Monday, February 22, 2010

Part 2: What Can I Expect From a Language Agency?

(Back to Part 1.)


Just as in any business relationship, you should be able to trust an agency’s integrity. This is a fast-growing industry in some parts of the state and the nation, and there is little oversight. Because of fierce competition, high expectations by users and a lack of national standards in the field, it seems that some agencies stretch the truth a little – or a lot – in representing their services. When you approach an agency (or one approaches you) about providing services to you, don’t be afraid to ask questions and require verification of the answers. Agencies that are serious about providing a quality service will be willing to share this information.

Quality interpreting
The most important expectation you should have of a language agency is quality interpreting. After all, this is the product it is selling. Interpreters should be carefully screened and should have professional training. An agency should be willing to guarantee the quality of the language services being sold. When the agency cannot provide an interpreter whose skills it can stand behind, it should advise you before accepting the assignment and tell you the qualifications of the person it can provide. Especially with languages of limited diffusion, it may be that an untrained bilingual is the best you can hope for, but you should know that before the interpreter arrives.

High quality customer service
A language agency, like any business, should be able to provide good customer service to you, the client. Some aspects of good customer service include:
Polite and efficient call center staff
When you call the agency, whoever answers the phone should be courteous,
efficient and knowledgeable.
Ability to meet your demand for interpreters
The agency should be able to fill most of the appointments you assign, except in
languages that it told you at the time of contract that it could not provide. A
response rate over 85 percent is acceptable for some, but many agencies have
internal benchmarks of 95 percent or higher. Telephonic availability rates will
likely be higher than in-person rates, and the rates for “hard to find” languages will likely be lower. Remember that no agency will be able to fill your requests 100
percent of the time.
Low cancellation rates
If an agency commits to sending an interpreter, you should be able to expect that
it will send one. Calling you back to say that an interpreter could not be provided
for an appointment that was already accepted should be a very rare occurrence.
Low no-show or late arrival rates
When the agency commits to sending an interpreter, the interpreter should actually arrive — and arrive on time. Again, there will always be occasional no-shows
or late arrivals, but this should be the exception.
Acceptable emergency response time
If you call an agency for a walk-in patient, the agency should be able to get you an
interpreter within an hour (depending on the location of the appointment and the interpreter and the language). Many agencies, even those that do not routinely offer telephonic interpreting, will offer an interpreter over the phone in emergency
situations that require an interpreter immediately.
If you request it, an agency should be willing to train your staff on how to use the
agency’s services, and perhaps even on how to use an interpreter if the agency is the sole provider of language services in the system.
Rational scheduling of interpreters
It is reasonable to expect that the agency will not overbook its in-person
interpreters so that the interpreter must leave in the middle of an appointment. If
the appointment runs over because the clinic is running behind, or if more services
are required than were originally requested, the interpreter and the agency should
not be penalized if the interpreter has to leave. If this becomes a pattern, it would be wise to negotiate a solution with the agency.
Rapid connect rates
For telephone interpreter services, the agency should be able to provide an average
connect rate of under a minute, measured from when the phone starts to ring at
the agency to when an interpreter is on the line. Some agencies’ average connect
rates are under 30 seconds.
Effective complaint resolution
Preferably, there should be someone assigned to your account (an account
manager) or someone assigned to resolve problems who will respond to your
concerns promptly. It is reasonable to expect at least a return call within 24 hours, even if resolving the problem takes longer. Agreements should then be fulfilled and promised services delivered. In addition, the agency should have a method of tracking and documenting concerns so that patterns can be identified.

Good business practices
Language agencies should be treated like any other contracted service:
There should be a clear contract in place that assigns liability and specifies
responsibilities, pay rates and the manner of resolving difficulties. A contract
should be signed regardless of how small a client you may be.
Computerized billing
The agency should have a system for providing accurate, timely billing.
Computerized billing is a virtual necessity, with tracking based on signed
encounter forms if the service is done in-person.
Data collection
The agency should have the capacity to collect and report on basic data such as
appointment date, language, encounter, name of the interpreter, and start and end times.
Financial stability
The agency should be financially stable. Agencies which function with limited cash
flow will not be likely to provide you with consistently high-quality services.
Agencies can reasonably be expected to wait 30 days for payment, but if your
institution routinely takes 60 or 90 days to pay contractors, you should make sure
the agency is able to wait that long for payment and still remain solvent.
The agency or its interpreters should not solicit your providers directly but should
deal with administration.

Extra services
Some agencies may be able to provide additional services such as customized billing, participation in pilot projects, special tracking, provider training, telephonic aid in identifying patient languages, language identification cards, patient reminder calls, account managers, special pricing programs, implementation support and consulting services around language access services.

What’s not reasonable?
As mentioned above, some expectations of agencies are not reasonable. NO agency can be expected to:
• Fill all your requests all the time.
• Guarantee a 0 percent no-show rate.
• Have access to interpreters in every language in the world.
• Provide highly trained interpreters in languages of very low demand.
• Guarantee in-person interpreters available in under an hour.
• Provide weekly billing.
• Allow you to require its interpreters to do written translations while on an
interpreting assignment.
• Provide patient transportation.
• Allow its interpreters to participate in medical interviewing or securing
information from patients without providers present.
• Publish a list of its interpreters.
• Give out telephone numbers of interpreters.
• Allow you to work interpreters over three hours without a break.
• Provide highly complex data analysis at no extra cost, beyond normal
• Implement different policies and procedures for each customer.
• Allow you to contract directly with an interpreter who has come to your
institution through the agency.
• Write off charges incurred because of errors on the part of the health institution

Most important in deciding what is reasonable and unreasonable to expect from an agency is to have clear understandings at the beginning of the partnership and to maintain regular open lines of communication so that difficulties can be addressed and resolved.

Source: Roat, Cynthia E. “How to Choose and Use a Language Agency: A Guide for Health and Social Service Providers Who Wish to Contract With Language Agencies.” Los Angeles: The California Endowment, February 2003.

(Go to Part 3.)

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