Now we have to wait about a half an hour for them to set our table up and get us seated, so we went next door to the new bar they have. I didn’t order anything because they didn’t have any spiced or cherry rum. How do you  not have any flavored rum? It’s supposed to be a bar, pfft.

Finally our table is ready and I wanted something light, so I ordered the grilled salmon with asparagus because my appetite even at 8:30 pm was not huge. We also got a bottle of Riesling since I had a $25 off coupon from my American Casino Guide Coupon Book, which was plenty enough for my husband and I to have a glass and a half each with our meal. Once we were finished up at dinner, we decided to go hang out at the casino until we figured out what we were doing with the rest of our evening. I sat by my friend at one of the slot machines. She’s a newbie at gambling with slots, so it was kind of amusing seeing her bet the most minimum you could bet on a penny slot. Both her and her husband are cheap, so I knew she’d probably be focused on the penny slots. But, you can’t win if you bet 1 penny x 1 line. That’s betting 1 cent. You’re pretty much just going to waste your time and money, but if pushing the button or pulling the handle is what you enjoy, then I guess you’re set. Anyways, a drink staff member comes by and yells drinks, anyone want drinks. And of course I say yes. But then she looks at my machine and says are you going to play. I said yeah. I don’t need someone to tell me I need to gamble in order to get a drink, especially when you get a tip lady. She pretty much just ruined her chances of getting a tip. When I was at Mandalay Bay, I was sitting at a machine without gambling and a lady asked if I wanted a drink, so I know they don’t care if you gamble since you’re in the casino and have probably gambled at some point.

Even though she pretty much told me I needed to gamble to get a drink, I decided to put a $5 bill in the penny machine next to my friend. I bet the most amount of lines which I think was 30, then x1 or x2, which is either .30 or .60 cents a pull. Since I am not lucky with penny machines, I tend to avoid them, but it was actually paying off a little bit to sit there and play this machine. I got the bonus a few times, which resulted in small wins, but at least I walked away with $40 instead of $5. And the lady never got a tip from me when she brought my drink to me. That’ll teach her to tell me I need to gamble. I’ll walk away with money and not share any.

After that, we all decided to head back to our room at the D and chill a bit with some drinks. After about midnight, the other 2 couples decide to head back to their room and call it a night at the Excalibur. I heard a really good metal guy outside singing, so I wanted to go back down there, but didn’t get the others to get off their butts until 1 am when they stop all the concert shows. I guess I could have went down there by myself, but it’s a scary place down there when you’re alone. So I decided to gamble some upstairs at the D where the coin machines are that actually pay you in coins and not tickets. That’s old school yo! I was actually having a bit of luck on the haywire machines and at around 3am, I decided I am way too tired to be up this late, when we just stayed up til 5am the previous night. So I headed to bed, while thee husband stayed upstairs and gambled some more. Might seem crazy, but we enjoy it. I actually made out more than I had put in, which was only $20. I was pretty much just trying every machine I could to try and get rid of the coins I had so I wouldn’t have to go downstairs, but that didn’t work since I kept getting more out. lol

Call me weird, I know.

I at least was up for the day and probably for the entire trip that time. I usually don’t put much in at a time, and that seems to work best for me, at least so far.

Until next time.

Vegas: We Have Arrived!!

Even though I’ve flown to Vegas 4 times now, this being my 4th, I am never fully prepared for the plane ride. It gives me major anxiety to where I need to shit a few times throughout the day. Maybe a little TMI?Anyways, we set out the door to head to my moms so she can take our car back home with her so we wouldn’t have to pay ridiculous parking fees for 5 days. We arrive at the airport, pick up our boarding passes and drop off our bags. Head to the security area and take off everything required upon entering their body scan machine. Some new thing they’re doing now, which makes me a bit nervous and creeped out because they can see your private parts. They say they are being removed by the TSA, but why are they still in Portland and Vegas airports?

Once we arrive in Vegas, we hop on the shuttle transport to pick up our car at Enterprise. This was kind of a breeze since we used the kiosk instead of waiting in the line for a half an hour. Although, they seemed to add on some more taxes and shit that weren’t included in our reservation prices. One thing I hate about Vegas is they nickle and dime you for EVERYTHING.

Now’s the time to pick up some booze at Walmart. Yes, Walmart of all places since it’s the cheapest booze place in town. We discovered that on our first trip since most drinks are $10+, even for wells, and you can get a $10 fifth at Walmart and some solo cups and walk around with your own booze. Bad thing is, you have to head to your room every time you want another drink though. But when you’re staying downtown, it’s not too bad. However, on the strip is another story since each hotel is miles and miles long, so you kind of have to get a drink in between trips back to your room.

