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Credential Compliance for Healthcare Interpreters

Updated: Oct 19, 2020

  The question is often asked, "why do I have to go through a lengthy credentialing process when I sign up to be a medical interpreter?" This process is the biggest barrier to recruitment of interpreters for professional interpreting agencies here in the United States. Credentials, however, are a very important assurance that professional interpreting agencies offer their clients. In fact, a majority of major hospital systems have their own online credentialing process to check the credentials of persons that provide services to their institutions.

Does every interpreter that takes appointments for healthcare on-site have to go through this process? (short answer: Yes)

Training Requirements

In today's world of medical interpreting, "ad-hoc" interpreting agencies are dying out. New regulation and auditing efforts by the Joint Commission and other accrediting associations have put pressure on major hospital systems to conform to training standards for medical interpreters. The current standard is for medical interpreters to have passed both English and target language proficiency tests and obtained 40 hours of medical interpreter training that contains a section on medical terminology. By meeting these requirements, medical interpreters receive the title of "Qualified Medical Interpreter" (QMI). 

The next level is CMI, Certified Medical Interpreter, developed by the IMIAor CHI, Certified Healthcare Interpreter, developed by CCHICMI and CHI certificates are currently the highest training certificates available to medical interpreters in their careers. Individuals with this level of certification are frantically sought after by professional interpreting agencies across the United States. For professional agencies that take standards of practice seriously, building an interpreter list of CMIs and CHIs is an utmost priority. While most healthcare systems currently accept QMIs, it is only a matter of time before they require CMI or CHI levels of certification for on-site interpreters. 

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Immunization & Health Record Requirements

To work in the healthcare system at almost any level, interpreters will need to submit records of their immunizations, like MMR. There are annual requirements like the influenza vaccine or Flu shot and TB testing. While tuberculosis testing (TB testing) is not an immunization, it's included in this section as a part of the credentialing process. 

  Most of us have had our MMR vaccines, Measles, mumps, and rubella. These records

can be obtained from your doctor, schools you used to attend, and lab testing to show

you have had your MMR vaccine.  Due to the fact that people rarely need these

documents once we are out of school, they often get lost and the applicant doesn't have

them anymore. However, they are essential in becoming a medical interpreter and are

relatively easy to track down. 

   There are a couple of annual requirements, the influenza vaccine or commonly

known as the flu shot, Tuberculosis testing. The influenza vaccine can be

administered at most pharmacies, doctors offices, and hospitals. The second

annual requirement is the Tuberculosis test also called a Mantoux tuberculin test.

This test is usually administered as a simple skin test at the doctors office;

however, if the medical interpreter had the Tuberculosis vaccine they will need to do a

chest X-ray to fill this requirement. For those who have received the TB vaccine they will

always test positive for TB when a simple skin test is done, this is the why the X-ray is needed to fill that requirement. 

    State to state, and healthcare system to healthcare system their immunization requirements may vary, the ones listed above are universal and considered the minimum requirements. The process to confirm credentials may vary as well. Some medical interpreters may find that they only have to submit their records to the interpreting agency, while others will be asked to upload those documents through an online portal. When an agency asks the medical interpreter to upload those documents to an online portal it is usually at the request of the healthcare system they have a contract with. 

   There is no exception for the immunization or healthcare record requirements, except for allergies. If the medical interpreter is allergic to the vaccine and have a note from their doctor, they can be excused from the requirement for the vaccines they are allergic to. There is no waiver for religious objection. There are not many, but some medical interpreters have religious objections to getting the vaccine. Agencies, hospitals, and other healthcare institutions will not accept a faith based objection to the vaccine requirement. 

Streamlining the Process

 Professional interpreting agencies have a duty to follow the regulations that govern our industry, they have a commitment to the standards of practice. They do it to protect the safety of the clients, patients, and family members of those we facilitate communication. As well as safeguard the client from liability that comes when a language barrier is present.

   With strong fears of declining assignments, or having that lapse in service, an agency may be inclined to cut corners. To avoid this, the process itself must be made efficient and pragmatic. A step by step process to credentialing that will keep the medical interpreter on track, and follow up procedures to ensure completion of the process. This gives the agency a competitive advantage over those companies where their credentialing process is more fragmented. Below is only a short overview of effective strategies that companies of different sizes are handling their credentialing procedures. 

Small or Micro companies, 1-7 full time employees, annual revenue less than 2.5 million, these institutions will have to rely heavily on an interconnected workflow that splits the workload  among different departments. Traditionally, you do not want to have your primary recruiter also be responsible for credential requirements, but for smaller companies this may not be an option. If possible, smaller agencies should rely on online submission formats, and establish one person in the company to file and keep track of the progress of their medical interpreters. More can be done with technology, small companies can appear large, and do the work of larger companies with well developed, integrated, user friendly IT systems. Project & office management software can be found with a simple google search. These systems can be manipulated and set up to match the terminology and format for which the business operates. Automated workflows can be set up to alert different employees as the medical interpreter moves through the credentialing process. 

For medium sized companies, 8-25 full time employees, 2.5 million to 10 million in annual revenue, like Liberty Language Services, LLC which I founded in April of 2011, an efficient assembly line style process can be set up to ensure compliance with credentialing standards. The initial contact is made by the recruiter. The recruiter should determine if this interpreter needs training, or if they meet that requirement. After the recruiter sets the route to develop or on-board the interpreter, the credentialing department contacts the medical interpreter to start the credentialing process. Daily the roster of medical interpreters is checked, and follow ups are done to retrieve outstanding documents. Once all credentials are met the interpreter gets added to the pool of medical interpreters to be queued for assignments. 

   Large scale companies, 25+ full time employees, 10 million or more in revenue, these companies have the resources to streamline the process. The companies of this size will have multiple professionals in each department. They will use a mix of employee interpreters (staff interpreters) and independent contractors, requiring departments for human resources, and contractor affairs. These companies will use technology like specialized office management software, that often cases, is developed specifically for their company and reflects exactly how they do business. Development may be outsourced concerning their IT systems; however, the strongest companies will have their own IT department that would include development. Large companies may go as far as to develop their own medical interpreter training program instead of entering into a licensing agreement with a vendor. Most ambitious professional interpreting agencies hope to attain this level. Majority of institutions that hold this level with their processes are major hospital systems, and juggernaut interpreting agencies that value their Language Access Programs. 

Bottom Line....

 Interpreting agencies are at a crossroads. Unfortunately, a lot of them are choosing the wrong path. Ad-hoc agencies that continue "business as usual" and send untrained interpreters without proper credentials to medical assignments, will be to the detriment of their business. Ad-Hoc interpreting agencies are already feeling the pinch, and service agreements are being canceled when the agency is found to not be complaint with these standards. All signs point to the fact that the industry will be seeing more of this as time moves on. The smaller agencies are the most vulnerable to not being able to comply with these regulations. Although, being a small business is not an excuse to lower quality or to not abide by regulation, their team needs to be diligent, analytical, and pragmatic in their work performance in order to stay on top of the credentialing process. When industry demands anything, there is someone willing to fill that demand. Agencies that don't get with the program, will find themselves shut out of the industry in due time. 

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