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Policy and Procedure Name:
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Interpreter and Translation Services
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Policy #:
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CP-09-03
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Code/Rule Reference:
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R.C. 125 and R.C. 4112
Americans With Disabilities Act of 1990, Pub. L. No.
101-336, 104 Stat. 328 (1990); IC/BWC Joint Resolution R88-1-200
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Effective Date:
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07/23/20
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Approved:
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Ann Shannon, Chief of Claims Policy and Support
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Origin:
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Claims Policy
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Supersedes:
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Policy # CP-09-03, effective 11/14/16 and Procedure #
CP-09-03.PR1, effective 11/14/16
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History:*
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Previous versions of this policy are available upon
request
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Table of Contents
I. POLICY PURPOSE
II. APPLICABILITY
III. DEFINITIONS
American Sign Language (ASL)
Interpreter
State Contracted Vendor
Translation
IV. POLICY
A.
Interpreters
B.
Translations
C.
State Contracted Vendor
D.
Self-Insuring Employers
V. PROCEDURE
A.
Standard Claim File Documentation
B.
Recognizing the Need for Interpreting Services
C.
Over-Phone-Interpreting Services
D.
On-Site Interpreter Services for BWC Exams
E.
ASL Interpreting Services
F.
Document Translation Services
G.
Hospital-Based Interpreter Services
H.
Interpreting Services for Catastrophic Claims
I.
Interpreter Services for IC Proceedings
J.
Interpreter Services Required by Vocational Rehabilitation
K.
Interpreter Services Required by the MCO
L.
Publishing a Decision
M.
Payment of Over-Phone-Interpreting and Document Translation Services
N.
Payment for On-Site Interpretation Services – BWC Exams, IC Hearings or
Exams, or ASL Services
O.
Interpreting Services Paid from Surplus Fund
P.
Reporting Non-Compliance
The purpose of this policy is to ensure that BWC provides
interpreters for injured workers and employers and properly translates claim
documents that are in a language other than English, as necessary and
appropriate.
This policy applies to all claims services staff and managed
care organization (MCO) staff.
American
Sign Language (ASL): A complete, complex language that employs signs
made with the hands and other movements, including facial expressions and
posture of the body, used primarily by people in North America who are hard of
hearing.
Interpreter:
An individual or device that converts any spoken material from one language
into a different language. For purposes of this policy, the term “interpreter”
includes both an ASL interpreter and a foreign-language interpreter, unless
otherwise noted.
Limited
English Proficiency (LEP): A person with Limited English
Proficiency or LEP is one whose primary language is not English and is not able
to speak, read, write or understand English well enough to communicate
effectively when interacting with BWC staff.
State Contracted Vendor: A
person or company that has contracted with the Ohio Department of
Administrative Services to provide selected products and services for use by
state agencies and eligible users.
Translation:
Conversion of written material from one language to another.
A.
Interpreters
1.
It is the policy of BWC to provide necessary and appropriate interpreter
services upon the request of an injured worker (IW) or when the need is
otherwise identified, to facilitate:
a.
Expediting treatment in catastrophic claims;
b.
Filing or investigating a claim or an action pending in a claim; or
c.
Medical specialist consultations requested by the physician of record
(POR) or treating physician and approved by the MCO.
d.
Industrial Commission (IC) proceedings.
e.
Vocational rehabilitation services.
2.
ASL interpretation shall be approved and provided in these additional
claim-related circumstances, including but not limited to:
a.
Routine office visits with a POR;
b.
Communication with durable medical equipment suppliers; and
c.
Physical or occupational therapy.
3.
BWC will not pay for interpreters:
a.
For hospital-based services;
b.
For services not contracted or approved by BWC or the IC; or
c.
When family members, friends, health care providers, vocational service
providers, or community volunteers provide interpretation for the IW.
4.
It is the policy of BWC that any interpreter provided by BWC must be
able to interpret effectively, accurately, and impartially, both receptively
and expressively, using any necessary specialized vocabulary appropriate to the
circumstances.
B.
Translations
1.
It is the policy of BWC that a foreign-language document containing
information relevant to making a claim decision be appropriately translated to
English (e.g., letter from a surviving spouse; birth certificate of a
dependent; marriage certificate of an IW).
2.
If the foreign-language document is relied upon to make a claim
determination, BWC shall utilize the services of a professional translator that
has:
a.
Native or near native fluency in the language being translated and in
English; and
b.
Experience or expertise in the subject-matter of the document, adequate
to provide a reliable translation (e.g., legal or medical terms).
C. C.
State Contracted Vendor- It is the policy of BWC to use any state
contracted vendor(s) to provide interpreter services whenever possible. For
services outside the scope of the state term contract, claims services staff
may use alternative providers, as outlined in the procedures below.
