# Coverage/Billing of Interpreter Services



## sondra hayden

I have been asked if our hospital/physician offices may bill for interpreter services. I have searched for any transmittals/MLMs and can't find anything under interpreter... Please respond with any resource/hint you may have on this.

Thanks for your assistance.
Sondra Hayden,CPC
CVMC
802-371-4229:


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## RebeccaWoodward*

We don't have a separate fee for "interpretation services"...

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.

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


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## mbort

This was posted on the DH forum by Margie Vaught recently..It should help 

There are two separate laws/regulations regarding this 
One - President Clinton signed one relating to NonEnglish speaking and access to healthcare 
Second - Civil Rights-American's with Disability- 

Here is the information that you will need: 

http://www.hhs.gov/ocr/lep/revisedlep.html 

http://www.hipaadvisory.com/action/LegalQA/law/Legal27.htm 

Here is another URL: 
http://coloquio.com/english/limited.htm 
http://www.ama-assn.org/sci-pubs/amnews/pick_02/gvsa1202.htm 

Here are some URLs relating to this issue and what the National Association of the Deaf (NAD) has to say: 

http://www.nad.org/infocenter/infotogo/legal/doctors.html 
"Are Doctors Required to Provide INTERPRETERs for Medical Visits and Other Medical-Related Situations? The short answer is yes. This is covered under the Title III of the Americans with Disabilities Act (ADA). If you feel that you need an INTERPRETER in order to understand what your doctor/health care provider is telling you, then the doctor/health care provider is required to provide you with one. It is best to contact your doctor/health care provider directly and tell them, prior to your appointment, that you need an INTERPRETER. Do not hire your own INTERPRETER and expect the doctor/health care provider to pay your INTERPRETER for you. You may run into problems that way. 

The doctor/health care provider must pay for the cost of an INTERPRETER, even if the cost of the INTERPRETER is more than the cost of your visit. The doctor/health care provider is expected to handle the cost of INTERPRETER as a normal business expense or as part of the overhead costs of operating a business. 
If your doctor/health care provider tries to encourage you to bring in a signing family member or a friend as a way to "save costs", say no. Family members and friends cannot be expected to be neutral and sign everything they hear. They may be emotionally or personally involved with you and this may affect their INTERPRETing. Using them as INTERPRETERs can also cause problems in maintaining your confidentiality as a patient. " 

http://www.idhhc.state.il.us/obligations/healthCare.htm 

http://www.deaflinx.com/law.html 
http://signlanguagesolutions.com/links.php 

"In August 2000, former President Clinton signed an executive order requiring all federally funded medical facilities to develop written policies on how they would serve patients who speak little or no English. Later that month, HHS released guidelines outlining medical facilities' responsibilities in offering language assistance, but those guidelines are rarely followed, the Post notes. "The requirement is a federal law. But the guidelines say what you should do, not what you must do if you want to be compliant," Robinsue Froehboese, principal deputy and acting director of the Department of Justice's Office of Civil Rights, said. " 

"Federal civil rights law requires hospitals and doctors receiving federal funds to provide services that can be understood by non-English speakers. In general, doctors cannot turn away patients simply because they don't speak English. 

And executive order signed by President Clinton emphasized that programs provided in English that are not accessible to those who speak limited English are discriminatory. 

This fall, the Department of Health and Human Services' Office for Civil Rights plans to issue guidelines for serving such patients. 

In California, advocates are pushing for a bill to require stricter enforcement of a 1973 law that makes state and local agencies provide bilingual services if they serve a substantial number of non-English-speaking people. 

And a new Maryland law says state agencies must translate vital documents if 3 percent of the population they serve is unable to understand or speak English. 

Doctors rely on a patchwork of methods of communicating with patients who don't speak English. Some enlist janitors, receptionists, other patients or relatives. At one hospital in the Washington, DC area, staff members occasionally use flash cards for women giving birth with phrases in Asian dialects for "pain," " pressure" and "push." 

A more sophisticated pilot project at Gouveneur Hospital in New York uses trained medical INTERPRETERs for simultaneous INTERPRETation of Spanish, Mandarin, Cantonese and ***inese, a Chinese dialect. Doctors and patients wear headsets and the conversation is transmitted over a wireless network to an INTERPRETER in another room." 


Margie Scalley Vaught, CPC, CPC-H, CCS-P, MCS-P, ACS-EM, ACS-OR
Healthcare Consultant


Mary, CPC, COSC


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