# Interpreter for the Hearing Impaired.



## kbarbag (Sep 2, 2008)

Has anyone had to deal with this issue in their practice? It is required by law that we provide an interpreter, but has anyone had any luck getting reimbursed by an insurance for this service?  If so what insurance and how did you get the reimbursement. 

thanks


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## BoyceSolutions (Sep 3, 2008)

*You are Correct*

Providing an interpreter whether hearing imparied, or a foreign language is required by federal law. This is required of the practice to supply the service. I know of no insurance company that reimburses this. It is a requirement of the medical practice to provide the interpreter for quality care. It is not a responsibility that falls back to the insurance carrier.
For foreign languages, I would check out the "Langauge Line". They charge a very small yearly fee to be a member and then you are only charged a per minute rate when you actually use them, based on the difficulty of the language needed. For sign langauge interpreters, you really just have to look locally for the best price and negotiate a deal with someone. You do not have to use the interpreter a patient brings if you can provide them the same service (since you are paying for it either way). Also you should keep in mind that sometimes patients have relatives or friends with them that could violate HIPAA, not to mention cultural norms in some places where it would be inappropriate to speak about one family members health in front of another. Also, if you have an employee who can interpret, this is usually not recommended as then you are in a risk situation where you are now responsible for an accurate interpreter personally. Hope this helps. All of these are usually lost money for any practice.


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## beckiw (Sep 4, 2008)

"Also you should keep in mind that sometimes patients have relatives or friends with them that could violate HIPAA, not to mention cultural norms in some places where it would be inappropriate to speak about one family members health in front of another. "

If a patient brings their own interpreter and allows that person to be in the treatment room, this does not violate HIPAA.  You can ask the patient to sign a release form, allowing discussion of their medical condition with that interpreter, if HIPAA concerns you.


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## BoyceSolutions (Sep 15, 2008)

*true*

This is true- however I was urging you to keep in mind cultural sensitivity issues with my statement above. While in the US it can be very common that we bring in family members to join in discussion, often times those needing interpretation services do not have our same customs. For example, while many foreign-born women may have their sons bring them in for a visit; in many countries it is inappropriate for a son to know about his mothers medical conditions. Getting that clearance through a HIPAA form is essential, both for the translation as well as the cultural sensitivity piece. Good luck!


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## FTessaBartels (Sep 19, 2008)

*Medical reasons for NOT using family member*

There are legitimate medical reasons for NOT using a family member to translate, and instead using a profesional medical translation service. 

Just think of the difficulty in explaining some medical terms to a native-English speaking person who does not have medical teminology education. (Heck, think of the difficulties WE sometimes have on this forum!) Now multiply that difficulty by relying up on a family member to translate possibly complicated medical information to a patient. The risk of misinterpretation is extremely high.

I grew up speaking Spanish, and I have training in medical terminology, but I wouldn't even THINK of trying to translate anything beyond "where does it hurt?" and "he says the pain is in his arm." 

It's a cost of doing business, but the best resource in these cases is a professional medical translation service. 

F Tessa Bartels, CPC, CPC-E/M


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## RebeccaWoodward* (Sep 22, 2008)

http://www.ada.gov/reg3a.html

36.303-reference for above link

And...

http://www.ada.gov/taman3.html


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## j.berkshire (Sep 23, 2008)

Coincidentally, this questions is on another listserv and I posted this FAQ from Palmetto GBA's website addressing the use of prolonged care codes:

"Can a provider submit charges for Evaluation & Management and prolonged care if the reason for the prolonged care was due to the patient requiring an interpreter? 

Yes, as long as the total face-to-face Evaluation & Management time was 55 minutes (25 minutes for CPT code 99214 plus 30 minutes over this time) or longer. In addition, the requirements for medical necessity of the service must also be met. In this case, the medical necessity for the prolonged care was valid because of the patient's inability to communicate. If time is considered the key or controlling factor in choosing the level of E/M service, then the prolonged services CPT codes (99354-99357) should only be used in addition if the service has exceeded 30 minutes beyond the highest level of E/M in the appropriate category. 

Additional information is available in the Current Procedural Terminology, CPT 2008."

Food for thought!


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