Case Studies

During AEP, CMS Event Audits Rapidly Report Compliance Issues

Posted by TrendSource on September 11, 2018

Background and Client Objectives

A Medicare Supplement provider needed to ensure it remained compliant with Center for Medicare/Medicaid Services (CMS) regulations during the Annual Election Period (AEP). They were particularly concerned about in-person meetings between prospective customers and their agents, namely 1:1 appointments, informal events, and formal events, all of which connected licensed providers to potential customers.

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Topics: CMS, Compliance, CMS Compliance, Mystery Shopping

Medicare Supplement Provider Ensures Year-Round CMS Compliance with Mystery Call Program

Posted by TrendSource on August 31, 2018

Background & Client Objectives

A national insurance company selling Medicare Supplements was concerned about remaining compliant with Centers for Medicare and Medicaid Services (CMS) guidelines and regulations year-round. Having already established a robust Annual Election Period (AEP) compliance program, they were looking to expand their compliance mystery shops, particularly in their call centers.

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Topics: CMS, CMS Compliance, Mystery Shopping, Health Care Compliance

Medicare Provider Finds Corrective Action to Avoid AEP CMS Violations

Posted by Nick Bravo on February 07, 2017

Background and Client Goals

A licensed Medicare Advantage and Medicare Supplement plan provider needed assistance monitoring their extended salesforce during CMS’s Annual Election Period (AEP).

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Topics: CMS, Health Care, CMS Compliance, AEP, Health Care Compliance

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