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Minnesota Department of Human Services Provider Manual
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Access Services

Revised: 04-17-2017

Minnesota Health Care Programs (MHCP) covers the following access services:

  • Transportation and ancillary expenses
  • Language interpreter services
  • Sign language
  • Spoken language
  • Transportation and ancillary expenses

    Transportation and other related travel expenses are covered when the services are necessary to enable a recipient to obtain a covered health service from a participating provider. Transportation to nonparticipating providers is covered if all of the following are met:

  • • The service is covered under the Medical Assistance (MA) state plan
  • • The nonparticipating provider could apply to be a participating provider
  • • It results in proper and efficient MHCP administration due to cost effectiveness
  • Covered expenses

    MA covers the cost of the most appropriate and cost-effective forms of transportation. Funded completely by state and federal funds, local county and tribal agencies administer this program and reimburse the recipient or the provider directly for costs incurred. Examples of services and expenses for which reimbursement is, or may be, available include:

  • • Parking and tolls
  • • Lodging
  • • Meals
  • Local county and tribal agencies must inform recipients of their transportation and ancillary service benefits and reimbursements. The local agencies must help recipients find necessary appropriate level of transportation to obtain an MHCP covered health service. Each local agency has a plan detailing how it will assure that a recipient obtains necessary transportation and ancillary services. Local county and tribal agencies may require authorization for the transportation and ancillary services they provide or reimburse.

    Refer to the following for more information:

  • Access Services Ancillary to Transportation under the Transportation section of the Provider Manual for more information about travel expenses and reimbursement
  • Prepaid Minnesota Health Care Programs for information about services provided by managed care organizations (MCOs)
  • Transportation Overview for more information about transportation services
  • Language Interpreter Services

    All providers are required to provide language interpreter services as follows:

  • • Sign language interpreter services when such services are necessary to help deaf or hard of hearing recipients get covered services
  • • Spoken language interpreter services to all patients with limited English proficiency (LEP), regardless of whether the patient is a recipient of MHCP
  • MHCP covers sign and spoken language interpreter service with the following conditions if the provider cannot communicate effectively with the recipient:

  • • Providers are responsible for arranging the interpreter service and paying the interpreter. Use the same principles that you normally use when hiring, contracting with, or arranging for a competent person to provide services to your patients. If a recipient comes to an appointment with an interpreter, the provider is not required to use that interpreter
  • • Three people must be present for the service to be covered: the provider, the patient and the interpreter
  • • For sign language interpreter services, the interpreter may be on a video screen when using video remote interpreter services
  • • For spoken language interpreter services, the interpreter may communicate by phone or teleconference
  • • Staff members at the provider’s office who are qualified in sign language or competent in spoken language interpretation may interpret the medical service, but not in conjunction with another service. For example, a bilingual staff nurse may interpret during an appointment, but may not perform the duties of a nurse while interpreting; only one service (either interpreting or the medical service) is billable to MHCP. If the provider delivers a medical service while communicating in the recipient’s language, it is not interpreting and not separately billable as an interpreter service
  • • Never use minor children as interpreters. Providers may not require a patient to use a family member or friend as an interpreter. However, some people may feel more comfortable when a family member or friend acts as an interpreter
  • • Providers must initiate an offer to provide free and timely language assistance when patients and staff are having difficulty understanding each other or when patients ask for language (sign or spoken) assistance
  • MHCP also covers language interpreter services for the parent or guardian when the patient is a minor.

    In some cases, interpreter services need to be made available on an expedited or emergency basis.

    Translating documents (paper to paper) is not a covered spoken language interpreter service.

    Qualified and Competent Interpreters

    All language interpreters must be qualified and competent, as well as the following:

  • • Demonstrate proficiency in both English and the targeted language (sign or spoken)
  • • Use the appropriate mode of interpreting given the situation (for example, consecutive, simultaneous, summarization, or sight translation)
  • • Have received appropriate ”interpreter” training that includes instruction in the skills and ethics of interpreting, and rules of confidentiality and data privacy
  • • Understand their role as interpreters without deviating into other roles, such as counselor or legal advisor
  • • Have fundamental knowledge in both languages of any specialized health care terms or concepts
  • • Be sensitive to the patient’s culture
  • MHCP does not enroll interpreters as providers.

    Eligible Providers

    All MHCP-enrolled providers except those listed below may bill MHCP for sign and spoken language interpreter services if the provider cannot effectively communicate with the recipient.

