Interpreter rules for PIP and WC

[Guest guest]

All,

Earlier this year, I was in discussion with the OBCE on the rules for DCs with regard to hiring an interpreter for all patients requiring one. I get automatic notices from Fred Bryuns office now and found this rule among the other OARs. It looks like, if I'm reading this correctly, the patient must choose an interpreter, the interpreter must bill the insurance company. If the patient 'no shows' the interpreter can't bill insurance. Just like we experience. However, they can have a signed contract and you can assist them in this endeavor; that essentially says the patient is responsible for paying in the event of a 'no show'. You and I know that most won't pay. They just don't reschedule with you. However, a 'no show' policy is a good idea for any services. This rule is specifically for work comp, however, billing for PIP is aligned in most cases. I'm not sure if it's aligned with respect to this rule. If anyone else knows, specifically any OBCE members reading this, please enlighten us.

Thanks,

Minga Guerrero DC

Who May Choose a Person to Provide Interpreter Services?

A worker may choose a person to communicate with a medical provider when the worker

and the medical provider speak different languages, including sign language. The worker may

choose a family member, a friend, an employee of the medical provider, or someone who

provides interpreter services as a profession. The medical provider may disapprove of the

worker’s choice at any time the medical provider feels the interpreter services are not improving

communication with the worker, or feels the interpretation is not complete or accurate.

Stat. Auth: ORS 656.726(4)

Stats. Implemented: ORS 656.245

Adopted 3/1/11 as Admin. Order 11-050, eff. 4/1/11

Who Do Interpreters Bill for Providing Interpreter Services?

(1) Interpreters may only bill an insurer or, if provided by contract, a managed care

organization.

(2) Interpreters may only bill a patient if the insurer denies the claim.

Stat. Auth.: ORS 656.726(4); Stats. Implemented: ORS 656.245, 656.248

Adopted 5/27/10 as Admin. Order 10-052, eff. 7/1/10

Amended 2/16/12 as Admin. Order 12-050, eff. 4/1/12

What May Interpreters Bill for?

(1) Interpreters may bill for:

(a) Interpreter services; and

( Mileage when the round-trip mileage is 15 or more miles.

(2) If the interpreter arrives at the provider’s office for an appointment that was required

by the insurer or the director, e.g., an independent medical exam, a physician review exam, or an

arbiter exam, the interpreter may bill for interpreter services and mileage under section (1) of this

rule even if:

(a) The patient fails to attend the appointment; or

( The provider has to cancel or reschedule the appointment.

Stat. Auth.: ORS 656.726(4)

Stats. Implemented: ORS 656.245, 656.248

Adopted 5/27/10 as Admin. Order 10-052, eff. 7/1/10

Amended 3/1/11 as Admin. Order 11-050, eff. 4/1/11

Amended 2/16/12 as Admin. Order 12-050, eff. 4/1/12

When May Interpreters Not Bill?

When an appointment was not required by the insurer or director, interpreters may not

bill any amount for interpreter services or mileage if:

(a) The patient fails to attend the appointment: or

( The provider cancels or reschedules the appointment.

Stat. Auth.: ORS 656.726(4); Stats. Implemented: ORS 656.245, 656.248

Adopted 5/27/10 as Admin. Order 10-052, eff. 7/1/10

Amended 3/1/11 as Admin. Order 11-050, eff. 4/1/11

Amended 2/16/12 as Admin. Order 12-050, eff. 4/1/12

Minga Guerrero DC

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