Effect of Human Versus Computerized Voice Recognition Transcription on Billing Level in an Orthopaedic Surgery Practice

Computer based speech recognition transcription software (CBT) use has increased in prevalence in the last decade. However, its effects on level of billing in an orthopaedic practice have not been published. During a one-year period, patients were seen by the author at one of two Orthopaedic Surgery Clinics at the University of Arizona. One clinic utilized human transcriptionists (HT) and another CBT. A total of 1,758 notes were generated, 900 completed by HT and 858 by CBT. Of all HT notes, 70 (8%) were billed as level 4, whereas only 27 (3%) notes generated by CBT billed as level 4 (p< 0.01). When analyzing only new patient reports, 29 (9%) HT reports billed as level 4, whereas only 11 (3%) notes generated by CBT billed as level 4. CBT does not result in a higher level of billing. Caution must be used with implementation of this new technology on the basis of cost savings.