    Ineligible for interpreter services
    MHCP will not reimburse the following provider types for interpreter services:

  • • Community health workers (CHW) – included in CHW service rates
  • • Day treatment & habilitation (DT&H) providers – included in the DT&H rate
  • • Federally Qualified Health Centers (FQHCs) for federally funded encounter rate recipients – included in the encounter rate
  • • ICF/DDs – included in the facility rate
  • • Indian Health Service (IHS) for federally funded encounter rate recipients – included in the encounter rate
  • • Inpatient hospitals – included in the inpatient hospital DRG payment
  • • Nursing facilities – included in the per diem rate
  • • Rural Health Clinics (RHCs) for federally funded encounter rate recipients – included in the encounter rate
  • • Transportation providers – the service of transporting a patient does not include interpreter service reimbursements
  • MCO providers: contact the patient’s MCO for network sign and spoken language interpreters and billing instructions.

    Eligible Recipients

    MHCP covers sign and spoken language interpreter services when such services are necessary to help deaf or hard of hearing recipients or recipients with LEP get covered services, and the recipients are eligible for one of the following programs:

    AC

    BB

    EH

    FF


    FP

    HH

    JJ


    KK

    LL

    MA

    NM

    RM

    Alternative Care Program

    MinnesotaCare Plus One

    Emergency Medical Assistance

    MinnesotaCare Basic Plus
    MinnesotaCare Basic Plus Two

    Minnesota Family Planning Program (MFPP)

    HIV/AIDS

    MinnesotaCare Basic Plus
    MinnesotaCare Basic Plus Two

    MinnesotaCare Expanded

    MinnesotaCare Expanded

    Medical Assistance

    Noncitizen Medical Assistance (state-funded MA)

    Refugee Medical Assistance

    MHCP does not cover sign and spoken language interpreter services when recipients are eligible for one of the following programs:

    IM

    QM

    Institution for Mental Disease

    Qualified Medicare Beneficiary

    Sign Language Interpreters

    DHS Deaf and Hard of Hearing Services (DHHS) regional staff located throughout Minnesota can help with questions about sign language interpreter referral services or hiring freelance sign language interpreters. Refer to the DHHS and Sign Language Interpreter Referral websites for more information and resources or call 651-431-3253 or TTY 888-206-6507.

    Spoken Language Interpreters

    MHCP covers spoken language interpreter services only when the interpreters are actively enrolled in the MDH Spoken Language Interpreter Roster. Providers, including those enrolled with MCOs, are responsible to verify that spoken language interpreters are enrolled in the Roster.

    Limited English Proficiency (LEP)

    In August 2003, the U.S. Department of Health and Human Services published its own Guidance to Federal Financial Assistance Recipients Regarding Title VI Prohibition Against National Origin Discrimination Affecting Limited English Proficient Persons, designed to help providers understand the extent of their obligation to provide interpretation and translation services to patients with LEP.

    Take reasonable steps to provide effective spoken language interpreter services when such services are needed to help a person with LEP get medical services.

    To know what reasonable steps to take, start by conducting an individualized assessment that balances four factors:

  • 1. The number or proportion of people with LEP eligible to be serviced or the provider is likely to encounter
  • 2. How often people with LEP come in contact with the provider’s services
  • 3. The nature and importance of the services in people’s lives
  • 4. The language assistance resources available to the provider and what it will cost to provide those services to the public
  • The results of this four-factor analysis helps you determine the mix of language assistance services you should provide. For example, in most cases, interpreter services will be the most effective type of language assistance available. However, other forms of language assistance may be appropriate, such as using translated application forms and other documents, or using bilingual staff members who are proficient in both English and a non-English language. Base language assistance services on what provides meaningful access and is reasonable and necessary given the results of the four-factor analysis (Guidance pages 47314-16).

    DHS strongly encourages you to develop a written LEP plan, policy and procedure that describes how you will offer free and timely interpreter or other language assistance services to effectively communicate with non- or limited-English speaking patients. An LEP plan does not have to be lengthy or complicated. It may be as simple as being prepared to use a commercial telephone interpreter service or identifying bilingual staff members within the office who are proficient enough in both English and a non-English language to effectively communicate with a patient in his or her primary language (Guidance pages 47319-20).

    Refer to the LEP plans web page and to the Limited English Proficiency Plan (DHS-4210) (PDF) for more information or a template for your LEP Plan.

    You are not required to develop a written LEP plan if you serve very few people with LEP or have very limited resources. However, you are responsible for providing meaningful access to services for your patients with LEP and must have a plan, written or not, to do so. Consider alternative reasonable ways to show how you provide meaningful access in compliance with Title VI. Should a complaint arise, you must be able to show intent to comply with the law and have documentation sufficient to show what happened in the particular case.

