Speech Recognition Editing ??


What is it and why do I care anyway? Speech Recognition Editing the activity in which a Medical Language Specialist (MLS) reviews and corrects medical documents that have been dictated then converted by automatic speech recognition software to text. The medical transcription industry needs MTs with this particular knowledge to work with speech recognition. If there are not enough people trained to do Speech Recognition Editing, the industry is going to end up letting it go without an editor. This is going create a lot of mistakes in the transcribed medical reports, something that the medical profession cannot have.  Most doctors require no less than 98% accuracy from their MTs which is another reason the industry needs qualified Speech Recognition Editors.
Speech recognition is a great addition to your resume and is a skill that will help you remain competitive and stay employed in spite of economic changes and technological advances in healthcare documentation.

What is HIPAA ?

In 1996, the Health Insurance Portability and Accountability Act or the HIPAA was endorsed by the U.S. Congress. The HIPAA Privacy Rule, also called the Standards for Privacy of Individually Identifiable Health Information, provided the first nationally-recognizable regulations for the use/disclosure of an individual's health information. Essentially, the Privacy Rule defines how covered entities use individually-identifiable health information or the PHI (Personal Health Information). 'Covered entities' is a term often used in HIPAA-compliant guidelines. This definition of a covered entity is specified by [45 CFR § 160.102] of the Privacy Rule. A covered entity can be a:

  • Health plan

  • Healthcare clearinghouse

  • Healthcare provider


  • Overview of the Privacy Rule
  • Gives patients control over the use of their health information

  • Defines boundaries for the use/disclosure of health records by covered entities

  • Establishes national-level standards that healthcare providers must comply with

  • Helps to limit the use of PHI and minimizes chances of its inappropriate disclosure

  • Strictly investigates compliance-related issues and holds violators accountable with civil or criminal penalties for violating the privacy of an individual's PHI

  • Supports the cause of disclosing PHI without individual consent for individual healthcare needs, public benefit and national interests.

  •  HIPAA realizes that there is a critical need to balance the steps taken for the protection of an individual's health information along with provision of proper healthcare faculties. The Privacy Rule strives hard to regulate the sharing of PHI without making it a deterrent for accessing healthcare facilities. Thus, the Privacy Rule does permit disclosures, under special circumstances, wherein individual authorization is not needed by public healthcare authorities.

    Doctors or Data Entry Clerks?


    Upon visiting this year’s American Health Information Management Association (AHIMA) conference in Salt Lake City, Utah I am bewildered at the path our country is taking in the name of “improving” healthcare. Do we really want/need our physicians entering data in a computer? Is this what we believe “quality” healthcare is?
    If so, let me get this straight…what we are saying is after four years of undergraduate schooling and four years of medical school, with three to eight years of internships and residency (depending on the area of specialty); so in total, after spending between 11 and 16 years of training, what we want our highly trained (and highly compensated) physicians doing is spending 40 to 60% of their time entering data in a computer.
    Are we nuts?
    Where is the American Medical Association? Where are the physicians themselves? Where is the leadership of our healthcare system? Don’t they understand that paying physicians hundreds of thousands of dollars to be data entry clerks is not sustainable?
    I am astonished, with the number of smart people we have in this country, that this has gotten this far.
    What is even more astonishing is the business case some technology companies are using (and some healthcare leaders are buying) that says, “you can justify spending millions of dollars on their technology by transferring the data entry responsibility from today’s medical language specialists, medical billers, medical coders, medical scribes and other allied health professionals and place this responsibility on the shoulders of the physicians, nurses and other care providers.”
    This makes all the sense in the world…let’s get a physician earning $150 per hour to do the job that one of these other allied health professionals can do for $20 – $40 per hour – all the while there is a well known shortage of doctors and nurses and our population is aging and requiring more and more services.
    Someone please help me understand how this is improving the efficiency of our healthcare system?  Even at a 7.5:1 ratio ($150/$20) asking a physician to spend as little as 36 minutes per day entering data is a money losing and thereby inefficient proposition.
    Like most other highly trained and highly compensated individuals, physicians should have access to quality data/information to assist them in delivering their services – we should not require them to be entering the data. In fact, we should be mandating that they don’t!
    This would be the same as asking the CEO of Macy’s or Walmart to spend 40-60% of his or her time behind the cash register or asking the CEO of Exxon/Mobil to spend 40-60% of his or her time pumping gas or asking Tom Brady to work the concession stand at half-time of the game. Ridiculous!!

    List of Top medical transcription companies in India


    The difference in the value of currency between Indian Rupees and US Dollar, the availability of well-education skilled labour with English knowledge and the difference in time between these two countries has contributed towards the boom of Information Technology Enabled Services in India. The proliferation of internet and the revolution of computers have also played a major part in the development of ITES industry in India. Among the different ITES service, one of the prominent services, which is known to most of the people these days is Medical Transcription.
    The term Medical Transcription, which is also called as MT is an allied health profession that deals with the process of translating or converting of voice-recorded reports that are dictated by people in medical field to text format. The medical transcription sector in India offers a wide range of employment opportunities to fresh graduates with a very good pay scale. With the boom of medical transcription sector in India, different institutions are offering medical transcription diploma and certificate course, which enables the students to find a very good job prospects in the medical transcription industry. In India, Medical Transcription Services are being offered by number of companies and the names of some of the popular companies in this field are given below:

    Top Seven Medical Transcription Companies:
    • MT4MD ------ www.mt4md.com
    • Rekha Technologies Pvt. LTD. ------ www.rekhatranscription.com
    • Vee Technologies Private Limited ------ www.veetechnologies.com/
    • ADS Solutions Private Limited ------ www.adssol.com
    • Bhilwara Scribe Private Limited ------ www.bhilwarascribe.com/
    • CBay Systems India Private Limited ----- www.cbaysystems.com/
    Some of the details regarding these companies in the medical transcription field are given below:

    MT4MD
    MT4MD came into existence in the year 2004 and they are operating from the city of US, India, and Faridabad (NCR).  The principal activity of this company is to offer globally focused outsourcing services and to offer affordable technology and business solutions through outsourcing and global software development. Medical transcription is one among the different services offered by this company and they follow a step-by-step procedure for offering the best medical transcription services to their clients.

    Rekha Technologies Pvt. Ltd.
    Rekha Technologies Pvt. Ltd. has its operations in different parts of India in popular cities like Delhi, NCR and remote operations in Nagpur, Mysore, Bangalore, Hyderabad, Coimbatore, Pune and Mumbai. They offer dictation capture, transcription and document management solutions to individual physicians and a network of hospitals operating in the United States. This company serves the healthcare sector with broad range of solutions like billing and coding services, document management, speech recognition, voice capture and of course medical transcription.

    Vee Technologies Private Limited:
    Vee Technologies Private Limited has their operations in the city of Bangalore in Karnataka and Salem in Tamil Nadu. They offer the best medical transcription services to their clients and their service list includes discharge summary, progress note, operative reports, clinic notes, emergency room reports, subjective objective assessment and plan, consultation Notes, letters and Radiology reports.