D. D.
Self-Insuring Employers- Self-insuring employers are required to pay for
interpreter and translation services, with the exception of interpreter
services for examinations related to an Application for Determination of
Percentage of Permanent Partial Disability (C-92).
A.
Standard Claim File Documentation
1.
BWC staff shall refer to the Standard
Claim File Documentation and Altered Documents policy and procedure for
claim note requirements; and
2.
Shall follow any other specific instructions for claim notes included in
this procedure.
B.
Recognizing the Need for Interpreting Services
1.
When claims services staff becomes aware that an IW is LEP or is hearing
impaired, claims services staff shall:
a.
Check the “Primary Language” field at the customer level of the claims
management system; and
b.
Choose the IW’s primary conversational language from the dropdown box.
2.
Identifying an Interpreter and Arranging Services
a.
Claims services staff may work with the state contracted vendor or other
service providers to obtain services, as outlined in this procedure.
b.
If the IW requests that a family or friend provide interpreting
services, BWC may consider utilizing those services.
c.
When reasonable and effective interpreting services cannot be provided
by the IW’s family or friends, claims service staff may also investigate other
resources that may be available at no additional cost to BWC. Such resources
may include:
i.
Bilingual staff at the Customer Contact Center;
ii.
Telecommunications Relay Service (Ohio
Relay Service dial 7-1-1);
iii.
A health care or vocational rehabilitation service provider fluent
in the language of the IW. (NOTE: The health care provider or vocational
rehabilitation service provider will not be additionally reimbursed for
interpreter services); or
iv. Community
organizations.
d.
Choice of interpreting services shall be made by BWC utilizing BWC’s
policy objective that interpreters must be able to interpret effectively,
accurately, and impartially, both receptively and expressively, using any
necessary specialized vocabulary appropriate to the circumstances.
C. C.
Over-Phone-Interpreting Services- Claims services staff shall contact
the state contracted vendor to obtain these services. Click “here”
for instructions.
D. D.
On-Site Interpreter Services for BWC Exams– Claims services staff shall:
1.
Contact the state contracted vendor to schedule these services. Click “here”
for instructions.
2.
Provide the state contracted vendor 48 hours to report confirmation (e.g.,
verbal, email) that an interpreter has been scheduled for the exam.
a.
If confirmation is received, claims services staff shall document the
confirmation number in notes.
b.
If no confirmation is received, claims services staff shall contact:
i.
Feedback.medical@bwc.state.oh.us
for a list of BWC interpreting service providers to schedule an interpreter for
the exam; and
ii.
Field.C.1@bwc.state.oh.us
to report non-compliance.
E.
ASL Interpreting Services
1.
ASL services are not provided by the state contracted vendor. In
cases where an ASL interpreter is needed, claims services staff shall contact Feedback.medical@bwc.state.oh.us
for a list of service providers.
2.
Claims services staff may contact Field.C.1@bwc.state.oh.us with
questions or inquiries on the ASL services.
F.
Document Translation Services
1.
Claim services staff shall obtain a translation of documents written in
a foreign language that appear to be:
a.
Communications from, or on behalf of, a party to the claim; or
b.
Evidence in a claim.
2.
Claim services staff may consult with a bilingual BWC staff member regarding a
document to determine the nature of the document and its general contents.
3.
If the document appears to provide information or evidence upon which a claim
decision will be made, claims services staff shall contact Feedback.medical@bwc.state.oh.us
for a list of service providers to translate the document(s). Translation of
foreign documents to English is not a service provided by the state contracted
vendor.
4.
Claims services staff shall ensure the translation is imaged into the claim
file.
5.
Claims services staff may contact Field.C.1@bwc.state.oh.us with
questions or inquiries on the document translation services.
G.
Hospital-Based Interpreter Services
1.
Hospital-based interpreter services for an LEP IW:
a.
Will not be paid when associated with treatment an IW receives while
hospitalized.
b.
Will be paid if BWC needs to communicate with the IW and the IW requires an
interpreter.
2.
Caims services staff shall note the IW’s need of interpreter services in the
claim file.
H.
Interpreting Services for Catastrophic Claims
1.
The BWC catastrophic nurse advocate shall work with the MCO to review
available options when interpreter services are necessary.
2.
This communication can be accomplished by phone or email and noted in
the claim file.
I.
Interpreter Services for IC Proceedings
1.
LEP or hearing impaired IWs may require an interpreter so that the IW
can understand what is happening in IC hearings.
2.
If the claims services staff is referring an issue to the IC on a Notice
of Referral (NOR) or there is an appeal to a BWC order, claims services staff
shall ensure the “Primary Language” field is marked in the claims management
system, which will automatically alert the IC that the IW needs interpreter
services.
3.
