InterPro Medical Solutions -MT

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Facility Name: *
Contact Name/Title: *
Phone : *
Email : *
Address:
Type of Facility:
Number of:	Beds Physicians MT Employees
	Patient Encounters / Visits per Year
	Annual minutes dictated
	Annual lines transcribed
	Annual transcription budget
Does facility currently utilize a Transcription vendor? Yes No

if yes,
Name of vendor
Volume of work outsourced?
Rate current vendor on a scale of 1-10 (1=considering terminating, 10=extremely happy)
Does current vendor interface/integrate with your HIS / MIS system?
How are transcribed reports accessed and stored?

Current vendor features (eSign, autofax, etc.)
Current dictation system:
Current transcription system:
HIS / MIS system and interfaces:
Plans to replace/update system:

In order of importance on a 1-8 scale (1=most imp. 8=least imp.)
Price Quality TAT US-based Resources
Customer Service Tech Support
Physician Satisfaction Other

Check current challenges:
Staffing (under, over, difficulty recruiting) Poor MT performance Poor quality Slow turnaround time Obsolete technology Current vendor contract expiring High MT employee costs High vendor costs
Other:

When do you want to improve transcription while reducing costs?