    ADS Solutions Private Limited:
    ADS Solutions Private Limited is operating from the city of Bangalore and this company was established with the objective of becoming a leading Medical Transcription company in India. They offer round the clock, world-class transcription services to the best satisfaction of their customers. They use the power of technology to offer customer-friendly and cost effective medical transcription services.

    Bhilwara Scribe Private Limited:
    Bhilwara Scribe Private Limited came into existence in the year 2000 and they offer the best BPO solutions and services with total commitment towards understanding and delivering the exact requirements of their customers. They are pioneers in the healthcare BPO sector in the central part of India and they have their production unit and head office at the city of Bhopal with second production unit in the city of Bangalore.

    CBay Systems India Private Limited:
    CBay Systems India Private Limited has its operations in different parts of India in popular cities like Nagpur, Mysore, Bangalore, Hyderabad, Coimbatore, Pune and Mumbai. They offer dictation capture, transcription and document management solutions to individual physicians and a network of hospitals operating in the United States. This company serves the healthcare sector with broad range of solutions like billing and coding services, document management, speech recognition, voice capture and of course medical transcription.

    How EMR (EHR) Is Going To Affect Medical Transcription Industry?

    Ever since healthcare reforms started to surface in Obama’s speeches or rather after he signed the stimulus package to law setting aside $19.2 billion for healthcare IT alone to reach a goal of full EHR by 2014 promising hundreds of thousands of new jobs by boosting healthcare, the question “How is it going to benefit or affect the medical transcription industry?” started gaining prominence.  There were doomsayers as well as welcomers.  However, nobody was able to give a clear picture all these days on how medical transcription industry is going to evolve through this phase, whether it will have adverse effects or if it will be an added advantage.  Earlier when speech recognition was considered as a challenge, my view was that it would be an advantage to improve productivity and unless we have artificial intelligence and robots understanding each and every command of ours, we will not have a completely reliable voice recognition output with no human intervention needed, so the possibility of speech recognition eliminating medical transcriptionists was completely ruled out.  However, this time that is not going to be the same case with EMR as the data here is directly fed by the doctors into the system.
    As such, one of MT Herald’s readers who preferred to remain anonymous (as usual?) put forward these questions:
    With Obama’s push for implementing EMR in every clinic/hospital, do you see the demand for MT decreasing?
    My brother lives in Florida, USA, and he went to see an ENT doctor.  His clinic has about 3-4 doctors, and they have implemented EMR in their office and have stopped using transcription altogether.
    Do you think widespread EMR adoption will be bad for MT industry?
    What are the prospects of gaining business from other countries like UK, Canada, Australia?
    We gain a lot of information by exchanging views. You gain more information when you answer questions than when you ask.  It is when you teach that you learn a lot than when you are a student.
    However, this time before coming to a conclusion on my own for these questions, I thought to put across the question “Do you think widespread EMR adoption will be bad for MT industry?” to all my medical transcriptionist friends and some eminent personalities in the medical transcription industry by email, tweet and instant messaging. Interestingly, when I passed the question to the MTs, both onshore and offshore, many of them were still ignorant of what the acronym EMR deciphers! So do you know what is the difference between an electronic medical record, an electronic health record and a personal health record?  The National Alliance for Health Information Technology, (NAHIT) differentiates and defines these terms as follows:

    What Is An Electronic Medical Record (EMR)?

    An electronic record of health-related information on an individual that can be created, gathered, managed, and consulted by authorized clinicians and staff within one health care organization.

    What Is An Electronic Health Record (EHR)?

    An electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be created, managed, and consulted by authorized clinicians and staff across more than one health care organization.

    What Is A Personal Health Record (PHR)?