    Do not plan to rely on a person’s family members, friends, or other informal interpreters to provide meaningful access to services. Respect a person’s desire to use an interpreter of his or her own choosing in place of the language service you may offer. You may use a patient’s family member or friend as an interpreter in emergencies (Guidance pages 47317-18).

    Qualified spoken language interpreters must understand and follow confidentiality and impartiality rules to the same extent as the staff person involved (Guidance page 47316). Under the Guidance, an interpreter must be competent to provide interpreter services. Competency does not require formal certification as an interpreter, but does require more than just self-identification as bilingual.

    Interpreter Unit Authorizations

    Submit an authorization request for additional interpreter service units only after the allowed 8 units (1 unit = 15 minutes) of interpreter services per date of service have been used.

    The prior authorization must include, but is not limited to:

  • • Name and provider number of the enrolled MHCP provider delivering the covered service that requires the additional interpreter service units
  • • Name, date of birth (DOB), and MHCP recipient ID number of the fee-for-service (FFS) patient requiring the additional interpreter service units
  • • Service code or description of the service being provided requiring the additional interpreter service units
  • • Brief explanation of why this service will require additional interpreter service units
  • • Self-attestation by the provider that none of the interpreter service units include time or consideration for reimbursement for any of the following:
  • • Travel time
  • • Wait time
  • • Mileage
  • • No-shows or cancellations
  • • Form translation activities
  • • Form completion activities
  • • Time when all three people required for interpreter services (provider, patient, interpreter) are not involved in the discussion or delivery of the patient’s covered service(s) provided during the appointment
  • Do not include the initial 8 units as part of the additional interpreter units being requested.

    Submit the authorization request to KEPRO through the MHCP authorization process.

    Billing Language Interpreter Services

    Providers are responsible for providing interpreter services, at the provider’s expense, for patients whose coverage does not cover interpreter services. The amount paid by MHCP may not cover the full cost of the interpreter service. Providers must bear the cost or cost-difference for providing interpreter services. For interpreter services, providers must document the following in the patient’s chart:

  • • That an interpreter was used
  • • The date and time the interpreter was used (for example, 06/01/11, 1:00 p.m. – 1:15 p.m.)
  • • The name of the interpreter and agency
  • For MCO enrollees, contact the recipient’s health plan for billing instructions.

    Bill sign or spoken language interpreter services to MHCP using the following guidelines:

    Code

    Mod

    Description

    T1013

    Face-to-face spoken language interpreter service

    T1013

    U3

    Face-to-face sign language interpreter service

    T1013

    GT

    Telemedicine interpreter service

    T1013

    U4

    Telephone interpreter service

    T1013

    UN
    UP
    UQ
    UR
    US

    2 patients served
    3 patients served
    4 patients served
    5 patients served
    6 or more patients served
    Do not use modifier 52 to denote multiple recipients in a group setting.


  • • Bill only for the direct face-to-face, video or phone service time
  • • Bill in the electronic 837P or 837I format only (do not use 837D format; dental providers, use 837P transaction)
  • • Bill appropriate modifier to identify the interpreter service provided
  • • Report one unit of T1013 per 15 minutes (at least 8 minutes must be spent to report one unit)
  • • Bill directly to MHCP when the recipient is dually eligible (Medicare and Medicaid) as Medicare does not cover interpreter services
  • • IEP providers: Bill interpreter services as described in the IEP section
  • MHCP does not cover these interpreter expenses:

  • • Travel time
  • • Wait time
  • • Mileage
  • • No shows or cancellations
  • Definitions

    Interpretation: The oral replacement of one spoken language (source language) into another spoken language (target language). Four modes of interpretation exist: consecutive, simultaneous, summarization and sight translation (when the interpreter reads text in one language and speaks it in another language),

    Translation: The written replacement of text from one language (source language) into an equivalent text in another language (target language).

    Person with LEP: A person not able to speak, read, write, or understand English at a level that allows him or her to interact effectively.

    Additional Resources

    eXchange: Resource for providers about language and cultural competency.

    Legal References

    Minnesota Statutes 256B.0625, subd. 18a(d) Covered Services, Access to medical services
    Minnesota Rules 9505.0140
    Payment for Access to Medically Necessary Services, Access to medically necessary services
    Minnesota Rules 9505.2175
    Health Service Records, Language interpreter services

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    Updated: 4/17/17 3:04 PM | Accessibility | Terms/Policy | Contact DHS | Top of Page | Updated: 4/17/17 3:04 PM