When Compliance Exceeds Reimbursement

July 25, 2016

What can you do when seeing a patient costs more than his or her insurance pays you?

Physicians are required by law to provide an interpreter for patients who do not speak the same language as the physician. This is also true for patients with hearing or speech impairments who require the use American Sign Language (ASL). If the physician and/or the staff can’t sign, then the office must provide an interpreter. A professional, paid interpreter.

And I’ve come to realize, I’m in the wrong profession. We have had to pay an interpreter recently, and we are paying her $50 more than we get from the patient’s copay and insurance combined. And according to other physicians I’ve spoken to, that is the going rate. So that means every time we see the patient, we don’t even break even. 

We can’t turn the patient down. That would be breaking the law. We are lucky that we only need to do this for one patient. What if there were several?

Granted, there is a stipulation that an exception can be made that the office is not obliged if it would cause financial hardship. I don’t think any judge would buy that $50 a few times a year will bring the practice to its knees.

And I don’t begrudge the patient for coming here. Of course, I believe that he deserves medical care just as much as an English speaking person or a hearing person. And he deserves to be able to express his thoughts and concerns, and we need to be able to get a good history and give explanations he can understand. But there should be a way to get reimbursed for the cost of the translator. I’m not looking to make money from this, just not to lose money every 3-4 months. 

We, as physicians, are required to do so much. The cost of compliance often exceeds reimbursement.  Take meaningful use, for example. And being unpaid for hiring a translator is just another one of those things.