    An electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be drawn from multiple sources while being managed, shared, and controlled by the individual.
    A research on Google Trends on which term that is extensively searched (electronic medical record v/s electronic health record) reveals that roughly four times more searches are performed for the term ‘electronic medical record’ than for the term ‘electronic health record’ in the searches originating from the US, and that there is a slight spurt in searches of these terms since the turn of this year since Obama got sworn in as President.  So despite the NAHIT definitions, market is still figuring out the appropriate term for common usage.
    Now that you got some in-depth knowledge of EMR, let’s see have a look at the responses for the question “Do you think widespread EMR adoption will be bad for MT industry?” from some MTs, eminent personalities and CEOs of a couple of MTSOs.Abishai Demetrius (He’s also a religious blogger at Weird Worldz) who witnessed the evolution of medical transcription industry for the past 10 years or more, both onshore and offshore, when contacted to predict the impact of EMR on medical transcriptionists was rather pessimistic and thinks it is hard for the doctors to make a switchover and commented instantly:
    What’s it gotta do with MTs? Do you think those lazy doctors also will do it?  ;) Before that happens on every medical practice out there and every doctor has to do it or just die, I don’t think we need to worry much, that’s just my 2 cents.
    I don’t think it’s going to be that tough for doctors to make a switchover to EMR.  They have already been subjected to rigorous training according to the curriculum in their academic portion of life.  As a matter of fact, handling an EMR is not that tough than even learning to drive a car!  It’s just as the effort as writing a prescription in legible handwriting!  So I don’t think a doctor has to be a geek to operate a tablet PC to write a prescription or fill in a template by just a few clicks.
    Lynette Cabeen who has been an MT for 10+ years and worked for several different companies either as an employee or as an independent contractor, says we are already working on electronic medical records by doing transcription from home over the internet and shares her views as (She just started blogging on medical transcription at Transcription Diary):
    The fact is, we already deal with EMR when we work remotely from home over the internet — dictations are uploaded digitally, downloaded digitally and transcribed, then uploaded digitally and stored digitally.  You can’t stay the same and hope to compete in a changing marketplace.  I agree with an article I read recently that EMR developers need to stop trying create software to get rid of the MTs (which will NEVER happen, even though our jobs may evolve) and concentrate more on security/privacy, developing a less complex interface and becoming more user friendly.  Also, small physician practices may never make the leap to EMR because of cost issues, so that also has to be taken into consideration.  I think EMRs have the potential to make our jobs easier (think of being able to go back and read prior reports to be able to figure out what “the mumbler” is saying), but it can also cause problems by perpetuating incorrect information if it’s not caught the first time.  Then there’s the debacle recently regarding inaccuracies found in a medical record that makes one pause before jumping on board fully.
    Bottom line, EMR is on the rise, and too many of the powers that be are pushing for it for things to stay the same, but I don’t think it’s going to impact our profession in a negative way.  It still has a long way to go, especially in regards to security and privacy.  One only has to take a look at the Conficker issue to know that having all records stored electronically can create a maelstrom of a mess if hacked.
    To err is human, to really screw things up requires a computer.
    Regarding hacking attempts:  If extremely sensitive bank, military, space program and government documents can be stored online safely and securely, why not these healthcare documents?  Of course, every one of these are have hacking attempts on a day-to-day basis, but have anyone gone back with this technology advance? Regarding the cost factor:  We saw in the video that for a subscription amount of mere $300 per month, the physician was able to maintain electronic health records online and the setup just costed him $6000.
    Jay Vance, CMT, President & CEO, Global Healthcare Documentation Group, is rather in a wait and watch mode.
    It is difficult to say with certainty exactly how the coming widespread use of EMRs is going to affect MTs.  This is partly because not all EMR systems take the same approach with regards to the mechanisms used to create patient encounter records.  Some EMRs are strictly point-and-click, template-driven systems that make no allowance for dictation and transcription, while other EMRs are DRT enabled, allowing physicians to use traditional dictation as a means of populating the EMR.  Obviously if the former type of EMR becomes more prevalent than the latter, the need for transcription is going to decrease.  But I believe it is too soon to state definitively whether or not physicians who are accustomed to dictating patient encounters will be willing to switch en masse to template-driven EMR systems.  Certainly it’s possible, but it is by no means a certainty, in my opinion.
    I wish I had a more definite answer to your question, but right now there just isn’t enough information to make a reliable prediction for what the future holds for the transcription industry.
    (DRT stands for Discrete Reportable Transcription)
    Okay, it’s a long way to 2014 from now.  By that time, even Obama may have moved out of power but, what if the doctors have to do it on their own by that time just because of any legal compulsion from the government to avoid medical errors (the prime focus of making a switching over), leave aside the savings they make eliminating transcription?
    Gift Jacob Chelraj, CMT, predicts it could be bad for the industry which is already in turmoil because of advancement of automations like voice recognition and stiff competition due to outsourcing.
    My opinion about EMR is it is a tool for interoperability (sharing of information quickly) between hospitals.  Nowadays, this sharing of information is through expensive means like faxing, etc., and this also requires that whatever the MT transcribes be printed in a paper, resulting in additional expenses for the hospital.  This could be avoided if all the patient information is available through computer network.
    There are certain drawbacks with EMR too, like cost, connectivity, health risks, etc. which are being speedily addressed by the US government, especially by President Obama, in a war footing to curb the rising costs of healthcare.
    I am not sure how it would impact an MT’s job as “physician notes” still have to be transcribed or edited after going through voice recognition.  EMR can be automated and physicians can enter lab values and transmit radiology reports faster; however, reports like discharge summary, history & physical, etc., which require physician notes, need to be transcribed by somebody.  I pray to God that the hospital will not retain physician notes in voice format in order to cut costs :-).
    My personal opinion is that if the axe falls on us, we will be required to be more productive and efficient (which is already happening through voice recognition).
    In summary, YES, this is bad for our industry and good in terms of healthcare efficiency.
    If I’m right, we are already in an arena where there is no permanent salary, instead all the pay structures are production based by which we are already under tremendous pressure to do more and more day by day.  How can we be further more productive and efficient?
    Julianne Weight, CEO, AlphaBest Consulting and Transcription, who has over 20 years of experience in the industry witnessing all the ups and downs, evaluates the situation (She also exchanges views on interesting facts and observations at MT Exchange) and reports that it has already created the dent:
    Yes, I see demand decreasing.  We’ve been seeing the trend here for the last couple of years and are already feeling the impact.
    I’m not sure I’d say it’s good or bad for the industry.  I think the industry needs to change and evolve into something else.
    She is sure that the industry needs to change or evolve into something or to a more stable form, but not sure how it would be and should be.
    Miguel Lopez, President, Transcript, Inc., assesses the adopting of EMR in healthcare is not going to be a doomsday for medical transcription industry.  Here is how he assesses on how is it going to be:
    It depends.  I think it will affect it as much as voice recognition has done so far in terms of job loss, but it will continue to be adopted because of the need to go to for electronic medical records.  It just means that MTs will need to adapt to the changing technology or lose the account.  The accounts will be going to EMR but if the MT is willing to dial in and type directly into the EMR or interface with it, they will be fine.  Those that continue to see the BIG cassette as the wave of the future will lose.  Just because they are going to EMR does not necessarily mean that they will be going to templates of voice recognition.  It just means they’re going paperless.  The smart MDs that still see the MT as necessary and cheaper than typing/reviewing the reports themselves will still use MTs.  I think, like with any new technology, there will be job loss due to the older local MTs unwilling or unable to adapt.
    Yes, the busy, highflying doctors, who have hundreds of patients a day, to increase their productivity, to save time and to keep going, instead of themselves incorporating all the details will still have to rely on assistance of medical transcriptionists through dictations even to fill in those details in an EMR but that is not going to be the case with every single doctor.  The female doctors or doctors above middle age may be reluctant to adopt new technologies and cost factor also can deter adopting new technology but that won’t prolong for decades.
    We end with that expert opinions with a clear answer.  Yes, EMR is going to affect the medical transcription industry or has already started affecting but none of them are able to predict the magnitude of the impact.  Consumer the king, the ultimate beneficiary of this evolution, is at the greatest advantage of this evolution, after all that is what anyone would need, but how we, the medical transcriptionists, or the medical transcription industry is going to survive these reforms?  There’s the fume coming around from the dormant or less active volcano but most of the MTs couldn’t assess the flame and danger behind it. Like Abishai or other MTs whom I didn’t mention here are either still ignorant about the looming guillotine or are overconfident that the doctors are lazy to make a complete switchover that they still have time to enact upon!  As long as the doctors are reluctant to change, it will keep us going.  However, if the axe falls this time, the impact is going to be much stronger than the already shaken medical transcription industry in the US with voice recognition and outsourcing with the interesting fact that this time it’s going to affect both onshore and offshore alike.  Even for planned surgeries, you can have template filling as the procedures will be almost stereotype ones.  However, emergency reports may need to be transcribed as the situations, complaints and problems will vary from patient to patient, case on case and I foresee only such rare possibilities of dictation and transcription.
    Studies show physicians who use EHRs pay few malpractice claims and we already have reports of medical transcriptionists losing business as the doctors migrated to EMR, it is time for us to think and enact upon.  With cost advantage being remarkable with the adoption of EMR, it is time for MTs to think how to adapt to this growing challenge.
    How can the medical transcriptionists be an inevitable part of these reforms?  By starting to think and deliver value addition to your services.  You should not confine yourself inside a shell as medical transcriptionist alone but have to keep on adding value to your services that the doctors should not be able to do business without you.  You should be a complete personal (virtual) assistant doing everything that the doctor wants to do on a computer.  Yes, nothing is stable in this ever changing world.  Your success lies in how soon you adapt and change yourself to the new things, latest demands and the need of that hour.  Unless you develop your skills and keep on polishing your resume, the going as a transcriptionist would get tough and at one point in time within the next few years you may get withered out and give up to EMR due to lack of efficiency.
    I wish to thank everybody who shared their views and opinions with me when I contacted them, and their inputs have thrown good amount of light into the issues surrounding the adoption of EMR with reference to medical transcriptionists.  I was so amused that the answers were so instantaneous from all those who I quoted here that I think they are keenly watching on how things are turning around and are striving to get informed on this subject. A special big thanks to all of them again.
    Now coming to the last part of the question “What are the prospects of gaining business from other countries like UK, Canada, Australia?”  Any of the readers in those countries could drop in their views.  But generally I’m of the opinion that if a doctor in the US can make a switchover to a completely automated healthcare documentation, won’t it be available for the doctors in the other countries too?  May be the cost may vary from country to country but if convenience and reliability outplace the cost factor, which is ought to happen, won’t the doctors in the other countries will also follow suit?

