Spoken language interpreters

As an Apple Health provider, you are required to ensure language access services are provided to your Apple Health (Medicaid) clients according to Title VI of the Civil Rights Act of 1964 and the Americans with Disabilities Act (ADA). The Health Care Authority’s (HCA) interpreter services (IS) supports you in your efforts by offering spoken language interpreter services for Apple Health health care appointments.

Note: For language access or ADA questions or to file a complaint, visit our nondiscrimination webpage.


Interpreters provided through HCA's contracts are required to provide services within the scope of practice as defined by the interpreter Code of Professional Conduct. Providers may not ask them to perform non-language-related tasks.

As a provider, you are required to provide interpretive services to any Apple Health (Medicaid) client that:

  • Experiences trouble speaking or understanding English.
  • Has a ProviderOne services card.

Over the phone and video remote services

The Health Care Authority's (HCA) interpreter services team and Universal Language Service have signed a new spoken language contract to provide over the phone and video remote interpreting services. The contract went live May 1, 2022 and will assist Medicaid health care providers in meeting their Title VI of the Civil Rights Act of 1964 responsibility. The new services will increase health equity for Apple Health Medicaid providers, language access providers and Apple Health Medicaid clients.

To register to use the over the phone and video remote interpreting contract, providers should email UniversalLanguage at accounts@ulsonline.net

To register to provide interpreting services for Language Access Providers (LAP) for the new over the phone and video remote interpreting contract, LAPs should email UniversalLanguage at interpreter@ulsonline.net.


How to request a spoken language interpreter

You must register as a new requester with UniversalLanguage in order for HCA to pay for interpreters for your clients attending Apple Health, Department of Social and Health Services (DSHS), or Department of Children, Youth and Families (DCYF) social service appointments.

Block appointments (DSHS/DCYF ONLY)

The DSHS Economic Services Administration (ESA) or DCYF may schedule block appointments. These appointments are for a specific amount of time rather than for a specific patient or client. For example, one interpreter for a two to eight hour block of time at a specific location.

Behavioral health appointment interpreter reimbursement

Did you know? UniversalLanguage may reimburse you for behavioral health interpreter service appointments if UniversalLanguage is unable to provide an interpreter through the scheduling portal. To learn more, view our behavioral health and interpreter services FAQ.

Language access providers (interpreters)

In order to be a language access provider (LAP) you must be a certified, authorized, or registered LAP with DSHS Language Testing and Certification (LTC) program. Once you have become certified, authorized or registered, you will be required to register as an LAP with UniversalLanguage to begin receiving and serving jobs for Apple Health, DSHS, and DCYF social service appointments.

LAPs are required to complete the UniversalLanguage online registration process and complete the incident resolution process (IRP) approved by HCA. In 2014, the Washington Federation of State Employees (WFSE) for LAPs and HCA developed the IRP in an effort to ensure high-quality language access services to the citizens of Washington and assure effective management and stewardship of state and federal resources.

NEW! DSHS LTC has partnered with three additional testing providers who's test will be accepted by DSHS LTC to certify medical interpreters starting August 1, 2022. Visit the DSHS LTC testing page for more information.

Frequently asked questions (FAQs)

Health care providers

How do I know if I am eligible to request an interpreter through HCA contractor, Universal?

To be eligible for HCA interpreter services through Universal, you must have a National Provider Identification (NPI) and be registered with HCA as an Apple Health (Medicaid)-enrolled health care provider.

If you are a Health Home care coordinator who needs an NPI to request interpreter services, speak with your care coordination organization (CCO) to determine which NPI is appropriate for your use.

How do I register with UniversalLanguage?

To be an authorized requester with UniversalLanguage you must register with Universal Language Service. Once you are registered, UniversalLanguage will provide you the login information and requester guide to help you navigate the scheduling portal for requesting interpreter services.

How do I request an LAP?

Once registered, you will have access to the UniversalLanguage software scheduling portal. On the portal you will enter the information regarding the Apple Health client, scheduled appointment date and time of service, and be able to request interpreter services for a specific appointment, series of appointments, or family member appointment.

How do I know if the LAP is qualified?

