# Interpreter/Translater Reimbursement



## BGoldsberry (May 14, 2010)

We treat a deaf patient that requires a Signing Interpreter to be present during her visits. Is it possible to seek reimbursement from her insurance for the interpreter fees?


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## kmhall (May 14, 2010)

Have you looked at the Prolonged Services codes 99354 - 99357?  Maybe this is an option.  Just a thought.


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## RebeccaWoodward* (May 14, 2010)

There are laws that require acommondation for these services. (Americans with Disabilities Act)

Sec.36.303 Auxiliary aids and services.


(a) General. A public accommodation shall take those steps that may be necessary to ensure that no individual with a disability is excluded, denied services, segregated or otherwise treated differently than other individuals because of the absence of auxiliary aids and services, unless the public accommodation can demonstrate that taking those steps would fundamentally alter the nature of the goods, services, facilities, privileges, advantages, or accommodations being offered or would result in an undue burden, i.e., *significant difficulty or expense*.


(b) Examples. The term "auxiliary aids and services'' includes --


(1) Qualified interpreters, notetakers, computer-aided transcription services, written materials, telephone handset amplifiers, assistive listening devices, assistive listening systems, telephones compatible with hearing aids, closed caption decoders, open and closed captioning, telecommunications devices for deaf persons (TDD's), videotext displays, or other effective methods of making aurally delivered materials available to individuals with hearing impairments;


(2) Qualified readers, taped texts, audio recordings, Brailled materials, large print materials, or other effective methods of making visually delivered materials available to individuals with visual impairments;


(3) Acquisition or modification of equipment or devices; and


(4) Other similar services and actions.


(c) Effective communication. A public accommodation shall furnish appropriate auxiliary aids and services where necessary to ensure effective communication with individuals with disabilities.


(d) Telecommunication devices for the deaf (TDD's). (1) A public accommodation that offers a customer, client, patient, or participant the opportunity to make outgoing telephone calls on more than an incidental convenience basis shall make available, upon request, a TDD for the use of an individual who has impaired hearing or a communication disorder.


(2) This part does not require a public accommodation to use a TDD for receiving or making telephone calls incident to its operations.


(e) Closed caption decoders. Places of lodging that provide televisions in five or more guest rooms and hospitals that provide televisions for patient use shall provide, upon request, a means for decoding captions for use by an individual with impaired hearing.


(f) Alternatives. If provision of a particular auxiliary aid or service by a public accommodation would result in a fundamental alteration in the nature of the goods, services, facilities, privileges, advantages, or accommodations being offered or in an undue burden, i.e., significant difficulty or expense, the public accommodation shall provide an alternative auxiliary aid or service, if one exists, that would not result in an alteration or such burden but would nevertheless ensure that, to the maximum extent possible, individuals with disabilities receive the goods, services, facilities, privileges, advantages, or accommodations offered by the public accommodation.


http://www.ada.gov/reg3a.html#Anchor-97857

36.303


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## BGoldsberry (May 14, 2010)

Thank you, I appreciate your responses.


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## smrgr (Jul 20, 2010)

*interpreters*

In my state(ME) only Medicaid reimburses for interpreters but I have not had success with any other payers. I do have the provider make sure they document time spent with the patient and how much is counseling/coordination of care because these visits often take twice as long due to translating time. This helps recoup some of the cost because I can code based on time.


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## cyndeew (Jul 26, 2010)

For more information on providing translation services to patients, go to http://www.lep.gov (Limited English Proficiency Website) From there, you can download a brochure by the DOJ or click on this link http://www.lep.gov/lepbrochure.pdf 

Providers are required to provide interpretation services to patients, at _no cost to the patient. _

A New Jersey trial judge on March 10, 2009 upheld a $400,000 jury award in a discrimination claim against a doctor who refused to pay for a sign language interpreter at a deaf patient's request. The doctor had treated the patient for nearly two years, relying on written notes and the patient's family members. The award -- half of it in punitive damages -- is believed to be the largest of its kind. The court also tacked on attorney's fees, bringing total damages to $635,000. See Gerena v. Fogari and see the AMA article on this story at http://www.ama-assn.org/amednews/2009/04/20/prsa0420.htm 

Having said all this, you may be able to bill the carrier for a prolonged service to cover some of your costs, but you CANNOT charge the patient extra for this or collect coinsurance. If the patient challenged the charges to their carrier, I believe you would have to refund the carrier. Here's the reason - you would be using up the patient's annual/lifetime maximum benefit and because the law requires you to provide this service at no cost, you should not be able to bill the patient's carrier for the extra charges and the patient should not be billed for coinsurance. Also, technically, the carrier is not obligated to pay for charges that the patient has no responsibility to pay in the first place.

Tread carefully here as it is a slipery slope.


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