    List of Hospitals in Alabama

    Andalusia Regional Hospital, Andalusia
    Athens-Limestone Hospital, Athens
    Atmore Community Hospital, Atmore
    Baptist Medical Center East, Montgomery
    Baptist Medical Center South, Montgomery
    BayPointe Hospital, AltaPointe Health Systems, Mobile
    Beacon Children's Hospital, Luverne
    Bibb Medical Center, Centreville
    Brookwood Medical Center, Birmingham
    Bryan W. Whitfield Memorial Hospital, Demopolis
    Bryce Hospital, Tuscaloosa
    Bullock County Hospital, Union Springs
    Central AL Veterans Health Care System - West Campus, Montgomery
    Central Alabama Veterans Health Care System - East Campus, Tuskegee
    Cherokee Medical Center, Centre
    Children's of Alabama, Birmingham
    Chilton Medical Center, Clanton
    Citizens Baptist Medical Center, Talladega
    Clay County Hospital, Ashland
    Community Hospital, Inc., Tallassee
    Cooper Green Mercy Hospital, Birmingham
    Coosa Valley Medical Center, Sylacauga
    Crenshaw Community Hospital, Luverne
    Crestwood Medical Center, Huntsville
    Cullman Regional Medical Center, Cullman
    D.W. McMillan Memorial Hospital, Brewton
    Dale Medical Center, Ozark
    DCH Regional Medical Center, Tuscaloosa
    Decatur General Hospital, Decatur
    Decatur General West Beh. Medical Ctr., Decatur
    DeKalb Regional Medical Center, Fort Payne
    East Alabama Medical Center, Opelika
    Elba General Hospital, Elba
    Elmore Community Hospital, Wetumpka
    Evergreen Medical Center, Evergreen
    Fayette Medical Center, Fayette
    Florala Memorial Hospital, Florala
    Flowers Hospital, Dothan
    Gadsden Regional Medical Center, Gadsden
    Georgiana Hospital, Georgiana
    Greene County Hospital, Eutaw
    Greil Memorial Psychiatric Hospital, Montgomery
    Grove Hill Memorial Hospital, Grove Hill
    Hale County Hospital, Greensboro
    HealthSouth Lakeshore Rehab Hospital, Birmingham
    HealthSouth Rehab Hospital, Dothan
    HealthSouth Rehab Hospital of Montgomery, Montgomery
    HealthSouth Rehab Hospital of North Alabama, Huntsville
    HealthSouth Rehabilitation Hospital of Gadsden, Gadsden
    Helen Keller Hospital, Sheffield
    Highlands Medical Center, Scottsboro
    Hill Crest Behavioral Health Services, Birmingham
    Hill Hospital of Sumter County, York
    Huntsville Hospital, Huntsville
    Infirmary LTAC Hospital, Mobile
    Infirmary West, Mobile
    Jack Hughston Memorial Hospital, Phenix City
    Jackson Hospital, Montgomery
    Jackson Medical Center, Jackson
    Jacksonville Medical Center, Jacksonville
    John Paul Jones Hospital, Camden
    L.V. Stabler Memorial Hospital, Greenville
    Lake Martin Community Hospital, Dadeville
    Lakeland Community Hospital, Haleyville
    Lanier Health Services, Valley
    Laurel Oaks Behavioral Health Center, Dothan
    Lawrence Medical Center, Moulton
    Long Term Hospital of Anniston, LLC, Anniston
    Long Term Hospital of Birmingham, LLC, Birmingham
    Long Term Hospital of Dothan, LLC, Dothan
    Long Term Hospital of Montgomery, LLC, Montgomery
    Long Term Hospital of Tuscaloosa, LLC, Tuscaloosa
    Marion Regional Medical Center, Hamilton
    Marshall Medical Center North, Guntersville
    Marshall Medical Center South, Boaz
    Mary Starke Harper Geriatric Psychiatry Center, Tuscaloosa
    Medical Center Barbour, Eufaula
    Medical Center Enterprise, Enterprise
    Medical West, an affiliate of the UAB Health System, Bessemer
    Mercy Medical, Daphne
    Mizell Memorial Hospital, Opp
    Mobile Infirmary Medical Center, Mobile
    Monroe County Hospital, Monroeville
    Mountain View Hospital, Gadsden
    North Alabama Medical Center - Coffee Campus, Florence
    North Alabama Medical Center - Shoals Campus, Muscle Shoals
    North Alabama Regional Hospital, Decatur
    North Baldwin Infirmary, Bay Minette
    Northeast Alabama Regional Medical Center, Anniston
    Northport Medical Center, Northport
    Northwest Medical Center, Winfield
    Parkway Medical Center, Decatur
    Pickens County Medical Center, Carrollton
    Prattville Baptist Hospital, Prattville
    Princeton Baptist Medical Center, Birmingham
    Providence Hospital, Mobile
    Red Bay Hospital, Red Bay
    Regional Rehabilitation Hospital, Phenix City
    Riverview Regional Medical Center, Gadsden
    Russell Medical Center, Alexander City
    Russellville Hospital, Russellville
    Searcy Hospital, Mt. Vernon
    Select Specialty Hospital - Birmingham, Birmingham
    Shelby Baptist Medical Center, Alabaster
    South Baldwin Regional Medical Center, Foley
    Southeast Alabama Medical Center, Dothan
    Springhill Medical Center, Mobile
    St. Vincent's Birmingham, Birmingham
    St. Vincent's Blount, Oneonta
    St. Vincent's East, Birmingham
    St. Vincent's St. Clair , Pell City
    Stringfellow Memorial Hospital, Anniston
    Taylor Hardin Secure Medical Facility, Tuscaloosa
    Thomas Hospital, Fairhope
    Trinity Medical Center, Birmingham
    Troy Regional Medical Center, Troy
    UAB Callahan Eye Hospital, Birmingham
    UAB Highlands - A Campus of the University of Alabama Hospital, Birmingham
    University of Alabama Hospital, Birmingham
    USA Children's and Women's Hospital, Mobile
    USA Medical Center, Mobile
    Vaughan Regional Medical Center, Selma
    Veterans Affairs Medical Ctr.- Tuscaloosa, Tuscaloosa
    Veterans Affairs Medical Ctr.-Birmingham, Birmingham
    Walker Baptist Medical Center, Jasper
    Washington County Hospital, Chatom
    Wedowee Hospital, Wedowee
    Wiregrass Medical Center, Geneva

    Indian TV Commercials: Aishwarya Coca Cola Funny Advertisement

    How to increase accuracy in Speech Recognition

    How to improve accuracy with Dragon NaturallySpeaking Recorder Edition

    Answer ID 5762   |    Published 06/09/2009 12:00 AM   |    Updated 04/16/2010 04:34 PM
    How to improve accuracy with Dragon NaturallySpeaking Recorder Edition Information:
    There are multiple ways to improve accuracy when using Dragon NaturallySpeaking Recorder Edition:
    • Running the Acoustic and Language Model Optimizer.
    • Performing corrections.
    • Analyzing e-mail.

