Physicians and the Financial Challenge of Providing an Interpreter

November 11, 2013

When a patient needs expensive translation services, is there an alternative to paying for them and taking a revenue loss?

I’ve written before about unexpected expenses, and we recently ran into another one. 

Practices are required to provide access to care to patients regardless of their ability to speak the same language as the physician, and the practice must provide a reliable way to communicate with the patient. That means for patients who do not speak English (and in our practice, instead speak Filipino or Urdu), a translating service must be available. 

Patients may decline and use a family member, but the service must be available. There are different options for such a service. If there is a staff member who speaks the same language as the patient, the staff member can do it. Or the practice can contract with a translator service. As a less-expensive alternative, there is software that can translate, although that doesn’t always work as well. There are also telephone-based translating services.

Well, it isn't just the non-English speakers who need a translator. We recently had a patient come in who is hearing-impaired. When his appointment was confirmed, he reminded us (through a representative) that it is our responsibility to provide a sign-language interpreter.

We had never needed the services of a signer before.  Fortunately, he provided us with the number of someone we could call. It turns out, such services cost between $150-200 in our area. At least, that was the quote we got. 

At $150-200 a visit, that pretty much means that, at best, we break even for the visit, and more likely, we lose money each time we see him.

Since it is a requirement, I thought, "maybe there is a CPT code for 'use of a translator.'" Maybe we could get reimbursed for hiring someone. Alas, there is no such code, at least not that I could find. 

Now, this patient legitimately needed to see an endocrinologist. He wasn’t one of those people who just think they have an endocrine disorder because they are tired. He needed to be seen, and he will need follow up. And every time he comes, he needs an interpreter. Unless (according to the regulation) there will not be a significant amount of communication involved. What kind of doctor visit doesn’t entail communication?

My biller/husband said we should be able to say we can't see him, but (aside form it being the right thing to do) we have to, otherwise it violates a whole bunch of regulations. The exception to the rule is if it places "undue strain" on the practice. And according to previously filed lawsuits, one patient doesn’t break the bank.

So, we will continue to see him and provide him with an interpreter and take a loss each time. I was curious to know what the experience has been in other practices.