HCA requires Universal to provide DSHS certified, authorized, or registered LAPs for all Apple Health health care appointments.

How do I get reimbursed for behavioral health appointments?

Only behavioral health services are eligible for reimbursement under the HCA interpreter services program. You must first request an LAP through UniversalLanguage. If they are unable to provide an LAP, you may obtain an interpreter through other agencies and request reimbursement through UniversalLanguage.

You must submit your request through UniversalLanguage. If no interpreter has been assigned and you choose to cancel the request and obtain your own interpreter, you must provide documentation to UniversalLanguage for reimbursement, including:

  • A cancelled or unable-to-fill job number from UniversalLanguage.
  • Proof of payment.
  • Updated W-9 form (only required once).
  • The completed reimbursement voucher.

Send your documentation via secure email to: billing@ulsonline.net.

HCA will only reimburse up to the Collective Bargaining agreement (CBA) per the contract with UniversalLanguage. You are required to pay any additional fees incurred, including parking, ferry, and travel fees.

How do I know if my client is eligible?

Please refer to the IS billing guide.

Enter the client ID and information when scheduling an interpreter through the UniversalLanguage portal, UniversalLanguage will do an eligibility check immediately following the request and notify you if the client is not eligible.

How do I know if my services are covered?

Please refer to the IS billing guide.

In addition to determining client eligibility when you are scheduling an interpreter, UniversalLanguage will identify client's benefit service package and eligibility. If the client is ineligible for services, UniversalLanguage will notify you.

UniversalLanguage will not reimburse for services that are not covered under the benefit service package or for administrative services such as scheduling appointments, reminder phone calls, paperwork, inpatient hospital services, and nursing facility services.

Can I request an LAP on my own?

If you are unable to locate an agency or interpreter on your own, you can access multiple Department of Enterprise Services (DES) language contractors throughout Washington State. However, you will be required to pay for these contractors directly. HCA does not reimburse for spoken languages services other than behavioral health services, and only if scheduled through UniversalLanguage.

Do I have to use Universal?

If you use a private contractor or agency, HCA will not reimburse you for these services unless you have followed the rules for behavioral health services.

Can I request a specific interpreter?

Yes, if the appointment is deemed Medically Necessary for the continuity care and treatment for the client. You can request a specific interpreter for the following situations:

  • Continued counseling sessions
  • Applied Behavior Analysis (ABA) therapy sessions
  • Cancer treatments as requested by medical provider
  • Pediatric private duty nursing (PDN) sessions in the home setting
  • Continuity of care for treatment plan or any treatment or medical procedure where a change in interpreter would impact the effectiveness and efficacy of the treatment
  • Ethnic background or religion (gender preference, cultural)

HCA has developed a Specific Interpreter Policy that health care providers must adhere to. Misuse of the specific interpreter request may result in a health care provider to request a specific interpreter in the future.

How do I notify UniversalLanguage of a situation with LAPs?

HCA in coordination with UniversalLanguage has developed an Incident Resolution Process (IRP) that provides guidelines for when the provider should reach out to UniversalLanguage regarding the actions of a specific interpreter during a visit. To maintain high-quality language access services to the citizens of Washington State and assure effect management of interpreter services, the IRP allows providers to report good interpreter service skills and ineffective interpreter service skills.

UniversalLanguage requires all interpreters to read and sign the document when registering to accept appointments.

For language access providers (LAPs)

Who is Universal Language Service?

Universal Language Service is the contractor that provides an online scheduling platform to allow providers to schedule interpreter services for Apple Health (Medicaid) eligible clients for health care appointments and social service appointments for the Department of Social and Health Services (DSHS) and Department of Children, Youth and Family (DCYF) offices.

How do I get my certification?

Per WAC 388-03-1960, spoken language interpreters must be certified, authorized, or registered with DSHS' Language Testing and Certification (LTC). LTC is the certifying body for interpreters. For more information about medical and social service certification see the DSHS LTC requirements.

Effective August 1, 2022 Interpreters can contact DSHS LTC for additional information regarding third party testing availability for obtaining medical certification.

How do I become a LAP/interpreter?

