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What is Medical Insurance Translation & Why it is Important?

By: Ricky vela Posted on Thu, 05-10-2023

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The medical and healthcare field is a highly complex and evolving industry. When it comes to medical insurance, most people are unaware of what they are getting into.

Due to the highly complex paperwork of this type of content, the medical insurance work is best at the hands of healthcare facilities and insurance firms. Yet, the need to translate medical insurance claims arises from time to time. Moreover, in order to comply with state and federal laws governing the medical insurance business, it is vital to get medical insurance translation services

But why does medical insurance translation really matter? Before we explore the importance of translating medical insurance claims, let us explore what medical insurance claims are.

What are Medical Insurance Claims?

Medical insurance claims are forms that a patient needs when he needs reimbursement or direct payment for any medical services he has obtained. In case of any medical discrepancy, a patient can come up with a medical insurance claim at any time.

Simply put, a patient can file for medical insurance claims when he is not satisfied with his treatment.

Options for Medical Insurance Claims

There are two options for a medical insurance claim:

The medical service provider (on behalf of the patient in case of any discrepancy) can directly submit the claim for the patient to the insurance company electronically. The online insurance facility allows for filling out medical insurance claim forms without leaving the confines of the home.

The patients can personally fill out medical insurance claim forms and send the papers to the insurance companies. Many insurance companies now offer online forms that patients can fill out and submit without any hassle. This option is ideal when the medical service provider is not present in the network of a patient’s health insurance and cannot file a claim on his behalf.

What do Medical Insurance claims contain?

A medical insurance claim is a legal file that a patient can exercise in case he is not satisfied with the treatment or if any complications arise. A medical insurance claim form contains the following:

  1. An insurance policy number 
  2. A group plan number or a member number that is for identification purposes
  3. Verification of whether the recipient of the services is the primary person to be insured or is dependent
  4. In case the recipients of insurance are dependent individuals, there would be the identification of the dependent people. These may generally be spouses, children, or domestic partners of the insurance holder
  5. Clarification of whether the insurance policy is a form of co-insurance or whether it offers dual coverage

Reasons Why Medical Insurance Translation Matters

Now that you know what are medical insurance claims, let’s find out why their translation matters. Well, it is extremely important owing to the sensitive nature of the paperwork involved.

These are the reasons why medical insurance translations are required:

1. To Facilitate Smooth Communication

Medical insurance translation is important because patients with limited language proficiency have a right to communicate in their language like others. They must also be considered equal in their rights to understand the information they receive. In case they are not satisfied with the treatment they have obtained, they can file for insurance claims. However, filing for these insurance claims can become difficult if the patient does not understand the language of the healthcare providers and requires medical translation services. This may be common in cases where patients belong to other nationalities and are seeking medical treatments in countries where other languages are common. By providing professional translation services for their patients, medical insurance companies ensure equal rights for all their clients. 

2. Complex Nature of Medical Insurance Terms

Another major reason why medical insurance translations are necessary is that the health insurance claim forms contain highly complex terminology. This terminology may be obscure and hard to understand for patients. These can be difficult to understand even for native English speakers. To understand and comply with the terms of insurance, it is important to translate all the complex terminology of these insurance claims. 

3. To Cater Non-English Speakers

The importance of medical insurance is evident. However, most of the medical insurance claims are in English, and not everyone understands English. Even if insurance companies acknowledge that English is a global language, many patients out there do not speak or understand it fully. This means that these patients cannot make use of these claims in order to interact with doctors and insurance companies. In order to create greater inclusiveness and equal access to information, medical insurance files must be translated into multiple languages. 

4. Language Services are part of the Healthcare Provider’s Duties

Many state and federal laws obligate and direct healthcare providers to include translation services as part of their practices. The reason is that a large part of the patient community relies on these services. This may be due to their various linguistic backgrounds. According to statistics, over 25 million US citizens identify as speaking English “less than very well”. Considering this, medical insurance claims must be comprehensible and translated into multiple languages. 

5. To Improve the Efficiency of Insurance Companies

Medical insurance files ensure compliance with federal and state laws. The translation of medical insurance files can increase the efficiency of healthcare insurance providers. This efficiency can be beneficial both in terms of administrative and financial metrics. Furthermore, by providing these translation services, a healthcare insurance company or provider can improve customer service quality. It can also minimize processing times for claims. 

6. To Increases Member Enrollment By Resolving the Communication Barrier

If no translation services are provided to patients regarding their insurance rights, they may miss out on important ethical practices. Having a multilingual website can help increase member enrollment in these insurance programs. This, in turn, can allow for a greater ROI for the insurance companies. When translated insurance claim files are present on company websites, patients with limited English proficiency can easily understand forms in their native language. This ensures that they have full access to the insurance information. This may also contribute to a reduction in expenses for the firms, leading to corporate efficiency.

7. To Avoid Misrepresentation and Dire Consequences

One of the main reasons why medical insurance translations are of profound importance is that the misrepresentation of these claims can have dire consequences for patients. Every insurance company understands the risks involved in the vague communication of insurance terms and conditions. and this vagueness can increase if these terms are not present in the patient’s native language. Language barriers can result in extremely risky scenarios that can lead to the loss of life or health. If not properly translated, they could lead to multimillion lawsuits and legal cases.

8. To Help with Research

Many hospitals and healthcare organizations rely on research to gather patient data. Medical insurance claims are one type of data that explains the performance of a healthcare facility and the treatments provided there. In cases where patients have filed for medical insurance with a doctor, the affiliated healthcare facility can look into the performance of the doctor and inspect the reasons behind the insurance claims.

Key Takeaway

A medical insurance claim form is a file that preserves and protects the rights of both patients and healthcare providers regarding medical treatment or procedures. These claims are extremely important for the functioning of a healthcare facility. In cases where a patient is unsatisfied with the medical treatment, he can apply for medical insurance claims. Many patients may not speak or understand the same language as their healthcare provider. Therefore, the translation of these medical insurance claims is essential, as it helps identify the root cause behind the claims. Also, their translation is vital for unhindered medical treatments.