    Method 1: Performing corrections
    After the user transcribes an audio file, the user should correct any words that were not recognized properly. With the Recorder Edition, it is not possible to correct words by voice.
    To perform corrections:
    1. Open a digital recorder user profile.
    2. Perform a transcription of an audio file by using the "Transcribe" button on the DragonBar.
    3. Using the mouse, highlight the text that needs to be corrected.
    4. Click the "Correction" button on the DragonBar or press the Correction Hotkey (the "minus" key on the numberic keypad, by default) to display the Correction dialog.
    5. If the correct word is displayed in the Correction dialog, select that word to make the correction.
      Note: The user can click the "Playback" button at this time to verify what was originally dictated.
    6. If the correct word is not displayed in the Correction dialog, click the “Spell That…” option and type out the correct word in the Spell dialog.
    7. Press the "Enter" key or click “OK” to make the correction.
    8. Correcting in this manner will adapt the user's voice files, leading to continuously improving accuracy.
    Method 2: Analyzing e-mail
    Use the Increase Accuracy from E-mail tool to add the names of people the user has sent e-mail to into the Dragon vocabulary. The user has the option to edit these names and can also have Dragon scan the contents of the user's sent e-mail and add it to the language model.
    To analyze e-mail:
    1. Open a digital recorder user profile.
    2. Click "Tools > Accuracy Center".
    3. Click the "Increase accuracy from e-mail" link.
    4. The Increase Accuracy from E-mail wizard opens. Click the "Next" button.
    5. Select the e-mail source to be used:
      • Lotus Notes
      • Microsoft Outlook
      • Outlook Express
    6. Select one or both of the following options:
      • Add contact names from e-mail to the vocabulary
      • Improve my speech files from my e-mail writing style
    7. Select one of the following options:
      • Consider e-mail written since my last scan
      • Consider all e-mail
    8. Click the "Next" button to start analyzing e-mail.
    Method 3: The Acoustic and Language Model Optimizer
    Before running the Acoustic and Language Model Optimizer, make sure the "Store corrections in archive" option is enabled under "Tools > Options > Data tab". If this option is not enabled, the user may see a message that there is not enough data for the Acoustic and Language Model Optimizer to process.
    To run the Acoustic and Language Model Optimizer:
    1. Open a digital recorder user profile.
    2. Click "Tools > Accuracy Center".
    3. Click the "Run the Acoustic and Language Model Optimizer" link.
    4. Enable the "Perform Acoustic Optimization" and/or the "Perform Language Model Optimization" options.
      Notes:
      • Select "Perform Acoustic Optimization" to update the user profile with accumulated acoustic data from any corrections made by the user.
      • Select "Perform Language Model Optimization" to update the language model. The language model contains statistical information that predicts which words are most likely to occur in the context of the user’s speech.
    5. Click the "Go" button to begin the optimization.
    6. The Acoustic and Language Model Optimizer dialog box will display the amount of time to finish adapting the user files and display a progress bar to indicate how much of the job is complete. It generally takes as long to adapt the user files as the amount of data stored. For example, if there is 30 minutes of acoustic data stored, the processing time will be approximately 30 minutes.
    7. Once the optimization has completed, save the user profile by clicking "NaturallySpeaking > Save User Files".
    General tips on increasing accuracy:

    • If using the digital recording device's built-in microphone, always hold the device at the same distance from the user's mouth. Some users rest the device on their jaw for the most consistent results.
    • Consider connecting a headset microphone to the digital recording device rather than using the built-in microphone. Using a high-quality external microphone is likely to produce better quality recordings.
    • Adjust the Speed vs. Accuracy setting under "Tools > Options > Miscellaneous tab". The Speed vs. Accuracy setting adjusts the number of words and phrases that the program examines in order to find a word match. The more words that are examined, the greater the possibility of an accurate match. However, this comes at the expense of using more memory and taking a longer time to recognize the user's speech. The user can adjust the Speed vs. Accuracy slider to influence the performance of Dragon. As a general rule, the user should move the slider farther to the right on faster machines than on slower ones.

    List of medical transcription companies in India.


