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Costs of interpreters for the deaf can be negotiated
Leo d’Ambrosio, M.D., didn’t object when a deaf patient brought his own interpreter, but he did object to the $600 bill the out-of-town interpreter handed him.
“We have a lot less trouble finding foreign language interpreters,” explained Cheryl Sommerville, director of operations for Dr. d’Ambrosio. “Finding an interpreter for the deaf is a challenge.”
Patients who are deaf fall under the Americans with Disabilities Act that requires physicians to provide a “reasonable accommodation” to a patient with a disability. That also means physicians are responsible for all costs of providing the accommodation and cannot pass the charge on to the patient or insurance company.
What constitutes a reasonable accommodation depends on circumstances. In some cases, communicating with a deaf patient may be accomplished by writing notes or getting assistance from a family member. But keep in mind that failure to provide a reasonable accommodation, either literally or in the patient’s eyes, could result in a discrimination lawsuit.
Negotiating the bill
“A doctor has the right to discuss and confirm charges with an interpreter prior to a session,” advised James Van Manen, Ph.D., director of Deaf and Hard of Hearing Services for the Indiana Family and Social Services Administration. “You can expect to pay an interpreter about $90-$100 for two hours. Travel time, mileage or portal-to-portal charges can be negotiated.”
Dr. Van Manen advised physicians to only pay for professional interpreters, not family members. He also suggested that physicians hire an interpreter who holds any one of three state certifications.
MCO coverage
The HHW RFS-6-68 states: “The MCO must provide free oral interpretation services to its members seeking health care-related services in a provider’s service location in accordance with 42 CFR 438.10 (c)(4).”
The Office of Medicaid Policy and Planning confirms certain types of these services are not currently reimbursed by the state due to federal regulations. However, some managed care organizations (MCO) provide the services for members in the physician office, if the physician contacts the contracted MCO in advance.
Here is a summary from MCO provider manuals:
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MHS — Will make available individuals who are trained professional interpreters for Spanish and American Sign Language, who will be available onsite or via telephone to assist providers with discussing technical, medical or treatment information with members, as needed. Prior notification is needed; call the Member Services Department at (800) 414-5849. (See page 40 of the MHS provider manual for more details.)
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Anthem — Telephone, face-to-face and sign language interpreters are available through the health plan by calling the Customer Care Center in advance at (866) 408-6132. Details>>
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MDwise — Does provide interpretive services. Contact your delivery system provider relation’s staff to learn about available resources.
Lessons learned
Dr. d’Ambrosio is in the process of negotiating the $600 interpreter’s bill, but his staff now offers to provide an interpreter. The practice also is putting together a list of interpreters and their charges
Resources
The Deaf and Hard of Hearing Services of FSSA provides a complete statewide list of interpreter services. Find the directory and select “resource directory.”
Read the AMA’s legal view about the Americans with Disabilities Act and hearing interpreters.
Certification
Interpreters for the deaf are not required to be certified in Indiana, unless they work for the state. The Registry of Interpreters for the Deaf (RID) provides national certification in which interpreters must pass written and performance exams. Read more about the certification>>
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