Deaf Oppression– Medicine in Philadelphia

According to the ADA guidelines, the doctor is responsible for paying for interpreters. The idea behind that is the interpreter is performing a service for the doctor, much as a CPA might. The cost is to be be assumed as overhead, regardless of the income from the deaf patient’s visit.

While at first, this has always seemed reasonable and right to me, I now think that it’s wrong… the insurance company should be the one to pay for the interpreters. I think that it sets up an adversarial relationship between me and the doctor if the doctor has to pay. After all, I selected them, they didn’t select me. And people refer their friends to their doctors. So it’s possible for one doctor to have several deaf patients, while another doctor in the same medical office building has none.

Kaiser Permanente functions as both the insurance company and the medical care provider. Their doctors are salaried employees and Kaiser pays for the interpreter, not the individual doctor or their office. In the hospital, too, the hospital pays for interpreters for patients, not the doctors. I think that’s why it’s easier (though still far from perfect in most cases) to get interpreters when hospitalized.

Now, I always thought that Medicare pays for the interpreter by reimbursing the doctor. Recently, I’ve been told that Medicare doesn’t pay for interpreters and now I’m confused.

According to the Deaf Doc, Carolyn Stern, http://www.deafdoc.org/ask/answerdisplay.php?id=60 the funding for Medicare reimbursement for interpreters is provided by the state, but the difficultly lies in finding out how the doctors can access those funds.

A couple of weeks ago, I searched Independence Blue Cross’s site looking for info on interpreters, and didn’t find any. Today, I found something (just put up or edited a few days ago):

http://www.ibx.com/htdocs/custom/adultbasic_manual/using_interpreter.html

That page says, “The Foundation offers adultBasic members interpreter services covering 66 different languages and dialects, as well as Certified Deaf Interpreters [sic] who translate American Sign Language. All interpreter services are provided at no cost to members and patient confidentiality is assured.” So, this means that Betty’s interpreters are covered by her insurance, right?

Maybe the doctors in the plan don’t know this.

In my experience, the doctor’s office must make the request for the interpreter. That’s only right, because they are the provider and it’s their responsibility. But the page above has new info for me– says that “An adultBasic member may call 1-800-464-5437 directly to schedule interpreter services for their doctor visit. Requests should be made at least two weeks before the doctor’s appointment.” That surprises me. I’ve never known of the the consumer, rather than the provider, making the request.