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What It's Actually Like to Work as an On-Site Freelance Medical Interpreter

Geri McClymont has been working as a freelance medical interpreter since 2013. She obtained her certification through NBCMI in July 2015.

Language agencies often can’t foretell how far in advance they’ll need interpreters in any given language pair, so always be ready!

Language agencies often can’t foretell how far in advance they’ll need interpreters in any given language pair, so always be ready!

What Is It Really Like to Work as a Freelance Medical Interpreter?

You’ve completed your medical interpreter training program and are ready to start working as an independent contractor. You’ve likely been told you should apply to language agencies as a start, yet you want to know what you’re getting yourself into before you start applying.

Here's an inside look at what it’s like working for language companies as an on-site freelance medical interpreter, based on my own experiences.

This article will cover:

  1. Assignments
  2. Employment verification forms
  3. Confidentiality (HIPAA)
  4. Evaluation forms
  5. Creating an efficient filing system
  6. Payment
  7. Working for multiple agencies
  8. Documenting wait time
  9. Challenges of working as an independent contractor
  10. Final thoughts

1. Assignments

Once you’ve signed your first contract with an agency, be prepared to start receiving assignments by phone as well as electronically right away! Unless you’ve specified that you don’t accept same-day requests, expect to be contacted anywhere from several weeks in advance to the hour of the assignment.

While it’s a good idea to ask each agency before you sign the contract how much prior notification they will normally provide you for assignments, language companies often can’t foretell how far in advance they’ll need interpreters in any given language pair. This is driven by their end clients’ request for interpreters, which is often completely unpredictable.

Be sure to decide in advance what your rates will be for work you accept with less than 24 hours’ notice.

Also make sure you have everything you need for your assignments before you head out the door each day!

2. Employment Verification Forms

Each time you accept an interpreting assignment from an agency, the agency either sends you an employment verification form (EVF), complete with assignment details, or they ask you to complete a blank EVF with the details they send you separately. EVFs generally include the following information:

  • Interpreter’s name
  • Language (other than English)
  • Date of assignment
  • Contracted assignment beginning and end times
  • Name and address of medical facility
  • Department within the medical facility (neurology, pediatrics, etc.)
  • Patient medical record number (MRN)
  • Patient name

Note: It’s important to record on EVFs the actual start and end times for assignments, which may differ from your contracted start and end times, such as when patients arrive early or appointments last longer than anticipated.

Each EVF is signed by both the interpreter and the medical provider at the conclusion of each assignment and must be received by the agency within 24 hours. You may fax them directly to the agency or scan them as email attachments. If you do the latter, be sure to scan them as encrypted email attachments to protect their confidentiality.

3. Confidentiality

Because EVFs normally contain highly sensitive information, such as patient names and medical record numbers, it's imperative to keep them in a safe location at all times, as well as to shred hard copies and delete electronic versions immediately after submitting them to their designated agencies.

The Health Insurance Portability and Accountability Act (HIPAA) is a federal law that mandates the protection of the privacy and security of patients’ health information and enforces severe consequences for violations of this act, including termination of employment, jail time, and fines of up to $50,000 per violation.

Make sure to keep separate documentation of your assignments, including dates, locations, and beginning and end times, for your own records.

HIPAA Regulations

4. Evaluation Forms

Some agencies will ask you to take an interpreter evaluation form with you to each assignment. These are for the medical provider to complete regarding your performance after each assignment and are normally faxed directly to the agency by the medical provider himself.

Questions on evaluation forms may include:

  • Did the interpreter arrive on time for the assignment?
  • Was the interpreter dressed appropriately?
  • Did the interpreter introduce him or herself?
  • Did the interpreter communicate effortlessly?
  • Did the interpreter communicate effectively?
  • Did the interpreter conduct him or herself in a professional manner?

5. Create an Efficient Filing System

It's critical to have an excellent filing system to organize your paperwork for the various agencies you’ll work for. This will help you locate forms quickly as you prepare for your daily assignments and send out invoices at the end of the month, in addition to making your life easier during tax time.

