The following procedure outlines Pinnacol's contract obligations and the Division of Workers' Compensation (DOWC) requirement for interpretation services for Pinnacol injured workers.
These procedures comply with 2020 DOWC Rules 18-7(H): Use of an Interpreter. "Rates and terms shall be negotiated. Prior authorization for payment (see Rule 16-6) is required except for emergency treatment. Non-qualified interpreters are not eligible for reimbursement. Bill DOWC Z0722."
- Interpreters must be nationally certified for Pinnacol Assurance and other payers to reimburse them for services as of 4/30/2020. The two certification programs specified by the DOWC are the Certification Commission for Healthcare Interpreters or the National Board of Certification for Medical Interpreters. Certification is available for Spanish, Arabic, Mandarin, Cantonese, Vietnamese, Russian and other languages.
- Assignment of an interpretation service vendor should come from Pinnacol Assurance. In cases where a medical facility has first contact with an injured worker requiring interpretation services, the facility should contact Pinnacol’s claim representative prior to the next appointment so interpretation services can be arranged with a contracted vendor. If the caller reaches voicemail, pressing “0” will direct the call to another representative who can assist. If an appointment is canceled, or the interpreter fails to show for the appointment, the clinic can contact the interpretation agency assigned to a claim to reschedule, conferring with the injured worker for a mutually agreeable appointment.
- Pinnacol staff has a list of contracted vendors that includes the languages offered by each vendor and the Colorado locations serviced. If certification is available for the language spoken by the injured worker, a certified interpreter must be utilized in order for the interpreter to be paid by Pinnacol. When an interpreter is contacted by anyone other than Pinnacol, the interpreter should redirect the request to Pinnacol prior to providing services on a new claim.
- Providers can use their own interpreters, but Pinnacol cannot pay them unless the interpreter is certified, and prior authorization is obtained. Providers may make alternative arrangements such as working directly with the vendors or employing bilingual staff to provider interpretation services for injured workers who request interpretation.
- Pinnacol may change the interpretation vendor at any time during the life of the claim with or without cause after notifying the current vendor and the primary care provider.
- Interpretation services provided by a certified interpreter will be authorized for complex medical treatment appointments, behavioral health appointments and when otherwise requested by the provider or injured worker.
If issues arise in the process of assigning an interpreter or with the services provided by an interpreter, please contact the Pinnacol claims representative immediately.
Your support and cooperation is appreciated. Our ultimate goal is to align all parties to provide uninterrupted, quality service to our non-English speaking injured workers.
Colorado Division of Workers’ Compensation – Proposed and Adopted Rules
Rule 16-2(E) and 18-7(H)