    AccuDoc InfoTech Private Limited
    #13, 3A Tawakkal Chancery,
    Banaswadi Main Road,
    Cooke Town,
    Bengaluru 560 0005, Karnataka
    Tel: +91-80-41251481, 41487206
    Email: info@accudocinfotech.com
    Accu-Swift
    Usha Enclave, A107, 8-3-833/A/1,2,3
    Navodaya Colony, Yellareddyguda,
    Hyderabad 500 073, Andhra Pradesh
    Tel: +91-40-23733570
    Cellular: +91-98663 34230
    Email: jreddy@accu-swift.com
    support@accu-swift.com
    admin@accu-swift.com
    Acme Data Services
    628, Star Plaza,
    Phulchabb Chowk,
    Rajkot 360 001, Gujarat
    Tel: +91-281-2443077
    Fax: +91-281-2385056
    Email: info@acmedataservices.com
    Ajaxdotcom Private Limited
    #1, Third Floor, Maruthi Complex,
    Above Food World, R T Nagar Main Road,
    Bengaluru 560 032, Karnataka
    Tel: +91-80-23535156, 23634881
    Fax: +91-80-23435165
    Email: ajax@ajax.in
    Alphaa Systems
    4 Om Ganesh Nagar,
    Vadavalli,
    Coimbatore 641 041, Tamilnadu
    Contact Person: Mr. C.R. Vasudevan, CEO
    Tel: +91-422-2426533
    Email: alphaa@alphaasystems.com
    Amadeus Technologies Private Limited
    #38, 13th Cross 4th T Block Jayanagar,
    Bengaluru 560 041, Karnataka
    Tel: +91-80-41604067, 41604068
    Fax: +91-80-26642565
    Email: sales@amadeustech.com
    info@amadeustech.com
    Ariaa Computech
    #33, 35th Main, Sixth Cross,
    BTM Layout (Second Stage),
    Bengaluru 560 068, Karnataka
    Tel: +91-80-41201484, 26681163
    Email: info@ariaacomputech.com
    Bharathi MediScribe Private Limited
    #135, I Floor, VII Main, IV Block,
    Jayanagar
    Bengaluru 560 011, Karnataka
    Tel: +91-80-22449121, 41307506
    Email: sales@bharathimediscribe.com
    British Orient Infotel Private Limited
    (British Medical Transcription)
    #29, First Main Road,
    Third Stage, Fourth Block,
    Basaweshwaranagar,
    Bengaluru 560 079, Karnakata
    Tel: +91-80-23485551
    Email: info@britishorientinfotel.com
    Cerebra Integrated Technologies Limited
    S-5, Off Third Cross, First Stage,
    Peenya Industrial Area,
    Bengaluru 560 058, Karnataka
    Tel: +91-80-28370282, 28370284,
    28394783
    Fax: +91-80-28372609
    Email: info@cerebracomputers.com
    CG Meditrans
    B-22, Corporate House
    Opp: Pakwan-II,
    Judge Bungalows Road,
    Ahmedabad 380 054, Gujarat
    Tel: +91-79-40032196
    Chrysalis Technologies
    14-B/1, First Street,
    Dr. Thirumurthy Nagar,
    Nungambakkam,
    Chennai 600 034, Tamilnadu
    Tel: +91-44-52137211
    Email: sales@chrysalistech.com
    Cripton
    510 Shalimar Morya Park,
    Off Link Road, Andheri,
    Mumbai 400 053, Maharashtra
    Tel: +91-22-6714-8888
    Fax: +91-22-6714-8884
    Email: submit@cripton.com
    Decipher Intime Transcriptions Private Limited
    #3, Lakshmi Road, Shantinagar,
    Bengaluru 560 027, Karnataka
    Tel: +91-80-22129293
    Email: support@decipherin.com
    Digital Compusoft, Inc.
    201 Sterling Centre, R.C. Dutt Road,
    Alkapuri,
    Vadodara 390 020, Gujarat
    Tel: +91-265-324155, 324166
    Email: info@digitalcompusoft.com
    Divine Mercy Transcription
    #18 Group-I, Pocket-C,
    Hastsal, Uttam Nagar,
    New Delhi 110 059
    Contact Person: Sujith Mathew
    Cellular: +91-98116 76698
    Email: info@divinemt.com
    DMT Medscribe Services
    Plot No. KD-16
    City Center, Sector-4
    Bokaro Steel City 827 004, Jharkhand
    Tel: +91-6542-325711
    Cellular: +91-94307 56081, 92346 30605
    Eyered Transcription Services
    C-1/124 Lajpat Nagar 1,
    New Delhi 110 024
    Cellular: +91-98106 20086
    Email: contact@eyered.com
    Harvest Transcription Private Limited
    Honnam Complex,
    1st floor, #8/12, South Cross Road,
    Basavangudi,
    Bengaluru 560 004, Karnataka
    Fax: +91-80-41464526
    Contact Person: Mr. Prem P Sarkar, President and CEO
    Email: premsarkar@harvesttranscription.com
    IndiaScribe Online
    111/C, Thachraj Society,
    Mansa 382 845, Gujarat
    Contact Person: Dr. Nand K. Khatri
    Cellular: +91-99793 59302
    Indoswift Consultancy Services
    B-1/43, Sector-18, Rohini,
    New Delhi 110 085
    Cellular: +91-98115 54843
    Email: info@indoswift.com
    Indus Valley, Inc.
    #588, First Floor, II Block
    (Above Andhra Bank)
    Dr. Rajkumar Road, Rajajinagar,
    Bengaluru 560 010, Karnataka
    Tel: +91-80-65701774
    Fax: +91-80-41537096
    Cellular: +91-98860 24388
    Email: info@indusvalley.biz
    Innovations
    (Innovations Institute of Medical Transcription or IIMT)
    #867, First Floor,
    11th B Cross, 23rd Main,
    2nd Phase, J. P. Nagar,
    Bengaluru 560 078, Karnataka
    Tel: +91-80-26596977, 26595893
    Fax: +91-80-26596317
    Email: iimt7@vsnl.com
    Kirat Medical Transcription Services
    109, Sandesh Vihar, Pitampura
    Delhi 110 034
    Email: info@kiratmt.com
    KMITES
    #2 Nandidurg Road,
    Benson Town,
    Bengaluru 560 046, Karnataka
    Contact Person: S.J. Ramesh, Director
    Tel: +91-80-41289211, 41285443, 41285230
    Cellular: +91-92431 00578
    Email: ramesh@kmites.com
    LanceSoft India Private Limited
    T5, 1 Mahalingapuram Main Road,
    Chennai 600 034, Tamilnadu
    Tel: +91-44-42013322
    Fax: +91-44-42023322
    Email: info@lancesoft-india.com
    Last Peak
    11A Rawdon Street
    Kolkata 700 017, West Bengal
    Tel: +91-33-22871805
    Fax: +91-33-22830741
    Email: info@lastpeak.com
    Lee & Nee Software Exports Limited
    (LNSEL’s Medlinez Medical Transcription Services)
    Block GP, Sector V, Salt Lake City,
    Module No 511-513,
    Fourth Floor, SDF Building,
    Kolkata 700 091, West Bengal
    Tel: +91-33-23573205, 23573154
    Email: transcription@lnsel.com
    MCK Infolink Online Limited
    1516, Sector 17-C, MDI Pocket,
    Gurgaon 122 001, Haryana
    Tel: +91-11-32938078
    Email: sales@mckiol.com
    Medical Language Specialists, Inc.
    2/11 AALAY, Vastrapur,
    Ahmedabad 380015, Gujarat