Consistent with IC/BWC
Joint Resolution R88-1-200, the IC is responsible for ordering and
scheduling interpreters for IC hearings and IC medical examinations for IWs who
have difficulty communicating due to a hearing impairment or limited English
proficiency. Claims services staff shall refer any questions regarding
interpreter services for IC hearings or IC medical examinations to IC Customer
Service for assistance.
J.
Interpreter Services Required for Vocational Rehabilitation
1.
Claims services staff shall ensure that an IW receives necessary and
appropriate interpreter services, particularly at critical stages in the
rehabilitation process, including, but not limited to:
a. The initial
interview with the IW;
b. The meeting
to discuss and sign the rehabilitation agreement;
c. When the plan
expectations are discussed; and
d. When there
is a change in the case direction.
2.
BWC Vocational Rehabilitation Policy staff will be available to help in
individual cases, upon request.
K.
Interpreter Services Required by the MCO
1.
If an IW needs an interpreter for a non-BWC examination that is required
and scheduled by the MCO, the MCO is responsible for payment of both the
examination and the interpreter services. The MCO may use its own interpreter
service or may request assistance from BWC or the IC, as applicable.
2.
If the IW needs interpreter services related to an Alternative Dispute
Resolution (ADR) examination, the MCO will contact the IW’s assigned CSS or DMC
to make the arrangements. BWC will pay for interpreter services for ADR
examinations as often as necessary.
3.
Staff shall place a note in the claim reflecting the discussion with the
MCO and their agreement as to the entities responsible for payment.
4.
If an MCO approves interpreter services in error, without BWC approval,
the MCO shall be responsible for reimbursement to the provider. Payment will be
transferred from the MCO’s administrative account into the provider account to
cover the exact payment issued from the provider account to pay for the interpreter
services. Supporting documentation for the transaction must be maintained for
audit purposes.
L.
Documenting a Decision - Claims services staff shall enter a claim note
which includes the following details:
1.
Approval of the request;
2.
The specific type of interpreter being approved (e.g., ASL interpreter, over
the phone, on-site, or document translation services);
3.
The date and event approved for interpreter services; and
4.
The name and contact information of the service provider.
M.
Payment of Over-Phone-Interpreting Services
1.
Once over-the-phone services are provided, the state contracted vendor
will create an invoice for that service and email the invoice to Ohio Shared
Services for payment processing and copy Claims Services Administration.
2.
Claims Services Administration will review the invoice to determine if
they should approve or reject the invoice for payment. If the invoice is:
a.
Approved, Claims Services Administration will notify Accounts Payable via email
that the invoice is approved and should be processed.
b.
Rejected, Claims Services Administration will notify Accounts Payable via email
that the invoice is rejected with the underlying reason(s). Ohio Shared
Services will return the invoice back to the state contracted vendor with the
reason for the rejection (e.g. duplicate invoice, or invoice is missing
necessary information).
3.
Ohio Shared Services will not pay invoices without the proper approval
from BWC.
N. Payment
for On-Site Interpretation and Document Translation Services
1.
BWC will pay for approved on-site interpretation (including ASL
services) for BWC and IC examinations, and for IC hearings as well as document
translation services.
2.
The interpreting service provider or IC shall submit the request for
reimbursement for services on a C-19 to BWC. Imaged C-19s will appear on
the Medical Billing and Adjustments (MB&A) Unit’s work list.
a.
When MB&A receives the C-19 directly:
i.
MB&A shall review the claim for the claim note approving interpreter or
translation services.
ii.
If MB&A is unable to locate adequate documentation of approval by the
claims services staff in the claim, MB&A shall forward the C-19 to either
the claims services staff or Claims Services Admininstration, requesting the
necessary information so that payment may be processed.
b.
When claims services staff receives the C-19, either directly from the provider
or from MB&A, claims services staff shall:
i.
Verify that the services were provided and the information is correct;
ii.
Place his or her “A” number in Box 9 on the completed C-19 before it is imaged;
iii.
Index the document as a C-19; and
iv.
Update the approval in claim notes.
c.
MB&A will also process for payment all interpreter service invoices
received from the IC.
d.
BWC shall not pay for interpreter services that are not approved by BWC or the
IC.
O. O.
Interpreting Services Paid from Surplus Fund
1.
Payment for interpreter services shall be made from the Surplus fund.
2.
Non-complying employers shall be billed for payments made from the
Surplus fund in no-coverage claims.
3.
Examinations related to an Application for Determination of Percentage
of Permanent Partial Disability (C-92) in self-insuring employer claims
shall be made from the Surplus fund.
P. P.
Reporting Non-Compliance - Claims services staff shall report state
contracted vendor non-compliance or other issues to Field.C.1@bwc.state.oh.us.