Your files for each agency might be labeled something like this:

Files for Each Agency:

  • Policies and Procedures
  • Contract
  • Completed Employment Verification Forms (make sure you shred and delete these immediately after sending electronic copies to agencies)
  • Blank Employment Verification Forms
  • Blank Evaluation Forms
  • Invoices
  • Monthly Activity Reports

6. Payment

Some language companies will request that you send them an invoice at the end of each month, while others will send you a monthly activity report/invoice based on the time recorded on your EVFs.

Agencies typically pay you electronically by depositing your payments directly into your bank account on a monthly or bi-monthly basis.

Keep close tabs on your deposits to ensure they're accurate!

7. Working for Multiple Agencies

Each agency is unique. Once you begin working for more than one, you'll inevitably notice similarities and differences in their policies and procedures.

For example, one company may require that you contact them immediately if your patient doesn't show up within fifteen minutes after your contracted start time, while another company may request that you only contact them if the appointment duration exceeds your contracted time by more than an hour.

These policies are normally based on the agencies’ agreements with their direct clients, meaning the medical facilities you interpret at, and it’s essential that you stay on top of these nuances. If needed, create a table with each agency’s requirements and carry it with you as a guide.

You may also want to use a log sheet to document your communications with language companies during assignments to help you monitor your compliance with their guidelines.

These are some additional instances in which agencies may request that you call them during assignments:


  • if a patient shows up before your contracted start time
  • if the appointment was cancelled
  • if the appointment ends 20 or more minutes before your contracted end time

8. Document Wait Time

As a medical interpreter, expect long periods of wait time during assignments.

To protect yourself as well as the agencies you represent, it's important to document all wait time, including:

  • When a patient arrives late
  • When the medical provider arrives late
  • Any time period after which a patient has been admitted for his appointment and is waiting to see a medical provider, including the waiting period after a patient has had his vital signs checked by a nurse and is waiting to see a specialist

This way if you are later asked by your agency why an appointment that should have lasted an hour lasted two hours, you have documentation to back you up.

9. Challenges of Working as an Independent Contractor

Working as a freelancer certainly has its advantages, but make no mistake—there's a trade-off for the freedom you have as a freelancer.

Here are some of the challenges you'll face:

  • You're not guaranteed a certain number of hours per week or per month, so your income may fluctuate drastically from one month to the next. This can be especially difficult if you rely primarily on your freelance work for financial support. Even working for multiple agencies does not guarantee you steady work and income. In fact, it's common for different agencies to want to contract you for appointments at overlapping times, so you inevitably have to decline one offer in order to accept the other.
  • As an independent contractor, you won't receive benefits that are normally offered to full-time employees, such as health and dental insurance, so you are responsible for paying for these out of pocket if you want them.
  • As a freelancer, state and federal taxes won't be withheld from your paychecks, so it's important for you to remember to budget for these, as well as for self-employment taxes, so you aren't caught off guard when tax time rolls around.
  • Staying on top of each agency's policies can be confusing. For example, one agency may require you to call them if the patient doesn't show up within a certain amount of time after the assignment begins, whereas another agency may not. Neglecting to stay on top of these individual nuances may cost you future work with an agency.
  • You'll be traveling to multiple locations and will need to familiarize yourself with the driving route and distance to each one, as well as with the parking facilities at each building, in order to know how much driving time to allow yourself so you aren't late to assignments.
  • You'll frequently receive short notice for assignments.
  • Your schedule will likely change daily.

10. Some Final Thoughts

  • Stay connected with your local medical interpreters organization as a source of ongoing support as well as networking opportunities.
  • Keep a mileage log to help track your traveling expenses.
  • Keep your vehicle in good condition.
  • Always give your best!

This article is accurate and true to the best of the author’s knowledge. Content is for informational or entertainment purposes only and does not substitute for personal counsel or professional advice in business, financial, legal, or technical matters.

© 2016 Geri McClymont