    Tel: +91-26754652
    Cellular: +91-98251 96629
    Email: webmaster@mls.5u.com
    medicspecs@yahoo.com
    Medico Trans Private Limited
    17 Mahesh Nagar,
    Pimpri,
    Pune 411 018, Maharashtra
    Tel: +91-20-27425488, 65312094
    Fax: +91-20-27421134
    Email: info@medicotrans.com
    Medi-SCRIBE
    (Medical transcription division of Destiny Infotek Limited)
    Ishika Technologies Private Limited
    P-121, Block-B, Ground Floor,
    Lake Town,
    Kolkata 700 089, West Bengal
    Tel: +91-33-40068960
    Email: info@ishikatech.com
    Meditech Transcription Technologies
    #302, Kumar Garima,
    Tadiwala Road,
    Pune 411 001, Maharashtra
    Tel: +91-20-26059259, 26059802
    Email: info@mttindia.com
    Medusind Solutions
    22 Nirlon Complex, Second Floor,
    W.E. Highway, Goregaon (E)
    Mumbai 400 063, Maharashtra
    Tel: +91-22-66664700
    Fax: +91-22-66664701
    contact@medusind.com
    Microbridge Solutions Private Limited
    50-51, Sector 34A
    (Adjoining Mukat Hospital)
    Chandigarh 160 022, Union Territory
    Tel: +91-172-5019776
    Fax: +91-172-5019775
    Email: info@microbridge.biz
    Micronova Infotex Private Limited
    89/2, Gandhi Bazar Main Road,
    Basavanagudi,
    Bengaluru 560 004, Karnataka
    Tel: +91-80-41463508, 26602451
    Fax: +91-80-26670896
    Email: info@micronovainfotex.com
    Noble Data Management Private Limited
    Office #430, Gundecha Industrial Complex,
    Akurli Road, Next to Big Bazar,
    Kandivali (East),
    Mumbai 400 101, Maharashtra
    Tel: +91-22-40833222, +91-22-40833233
    Fax: +91-22-40833239
    Email: info@nobledata.org
    N.S Infotech Private Limited
    Mallikarjun Arcade,
    Vidyanagar,
    Hubli 580 021, Karnataka
    Tel: +91-836-2372221
    Fax: +91-836-4251011
    Email: nsinfo@vsnl.com
    OXO IT
    Austin Town,
    Bengaluru 560 047, Karnataka
    Tel: +91-80-65467784
    Cellular: +91-97317 97797
    Email: mail@oxoit.com
    Pacific Ventures Private Limited
    D-92, Electronic City, Sec 63,
    Noida 201 301, Uttar Pradesh
    Tel: +91-120-4329901, 4329902, 4329903
    Contact Person: Vivek Gaur
    Cellular: +91-98100 65318
    Email: vivek@pacificbpo.com
    Perry Johnson Outsourcing Private Limited
    No. 45, Old Race Course Road,
    Austin Town,
    Bengaluru 560 047, Karnataka
    Tel: +91-80-41131212, 64543241
    Fax: +91-80-41131076
    Email: hr@pjoindia.com
    Polymath Transcription Solutions
    11, Ankur Plaza, Near Warje Flyover,
    NDA Road, Warje,
    Pune 411 025, Maharashtra
    Tel:  +91-20-25237484
    Email: info@i-polymath.com
    hiten@i-polymath.com
    QMT India
    Sarat Bose Road, Hakimpara,
    Siliguri 734 401, West Bengal
    Contact Person: Deepali Sinha
    Tel: +91-353-2541744, 2542047
    Cellular: +91-94740 28500
    Email: info@qmtindia.com
    dsinha@gmail.com
    Rachna Transcriptions Private Limited
    95 Bazullah Road, F-2 TLV Kamalam,
    Opp. Ramakrishna School, T.Nagar,
    Chennai 600 017, Tamilnadu
    Tel: +91-44-42606260
    Email: info@rachnaindia.com
    rachnaindia@yahoo.com
    Rely Services
    Ankur Plaza, Second Floor,
    Next to Akhsay Palace,
    Opposite Warje Flyover, Warje
    Pune 411 052, Maharashtra
    Tel: +91-20-32415458
    Email: info@relyservices.com
    sales@relyservices.com
    Rekha Transcription
    834 Veer Apartment
    Sector-13, Rohini
    New Delhi 110 065
    Cellular: +91-98116 79010
    Email: info@rekhatranscription.com
    Sai BPO Services Limited
    (Business Transcription Services)
    Sri Niketan Building, Palace No. 10,
    Statue Junction, Tripunithura,
    Kochi 682 301,
    Ernakulam, Kerala
    Tel: +91-484-2784057, 6546469
    Fax: +91-484-2784056
    Email: info@saibposervices.com
    Scriptacom BPO Systems Private Limited
    24/39, Fourth Block, Fourth Stage,
    Gandhi Layout, Magadi Main Road,
    Basaveshwaranagar
    Bengaluru 560 079, Karnataka
    Tel: +91-80-23102423, 23115930
    Fax: +91-80-23115928
    Email: info@scriptacomsystems.com
    Shyamala Systems Private Limited
    No. 3, Ninth Main,
    Jayanagar Fifth Block,
    Bengaluru 560 041, Karnataka
    Tel: +91-80-26636939, 26342984
    Cellular: +91-99866 94973
    Email: rashmi@shyamalasystems.com
    Skryption
    IB-16 Sector III,
    Salt Lake City,
    Kolkata 700 106, West Bengal
    Tel: +91-33-2355696
    Email: info@skryption.com
    Smart Technologies
    #140-A, Fourth Cross, Seventh Main,
    J.P. Nagar Third Phase,
    Bengaluru 560 078, Karnataka
    Fax: +91-80-26587747
    Cellular: +91-93428 85011
    Email: contact@smartgroupinfo.com
    Softechscribe
    Flat No. 2 & 4,
    “Nath Vishram” 425/8,
    Tilak Maharashtra Vidyapeeth Colony,
    Near Bank Of Maharashtra,
    Pune 411 037, Maharashtra
    Tel: +91-20-2426 5717
    Taurus Data Links Private Limited
    144, Naveen Market,
    The Mall,
    Kanpur 208 001, Uttar Pradesh
    Tel: +91-512-2303006
    Cellular: +91-98399 08989
    Email: information@taurusdatalinks.com
    Teleradiology Solutions Private Limited
    Plot # 7G, Opp Graphite India
    Whitefield,
    Bengaluru 560 048, Karnataka
    Tel: +91-80-40187500
    Fax: +91-80-41103411
    Email: info@telradsol.com
    Totalmed Transcription Company
    C-65, Okhla Phase 1, Second Floor,
    New Delhi 110 020
    Cellular: +91-98119 40086
    Email: sales@totalmedtranscription.net
    Universal Technologies
    Room #15
    Software Technology Parks Of India,
    Priyadarsini Market Complex,
    CRPF Square,
    Bhubaneswar 751 012, Khurda,
    Orissa
    Tel: +91-674-2561269, 2561270
    Email: info@universaltechnologies.info
    Valliappa Transcriptions
    Sona Towers, No. 71, Millers Road,
    Bengaluru 560 052, Karnataka
    Tel: +91-80-2281131
    Fax: +91-80-2252350
    Email: info@valliappa.com
    Vantage Services
    402, Archana Arcade,
    St.John’s Road,
    Secunderabad 500 025, Andhra Pradesh
    Email: info@vantageservices.com

