Current through Register Vol. 63, No. 9, September 1, 2024
(1)
Providers shall take reasonable steps to ensure that persons with Limited
English Proficiency (LEP) have meaningful access and an equal opportunity to
participate in program services at all dental care visits, including
telehealth:
(a) The size or type of provider
does not matter. All providers serving OHP members shall tell members that
qualified health interpreter services are available free of charge. Interpreter
services shall be timely and protect the privacy and independence of the person
with LEP;
(b) Bilingual providers
and staff may become Certified Health Care Interpreters after completing the
requisite interpreter training and receiving a valid certificate from the
Authority;
(c) The Authority's
Health Care Interpreter Registry lists all qualified or certified Health Care
Interpreters available for provider use;
(d) Fee-for-Service (FFS) dental providers
may receive a $60 add-on fee, per date of service, for providing interpreter
services to OHP members. The addition of this add-on fee for FFS visits does
not change CCO requirements related to reimbursement of qualified and certified
HCIs for interpretation services.
(2) FFS oral health and dental providers who
furnish Certified Health Care Interpreter (HCI) services to OHP members are
eligible to receive a $60 add-on fee per date of service. The Authority will
cover this fee only when:
(a) The fee is
billed in conjunction with a covered OHP service or medically necessary
follow-up visit related to the initial Covered Service;
(b) The fee is not billed in conjunction with
bundled rate services that incorporate administrative costs (e.g., inpatient
hospital stays, home health or hospice visits, services provided by long-term
care facilities, or services billed at an encounter rate by rural health
clinics, federally qualified health centers and tribal health centers);
and
(c) The language assistance
service is provided by a qualified or Certified Health Care Interpreter as
described in Oregon Revised Statute (ORS) Chapter 413.
(3) Billing: Providers shall verify that the
interpreter is registered with the Authority's Health Care Interpreter
Registry. If the interpreter is registered, providers pay the interpreter
directly for services provided. After payment is made to the interpreter, bill
the Authority for the add-on fee on the claim form:
(a) Use CDT code D9990 for dental
visits;
(b) Use HCPCS code T1013
for medical visits;
(c) Add the
code to a new line on the claim form;
(d) Keep Documentation in the member's
medical record that indicates use of the qualified or certified Health Care
Interpreter for any potential audit of services billed.
Statutory/Other Authority: ORS
414.572 &
413.550
Statutes/Other Implemented: ORS
414.572 &
413.550
