Medical interpreter working with a patient and a clinician
Language Services Blog June 18, 2024

5 Times Payers Need a Medically Qualified Interpreter

As a healthcare payer, your organization is legally required to offer interpreter services for members who are limited English proficient (LEP), deaf, or hard-of-hearing. But while basic interpretation is a necessity during every interaction, there are key points along the member journey that can directly impact health outcomes and satisfaction.

During these critical moments, working with an experienced, medically qualified interpreter is vital. Here are 5 high-stakes situations when your case managers and member services team will benefit from working with an interpreter from AMN Healthcare Language Services:

1. Plan Enrollment

For new LEP members, your initial enrollment period presents the first opportunity to help them fully understand the details of their health plan. Since both healthcare and insurance terminology is notoriously complex, using a medically qualified interpreter at this stage can ensure nothing gets lost in translation.

An experienced healthcare interpreter can bring an added level of clarity around topics such as premiums, copays, deductibles, provider networks, and out-of-pocket maximums. By investing in high-quality interpretation from the start, payers can prevent member confusion down the line – and reduce the likelihood of LEP members receiving an unexpected bill or uncovered service.

2. Utilization Review

Conversations related to prior authorizations, referrals, and utilization reviews routinely confuse English-speaking patients. Add in a language barrier, and the need for precise, accurate interpretation is clear.

If an LEP member needs assistance communicating their medical history or navigating the complex healthcare system for pre-approvals, working with an interpreter that’s fluent in medical terminology is essential.

3. Grievances and Appeals

Trust and communication go hand-in-hand when delivering a positive member experience. So, if an LEP member is ever denied coverage, or files a formal grievance against your health plan, you'll want an experienced medical interpreter in your corner.

Certified medical interpreters are often tasked with interpreting for patients who are scared, confused, and vulnerable. In these difficult situations, an experienced interpreter can establish a sense of trust between the payer and provider. Whether that includes reading a patient's nonverbal cues or pausing the conversation to provide added clarity, the result is the same: Improved communication and a better member experience.

4. Chronic Care Management

To improve outcomes for LEP members with long-term chronic conditions like diabetes, congestive heart failure, or chronic kidney disease, members need to understand the ins-and-outs of their care plan. This may include a combination of lifestyle changes, medication management, at-home devices and testing between doctor visits.

When a payer’s case manager partners with an experienced medical interpreter, LEP members can help improve care plan adherence – reducing costly care gaps and hospital readmissions.

5. Transitions of Care

When a member transitions from an inpatient hospital to a post-acute setting, delays in sending patient information are all-too-common. As a payer organization, you may need to step in to ensure both the LEP member and rehabilitation providers understand the care plan. With so many changes happening at the same time, medically qualified interpreters can help ensure smooth transitions, maintaining continuity of treatment.

The same holds true for hospital discharges. Upon discharge, LEP members often receive complex instructions for medication, follow-up appointments, and lifestyle modifications. If payer case managers partner with a medically qualified interpreter, these instructions are more likely to be understood, promoting adherence to care plans and reducing readmission rates.

pregnant woman with video medical interpreter
See Also
5 Ways to Improve Language Access in Healthcare

 

Excellent Interpretation Requires More Than Fluency

At the most basic level, interpretation bridges a communication gap by translating words from one language to another. But language is complex and nuanced. That’s where working with an experienced certified medical interpreter can make a big difference. In addition to interpreting the words being spoken, experienced interpreters should bring with them an understanding of the following:

  • Medical language and culture: When an interpreter is solely focused on serving healthcare organizations, they become familiar with medical terminology in both languages across a variety of specialties. The more an interpreter works with payers, patients, and providers, the more they understand the medical culture – from oncology and emergency medicine to orthopedics and podiatry.
  • Cultural differences: Great interpreters are also sensitive to the differences between diverse cultures. This awareness allows interpreters to act as a cultural broker, bridging the gap between both language and worldviews to convey the right meaning.
  • Colloquial language: An experienced interpreter knows that the same word can carry different meanings depending on a member’s native country. Over time, interpreters gain a deeper knowledge of both culture and language that can help prevent errors caused by misinterpretations.

How Can a Certified Medical Interpreter Help You?

When it comes to LEP member interpretation, medical expertise matters. At AMN Healthcare Language Services, we connect payer organizations to experienced, medically qualified interpreters to help close care gaps, improve health outcomes, and enhance member satisfaction. To learn how we can help you, visit www.amnhealthcare.com/language-services.

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