The translation of health insurance documents for LEP (limited English proficiency) clients is a complex process that involves high levels of technical expertise. Long gone are the days when a bilingual relative could serve as a translator in medical communications. In order to stay in compliance with federal and state laws, medical insurance translation services are a critical part of the healthcare system. Find out why.
People with LEP have the right to communicate in their language
A top reason why medical insurance translation is important is that LEP users of the healthcare system must be considered equal in their rights to understand the information they receive. Particularly regarding medical coverage, the terms used in documents like insurance policies or claim forms can be obscure, even for native English speakers. In providing a professional translation service for LEP clients, insurance companies ensure equal rights for their clients.
This is, of course, applicable to medical translation as a whole, as most of the medical research worldwide is written in English. Even if we acknowledge that English is a global language, there are many patients who cannot make use of this channel in order to interact with their doctors or insurance company agents. In attempting to create more inclusive and equal access to information, translation services are essential. As health insurance providers, ensuring democratic access to information is not a luxury, but an imperative.
Also, federal and state laws obligate healthcare providers to include translation and interpretation services as part of their practices. This proves that there is a large part of the patient population that depends on this service. In fact, recent studies show that over 25 million US citizens identify as speaking English “less than very well.” If we were to multiply this number by the amount of documents each medical insurance claim involves, we would find the processes can be significantly more efficient when professional translation services are involved.
Professional translation services are an efficient business solution as well as an ethical practice
As well as ensuring compliance with federal and state law, hiring a professional translation service can provide health insurance companies with increased overall efficiency, both in terms of administrative and financial bottom lines. When LEP clients are accounted for in advance and communication strategies are adapted to fit their needs, a health insurance provider can improve their customer service quality and minimize claim processing times.
In addition, other practices, such as having a multilingual, localized website can help increase member enrollment and reduce expenses. Many insurers have also implemented an online claim submission system for their members. When translation is added to the mix, LEP clients can also easily understand and submit forms in their native language, ensuring access to information and expense reduction. Over-the-phone interpreting can also be a quick solution in bilingual sales calls. In short, corporate efficiency is one of the many positive side-effects of translation services.
Misrepresentation: a liability best avoided by translation services
But perhaps the main reason why translation services are essential in the medical insurance industry is the need to avoid misrepresentation. Every insurance company is fully aware of the risks involved in vague communication. Potential problems caused by language barriers and imprecise translations are especially risky, as they can lead to multi-million lawsuits and, more importantly, loss of life or health.
But why is misrepresentation such a problematic area in the field of medical insurance? One of the simplest answers to this is obtained by simply looking at the terminology used in health insurance. Have you ever noticed there is a “sea” of acronyms and terminology? If you haven’t, take a few minutes consider the next examples: PPO, HMO, HSA, PCP, indemnity, premium, deductible, coinsurance… are you overwhelmed yet?
It is true that not all terms in this field are cryptic, but their meaning can nonetheless be elusive, no matter what your level of English proficiency may be. To illustrate this point further, let’s have a short dive into the meaning of some top terms in the health insurance industry, which can be a great help when trying to understand a health insurance policy or deciding to sign up with an insurer.
What are the top health insurance terms?
The top individual health insurance terms everyone should be familiar with, according to our research, are:
The premium is the monthly cost you need to pay to the health insurance company, in order to ensure your coverage. Even if it is the main cost to keep in mind when selecting medical insurance, it is not the only one you should consider.
Copayment or co-payment:
Co-payment is a flat cost a patient needs to pay their healthcare provider when receiving a certain medical service. For example, you may need to pay $10 each time you receive a new prescription from your doctor. Even if the prescription is covered by your health insurance, the copayment is an extra, fixed amount that is paid to the clinic, hospital or medical center, not the insurer. Not all medical services require a co-payment.
The deductible refers to an amount of money the insured person needs to pay for a service before their insurance starts to cover. When selecting an insurer, you may choose one with a less expensive premium and higher deductibles. This means you will pay a smaller monthly amount, but when and if you need to receive a medical service, the insurance company will reimburse you for the total cost, minus your deductible amount.
Coinsurance is expressed in percentages. It refers to the portion of a certain service that you are required to pay, after paying for your deductible. In a typical example, coinsurance is 80/20, which means the insurance company will pay for 80% of the covered service and you will pay for the remaining 20%. Thus, if your medical bill is $1200 and your deductible is $200, 80% of the remaining $1000 will be paid by the insurer and you will pay a $200 coinsurance.
Out of pocket refers to the amounts paid by the insured, excepting the premium. In general, the term can refer to the co-payment, coinsurance and deductible involved in one specific service. “Out-of-pocket maximum” means the total amount to paid in a year, in addition to the premium.