We always grab a fifth of spiced rum, regular rum (since there’s a million places for slushy drinks and that’s what they mainly use [we bring flasks for this very reason]) and vodka for our 2 night stay downtown at the D.

We start heading downtown because there’s this Mexican place that was really good and inexpensive right across from El Cortez that a friend likes since we were all starving for food. Unfortunately when we got down there, we noticed that it was out of business. So then we park our cars and start walking down Fremont to find food. Normally we go to the place with the big beer mug outside for breakfast, but their service and food has gone down hill since the first time we ate there and so we tried to avoid that place, but then I was like well we can go to the place next door which was a fish house. I think they are owned and operated by the same people because the service and food was subpar still.

A couple of our friends head back to the airport around 9pm to pick up our friends that had to be fashionably late and check them in and hang out until around midnight on the strip where they were staying. After that, they head back downtown to chill with us some.  So there’s 8 of us hanging out in our room, listening to music, drinking booze, and around 2:30, 3:00 am we decided that we were hungry so we start walking down fremont which BTW is dead at that time. You won’t find the strip dead, but maybe that’s a good thing? We end up going into the Fremont hotel and find this 3.99 cafe for the Duece Breakfast, which features 2 pieces of bacon, 2 pieces of sausage, 2 eggs and hash browns. Not bad for the price when there’s nothing else opened!

Once we finished, we were all pretty tired and warn out for our first day, so we decided to head back to our hotels and pass the eff out.

Until the next day.

Bonneville Hot Springs Resort & Spa Review

Since my boyfriends family is from the Columbia gorge area, we knew we wanted to try the Bonneville Hot Springs Resort & Spa at some point as it’s only about a 40 minute drive from where we currently live now. My husbands brother had a free night certificate for working with the resort for business and decided to give it to us as a wedding gift along with a $50 gift card for anything in the resort. Good thing, because I wouldn’t have paid for their ridiculous $200-$250 nightly fee otherwise.

Upon pulling up and walking inside, it looks nice and cozy. Something you imagine a resort to look like in the gorge or mountain area. But the rooms for a resort need quite a bit of updating, especially with the price they charge. To me, it doesn’t feel like a resort, but I guess I have nothing else to compare it to because I’ve never actually been to one. The natural hot springs hot tub on the deck was nice, but the hot tub was far too small to be relaxing with anymore than 2 adults. His brothers and nephews stopped by to use the hot tub after work, which was fine, but there’s no way all of us could have fit.  I like that they don’t use chemicals that cause your skin to dry out and feel tight after sitting in there for a half an hour to an hour. And we got a nice view of the parking lot from our deck, which I figured would ruin any romantic gestures.

The bed was fine and comfortable, and the TV was a regular tube style TV. For a resort, that should be the first thing that’s upgraded. I compare the rooms to a shilo inn, but nothing that qualifies it to be called a resort other than the fact it has a spa room that charges an arm and a leg for a simple massage and beauty applications. We did not partake in that, since we didn’t really need it.

We decided to head down to the restaurant for dinner and noticed that the menu had about 6 things on it, none of which appeared appetizing to my husband. He asked the waitress if that was all they had and they said yes, but there was an additional menu for the bar area. I wouldn’t have minded having the salmon dinner in the dining room but we headed over to the bar after he decided that he’d much rather prefer something on their menu. The waitress kindly told me that I could order the salmon over there, but I didn’t want to make it too difficult for them, so I just stuck with the halibut and fries, which BTW were not cooked at the right temperature in the deep fryer since they were soggy and lacked flavor. My husband ordered the Bonneville bacon burger and he shared a bite with me and I was kicking myself for not ordering that or my salmon as I originally intended. The burger had so much flavor and was mouth watering. Probably one of the best burgers I’ve tasted and I am not even kidding! When we pass through the area to go visit his family, we’ll definitely be stopping there for lunch just to have a burger. YUM!

I didn’t get a chance to try out the pool that’s also filled with natural hot springs because check in time is after 4pm and we didn’t get there until 6, in which we had dinner and then enjoyed the hot tub in our room on the deck. I hear it’s really great, but not exactly big enough to accommodate a busy resort.

I was also hoping that the miniature golf would be under a covered area since it rains in the pacific northwest about 9 months out of the year. You’d think this would be a no brainer, but I guess they wanted it to feel authentic and outdoorsy in a wooded area. So unfortunately, since it was pouring buckets, we didn’t get to play.

Other than that, the experience was fine and I am grateful that I got a chance to try it out even if it didn’t exactly fit my standards of a resort. Guess that’s what happens when you’ve stayed in luxury hotels in Vegas.


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