|From Dental Compliance Specialists 4/9/2012
This is a question we received in the office last month. The answer is two-fold.
For Medicaid patients, the answer is a resounding YES. You must provide an interpreter for your deaf and hard of hearing patients.
Sign language interpreting services are available to Medicaid clients who are deaf or hard of hearing or to a parent or guardian of a Medicaid client if the parent or guardian is deaf or hard of hearing.
Providers in private or group practices with fewer than 15 employees may be reimbursed for this service. The physician will be responsible for arranging and paying for the sign language interpreting services to facilitate the medical services being provided. The physician will then seek reimbursement from Texas Medicaid for providing this service.
Sign language interpreting services are benefits of Texas Medicaid. Providers must use procedure code T1013 with modifier U1 for the first hour of service, and T1013 with modifier UA for each additional 15 minutes of service. Procedure code T1013 billed with modifier U1 is limited to once per day, same provider, and procedure code T1013 billed with modifier UA is limited to a quantity of 28 per day, same provider.
Interpreting services include the provision of voice-to-sign, sign-to-voice, gestural-to-sign, sign-to-gestural, voice-to-visual, visual-to-voice, sign-to-visual, or visual-to-sign services for communication access provided by a certified interpreter.
(This is directly from the MEDICAL AND NURSING SPECIALISTS, PHYSICIANS, AND PHYSICIAN ASSISTANTS HANDBOOK, Section 8.22.6:)
The physician requesting interpreting services must maintain documentation verifying the provision of interpreting services. Documentation of the service must be included in the client’s medical record and must include the name of the sign language interpreter and the interpreter’s certification level.
Documentation must be made available if requested by HHSC or its designee.
For non-Medicaid patients, the answer is: You need to do it. According to ADA (Americans with Disabilities Act) "Health care providers have a duty to provide appropriate auxiliary aids and services when necessary to ensure that communication with people who are deaf or hard of hearing is as effective as communication with others. 28 C.F.R. § 36.303(c)."
There is some language in the a way to get out of it, if you can show it would be an undue hardship. However, since it is probably not going to be a common occurance, it would harbor good will and cause you less stress if you would do it anyway. Besides that, it is difficult to prove hardships. If you are thinking you might refuse to provide this service, please contact your attorney to verify you risk exposure. You may call and check with the patient's private pay insurance company to see if they will reimburse you for the cost.
For more reading on this topic, visit the National Association of the Deaf's website: www.nad.org.