Once you have completed the certification, authorization, or recognized process through LTC, contact UniversalLanguage at interpreter@ulsonline.net to register to accept medical and social services appointments. You will be required to complete all HCA contract requirements to begin servicing jobs.

How do I know what jobs I can accept?

UniversalLanguage manages the HCA contract that oversees the coordination of Apple Health, DSHS, and DCYF appointments throughout Washington.

What is the Collective Bargaining Agreement (CBA)?

In 2011, the Collective Bargaining Agreement (CBA) was established between spoken language access (LAP) interpreters and the Governor of Washington to ensure equal access to pay, professional development, union management meetings, and grievances.

Over-the-phone and video remote interpreting

What about video appointments?

Video appointments will be allowed under the new OPI/VRI contract

Who contacts the client? 

If you are registered under the new OPI/VRI contract, and utilize the UniversalLanguage portal, they will provide the link to the health care provider. The health care provider is required to share the link and contact information for OPI or VRI jobs with the client.

What is an LAP?

A LAP or language access provider is an interpreter who provides spoken language assistance for this contract. All LAPs are covered under a collective bargaining agreement.

Will LAPs be available on demand?

No. HCA's interpreter services is only for pre-scheduled appointments.

What happens if UniversalLanguage cannot provide a LAP?

If UniversalLanguage is unable to provide a LAP for your scheduled appointment, you are still required to provide services to your Apple Health clients. This means you will need to secure an interpreter at your own cost. Per the Title VI of the Civil Rights Act of 1964, recipients of federal funds are required to provide access to care for Apple Health clients.

Can I change an in-person appointment to phone appointment?

No, you cannot change an appointment once it has been scheduled. Instead, you will need to cancel the appointment and reschedule for a different type of service (i.e., phone, video, etc.).

Can I change the date and time of appointments?

No, you cannot change an appointment once it has been scheduled. You will need to cancel the appointment and create a new appointment request.

Will I need any special equipment?

You will need a phone for over-the-phone calls and a computer, table, or phone with video technology abilities for video remote appointments. It is required that a screen larger than a cell phone be used for video remote appointments.

Am I required to use OPI-VRI services even if a client prefers an in-person appointment?

No, however it may be more conducive to secure an LAP for over-the-phone or video jobs, especially for languages of low demand. It is best to work with your client and UniversalLanguage to provide the best resource for the appointment.

How much notice do we need to give for making an OPI-VRI request, as well as canceling one?

It is recommended that you provide more than a 24-hour notice to request an appointment. The more time provided allows LAPs to review and accept the jobs. It is best to cancel as soon as possible and more than 24 hours from the start time of the appointment.

If I already use the HCA contract with UniversalLanguage for in-person appointments, do I have to register again?

Yes, this contract is new and separate from the in-person contract with UniversalLanguage and has different requirements.

Can I request an interpreter for any of my patients?

The HCA interpreter service contract only pays for services for eligible Apple Health (Medicaid) clients seeking health care services with their provider that is covered under their benefit plan.

Are the languages for the COFA communities available through Universal Language?

UniversalLanguage is currently unable to secure interpreters in these languages. UniversalLanguage continues to do outreach to increase the interpreter pool. However, interpreters must be certified/authorized/recognized for this contract. (Marshallese, Ralik, Ratak, Nauruan, Chuukese are not available by Universal Language)

Does DSHS LTC plan to reopen their language testing and certification program?

For more information about language testing, visit the DSHS LTC website.

If a provider uses an interpreter outside of UniversalLanguage, who pays the interpreter?

If a health care provider is unable to secure an interpreter through the HCA Universal contract, UniversalLanguage, and decides to schedule an interpreter from a private resource, the health care provider is responsible for the cost. HCA cannot reimburse the provider.

Will there be contracts or an interpreter pool outside of the DSHS LTC pool?

No, HCA must use language access providers (LAPs) that are certified/authorized/recognized by the DSHS Language Testing and Certification (LTC) program.

Will providers be required to provide their own hardware for using the service?

Yes, health care providers must have the hardware to utilize OPI and VRI and meet the minimum technical requirements and specifications.

Will the minimum technical requirements or specifications be made available?

Yes, UniversalLanguage will include this information on their website and in the requester materials.


Program updates

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