    XanaduTec Limited
    Xanadu House, Unit 2, Liberty Phase I,
    North Main Road, Koregaon Park,
    Pune 411 001, Maharashtra
    Tel: +91-20-40024415
    Email: info@xanadutec.com

    List of Medical Centers in Alabama


     4THEKIDS SUPPORT SERVICES LLC
     ABA ASSOCIATES, LLC
     ABSOLUTE DRUG DETECTION SERVICES, INC
     ACUMEN ASSESSMENT AND PSYCHOLOGICAL SERVICES
     ADVANCED CARDIAC SOLUTIONS, PC
     ADVANCED EYECARE OF MADISON, P.C.
     AHELMSDMDPC
     AIRMED INTERNATIONAL, LLC
     ALABAMA HEART & VASCULAR, P. C.
     ALABAMA INJURY & PAIN CLINIC INC
     ALABAMA OXYGEN AND MEDICAL EQUIPMENT
     ALABAMA WHEELCHAIR SPECIALISTS INC
     ALACARE HOME HEALTH SERVICES, INC
     AMENITY HEALTHCARE, INC.
     AMERICAN HOMECARE HOSPICE INC
     AMERICAN HOMEPATIENT, INC.
     ANALYTIC OPTIONS PC
     ANDALUSIA MEDICAL CENTER LLC
     ANNISTON RADIOLOGY GROUP, P.C.
     ATHENS EYE CLINIC, PC
     ATHENS LIMESTONE HEALTH SERVICS
     BAY AREA ENDODONTICS
     BEAUMONT PHARMACY, LLC
     BIO-MEDICAL APPLICATIONS OF ALABAMA INC.
     BROOKE R UPTAGRAFFT MD PC
     CAHABA MEDICAL CARE OF AL., LLC
     CALHOUN COMPOUNDING PHARMACY
     CARDIOVASCULAR ASSOCIATES OF THE SOUTHEAST, LLC
     CARE TEAM HOSPITALISTS LLP
     CAVER GROUP LLC
     CHARLES E. WILSON, MD, PC
     CLAUDIAS PLACE INC.
     COASTAL HOSPICE CARE, INC.
     COLONIAL HAVEN NURSING CARE & REHAB
     COMPASS LABORATORY SERVICES LLC
     CONTINUUMRX, INC.
     CORNERSTONE FITNESS AND WELLNESS
     CRENSHAW FAMILY CARE CENTER, LLC
     CULLMAN REGIONAL MEDICAL CENTER , INC.
     CUNNINGHAM PATHOLOGY, LLC
     DARK SIDE MEDICAL, LLC
     DECATUR GENERAL HOSPITAL
     DIVINE HELP IN HOME CARE & ASSISTANCE,LLC.
     DR STEVEN EUGENE JOHNSON PC
     DR. MICHAEL JOHNSON & ASSOCIATES
     EAST ALABAMA HEART AND VASCULAR CONSULTATIONS LLC
     ELEOS HOME MEDICAL, LLC
     ELITE RX, LLC
     ENCOMPASS MEDICAL, LLC
     ENCORE REHABILITATION, INC.
     ERIC B. WELLS MD, LLC
     ESCAMBIA COUNTY HEALTH CARE AUTHORITY
     ETHER BUNNY INC
     EXTENDED CARE MEDICAL ASSOCIATES LLC
     EXTENDED FAMILY INC
     FAIRHOPE PEDIATRIC DENTISTRY, PC
     FAITH IN ACTION COMMUNITY SERVICES, INC
     FLANNAGAN DENTAL
     FLORENCE MRI DIAGNOSTIC
     FORT MITCHELL CLINIC PC
     FOUNDATIONS COUNSELING CENTER, INC.
     GINA R SCOTT OD LLC
     GODBEE MEDICAL DISTRIBUTORS
     GREAT OAKS HEALTHCARE MANAGEMENT, LLC
     GULFSOUTH MEDICAL LLC
     H. RADCLIFF BROWN, JR., D.M.D., P.C.
     HALEIGH S. BLACKWELL, DMD, PC
     HAMES & HENDON INC
     HANCEVILLE NURSING & REHAB CENTER INC.
     HARTLEY NICHOLS EYE CARE, LLC
     HAYDEN FAMILY PHARMACY P C
     HUNTSVILLE CLINIC LAB LLC
     HUNTSVILLE HEALTH AND REHABILITATION, LLC
     IMC-EASTERN SHORE ADULT MEDICINE, P.C.
     INSTITUTIONAL PHARAMACY SOLUTIONS LLC
     INSTITUTIONAL PHARMACY SOLUTIONS
     J. ASHLEY HAGEMEYER, MD, LLC
     JACKSON'S ROCKY RIDGE PHARMACY, INC
     JAMES C RAINS JR MD PC
     JANE PEARSON MD PA
     LAKESIDE HOSPICE INC.
     LAKEWOOD PATHOLOGY ASSOCIATES, PA
     LANDERS FAMILY CHIROPRACTIC, LLC
     LANIER PEDIATRICS
     LARRY E. THORNE MD LLC
     LIFEGUARD AMBULANCE SERVICE OF TEXAS LLC
     LIVINGSTON CLINIC, INC.
     MADISON DENTAL ASSOCIATES LLC
     MARSHALL MEDICAL CENTER NORTH FAMILY MEDICAL CENTER OF ARAB
     MARSHALL MEDICAL CENTER SOUTH MANGANARIS PULMONOLOGY
     MARTHA ALDRIDGE MD
     MATTHEW KNIGHT MD PC
     MEDICAL HOME CARE, INC.
     MEDIREST, INC.
     MELVIN D THORNBURY JR MD PC
     MILLARD H. MCWHORTER III MD PC
     MILLRY PEDIATRIC CLINIC, LLC
     MOBILCARE MEDICAL, INC.
     MONTGOMERY EYE PHYSICIANS P.C
     MORGAN FAMILY PRACTICE, LLC
     MT CHEAHA DENTAL PC
     NEW CENTURIONS, INC.
     NEW HORIZONS WELLNESS CENTER
     NOLAND HOSPITAL MONTGOMERY, LLC
     NOLAND HOSPITAL TUSCALOOSA, LLC
     NORTH ALABAMA REHABILITATION AND PAIN SPECIALIST LLC
     NORTHWEST ALABAMA MENTAL HEALTH CENTER
     NWMC-WINFIELD PHYSICIAN PRACTICE LLC
     NWMC-WINFIELD PHYSICIAN PRACTICES LLC
     NWMC-WINFIELD PHYSICIAN PRACTICES LLC
     NWMC-WINFIELD PHYSICIAN PRACTICES, LLC
     ORANGE BEACH FAMILY PHARMACY
     ORTHOSPORTS ASSOCIATES, LLC
     PATHOLOGY LABORATORY ASSOCIATES P.A.
     PEOPLE HELPING PEOPLE INC
     PHOENIX MEDICAL, LLC
     PHOENIX WOMENS HEALTH LLC
     PHYSICIANS CARE OF SWEET WATER LLC
     PREMIER ORTHOSPORTS, INC.
     PROFESSIONAL HEALTH CARE SERVICES INC
     PROFESSIONAL RESOURCE MANAGEMENT OF WIREGRASS, LLC
     PROFESSIONAL RESOURCE MANAGEMENT OF WIREGRASS, LLC
     PROGRESS LISTENING & LEARNING CENTER LLC
     PROVIDENCE HEALTHCARE SERVICES INC
     PT SOLUTIONS MANAGEMENT, LLC
     QUALITY OF LIFE HEALTH SERVICES, INC
     R REX HARRIS MD LLC
     REGIONAL MEDICAL CENTER BOARD
     RESURRECTION LIFE CENTER
     RONISHIA THOMAS, MD, PC
     RUSSELL PHARMACY LLC
     SAAD ENTERPRISES, INC.
     SALTER & TAPSCOTT SURGICAL ASSOCIATES, LLC
     SAND MOUNTAIN INTERNAL MEDICINE AND GERIATRICS
     SARRELL REGIONAL DENTAL CENTER FOR PUBLIC HEALTH INC.
     SECURE HEALTH SYSTEMS
     SELIKOFF CENTER INC.
     SEQUEL TSI OF ALABAMA, LLC OWENS
     SHEARMETRICS HAIR SALON
     SHEHI MEDICAL, LLC
     SHOALS SENIOR SOLUTIONS
     SKIN PATHOLOGY ASSOCIATES, INC
     SLEEP APNEA PROFESSIONALS LLC
     SOUTHEAST ALABAMA RURAL HEALTH ASSOCIATES
     SOUTHEASTERN BALANCE CENTERS LLC
     SOUTHEASTERN BRACE, LLC
     SOUTHERN CARE INTERNAL MEDICINE PC
     SOUTHERN MEDICAL EQUIPMENT, CORP
     SOUTHSIDE PHARMACY INC
     ST JUDE THADDEUS INTERNAL MEDICINE
     ST. VINCENT'S EAST
     STABLER CLINIC, P.C.
     STACY L. SIEGEL, MD, LLC
     STAFF MEDICAL SERVICE HOME HEALTH, INC
     STARKEY LABORATORIES INC.
     STEPHEN KEITH MD
     SUMMERS W. TAYLOR, III, MD, PC
     SVPS PSYCHIATRIC SERVICES LLC
     THE EYE SHOP, INC.
     THOMPSON PSYCHOLOGY GROUP, LLC
     TIMOTHY H REAL MD LLC
     TOTAL PERFORMANCE MEDICINE
     TOTAL SKIN & BEAUTY PHARMACY LLC
     TROY REGIONAL PHYSICIANS INC
     TUCKER FAMILY DENTISTRY, P.C.
     UNITED FLORALA, INC
     US AMBULANCE LLC
     USA CHILDREN'S AND WOMEN'S HOSPITAL
     USA HEALTHCARE ADAMS LLC
     USA HEALTHCARE MORGAN LLC
     USA HEALTHCARE WOODLAND HAUS LLC
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