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					                                        CareWorks
                              Medical Treatment Policy
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TITLE:              Interpreter Services

CATEGORY:           Medical Provider/Specialties
DATE
CREATED/LAST
UPDATE:             10/02/12


                                         Internal Interpreters
         Refer to CareWorks’ Policy and Procedure 107 for current listing of CareWorks
         internal interpreters.

         Guidelines for Interpreter Services:
           1. The approval of interpreter services is a claims function and not a medical
              management function and therefore it is the responsibility of the BWC to approve
              and reimburse interpreter services.

            2. CareWorks shall refer all requests for interpreter services immediately to the IW’s
               assigned CSS/DMC.

            3. All requested for interpreter services that are eligible for reimbursement by BWC
               must be made directly to the CSS except in cases that involve vocational
               rehabilitation. (See policy 401 and 404).

            4. For IWs participating in a vocational rehabilitation plan, the Disability Management
               Coordinator (DMC) must approve and monitor the extent of the services.

            5. BWC/CareWorks will make every attempt to assist the IW by
               investigating the options available in his/her home community and at
               BWC prior to approving interpreter services.

            6. The CSS/DMC will work with CareWorks to facilitate communication of the IW’s
               needs for interpreter services and what is “reasonable, necessary and
               appropriate.”
                   “Necessary and reasonable” services are based on the individual situation of
                     each IW as determined by the CSS/DMC.
          The CSS or DMC shall approve or deny interpreter services and shall place a
            note in V3, stating that interpreter services were discussed and it was
            determined to allow or deny the request.
          The CSS/DMC will send a letter to the IW and parties in the claim once the
            decision has been made to approve or deny the request. Parties to the
            claim may file a motion if they object to the decision.

   7. The Industrial Commission (IC) approves services it deems necessary and makes
      arrangements for interpreter services for IC purposes.

                      Requests for Interpreter Services
Requests for interpreter services shall include the following information:
    Claim Number
    IW’s Name
    IW’s Social Security Number
    Date of Injury
    Type of Services (i.e. sign language of the specific language needed)
    Date service is required
    Location service is to be performed
    Customer Service Specialist Contact

                                  Language Line
Please note the language line is an added CareWorks’ expense. Prior to
utilizing the language line verify there is not an internal CareWorks employee
who can assist with translating and plan direction of the call. Refer to
CareWorks Policy and Procedure 107 for current listing. Keep call brief.

If an inbound call is received from a non-English-speaking caller, the AT&T language
line can be accessed:
       a. Announce to the caller that you are going to put them on hold.
       b. Place the non-English speaker on hold by pressing the CONFERENCE button.
       c. Dial the Language Line Services at 9-1-800-774-4344.
       d. Give the Language Line Representative (the Answer Point) the following
          information:
           The Language needed-Note: if unsure of what language is needed, the
              Answer Points are trained to assist you.
           Our Client I.D. number (712447)
           Organization Name (CareWorks)
           Personal Code (Your four-digit extension i.e., 5976)
       e. Wait for the Answer Point to conference in the interpreter.
       f. Brief the interpreter. Summarize what you wish to accomplish and give any
          special instructions.
       e. Press the YES key to complete the conference call, or press the CANCEL key to
          return to the original two-party call.
      g. Say, “end of call” when call is complete.

If an outbound call is being made to a non-English-speaker:
       a. Dial the Language Line Services at 9-1-800-774-4344.
       b. Give the Language Line Representative (the Answer Point) the following
          information:
           The Language needed-Note: if unsure of what language is needed, the
              Answer Points are trained to assist you.
           Our Client I.D. number (712447)
           Organization Name (CareWorks)
           Personal Code (Your four-digit extension)
       c. Wait for the Answer Point to conference in an interpreter.
       d. Brief the interpreter. Summarize what you wish to accomplish and give any
          special instructions.
       e. Conference in the non-English-speaker by pressing CONFERENCE, dialing the
          number, waiting for the non-English-speaker to answer, and then reconnect to
          the interpreter by pressing YES.
       f. Say “end of call” when call is complete.

                           Ohio Relay (for the Deaf)

To communicate to injured workers, employers, and other parties involved in a claim who
are deaf, hard-of hearing or speech-impaired, CareWorks associates may access the
Ohio Relay Service (ORS) by dialing 1-800-750-0750.

The Ohio Relay Service will text type your message to the phone of individuals with
hearing or speaking impairments. To access this service, call 1-800-750-0750 and give
them the number you are trying to reach. They will transmit to the phone of the impaired
person any communication needed to be conveyed. Please give the same number to the
impaired person who can then communicate to us for future reference. All services are
free of charge and may be used with our toll free number for individuals who are out of
the calling area.

                       BWC will Typically Not Approve
BWC will typically not approve Foreign Language Interpreter Services in the following
situations:
     Communication with durable medical equipment (DME) Suppliers
     Physician of Record (POR) office visits; (the IW has a choice of selecting his/her
        physician and is responsible for communicating with his/her physician.)
     Physical or Occupational Therapy

                                BWC Will Approve
BWC shall approve Sign Language Interpreters for deaf or hearing impaired IWs who use
sign language, when requested, in the following situations:
       Communication with durable medical equipment (DME) suppliers
       Physician of record (POR) routine office visits;
       Physical or Occupational Therapy

                                 Hospital Patients
BWC will not approve Foreign Language or Sign Language Interpreter Services for an
injured worker receiving hospital based services as the hospital is responsible for
providing these services. Hospital may inform BWC that an injured worker may require
interpreter services when discharged. This is especially true for planned hospitalizations
this will prevent delays in treatment. If the IW has been approved for hospital based
services and requires an interpreter, the CSS/ DMC should notify the hospital social
services or other department designated for obtaining interpreters, concerning the IW’s
need for assistance to facilitate communication. The CSS/DMC should inform the hospital
to call him/her if interpreter services will be needed soon after the injured worker is
discharged. Coordination of interpreter services for injured worker’s that need the
services, is a necessary part of eliminating time lost for the injured workers care and
return to work.

                         MCO Scheduled Examination
The MCO is responsible for payment of both the examination and the interpreter services
if the injured work needs an interpreter for an examination that is scheduled by the MC.
The MCO may use its own interpreter services or may request assistance from BWC.

If an MCO approved 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 services provided. Supporting
documentation for the transaction must be maintained for audit trail purposes.

                       Payment for Interpreter Services
Family members, friends, medical, health care and vocational providers and/or
community volunteers may provide interpretation for IWs but are not eligible for
enrollment or to receive reimbursement.

                   BWC’s Medical Billing and Adjustments
All Interpreter Services (BWC or IC) must be billed with the appropriate code(s) below on
a C-19 Services Invoice (C-19).
     W1930 Interpreter Services, per fifteen (15) minutes
     W1931 Interpreter Wait Time, per (6) minutes, Maximum of 30 minutes per date
        of service (including waiting for an IW that does not show up for appointment).”
     W1932 Interpreter Travel Time, per six (6) minutes (including travel time for an
        IW that does not show up for appointment).
     W1933 Interpreter Mileage, per mile.
REFERENCE   2012   REFERENCE   CareWorks Policy and Procedure 107.
DATE:              SOURCE:
                               BWC Billing and Reimbursement Manual 2012

				
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