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CMS Compliance Audits for Medicare Advantage Plans

Written by TrendSource | 9/11/23 10:22 PM

As the CMS Annual Election Period for 2023 approaches, companies selling Medicare Advantage Plans are rightfully preparing their staff for a simultaneous influx of inquiries and enhanced scrutiny. This is the yearly reality of selling Medicare Advantage plans, and companies have long built in processes to ensure they are rising to the occasion each and every year.

CMS Compliance Audits are an important tool for sellers of Medicare Advantage Plans. This is true for every point of contact between businesses’ front-of-line staff and their customers. These can include:

  • Medicare Advantage Phone Calls
  • Medicare Advantage Translator phone calls
  • Medicare Advantage TTY Phone Calls
  • Medicare Advantage Informal Events
  • Medicare Advantage Formal Events
  • Medicare Advantage 1:1 Appointments
  • Medicare Advantage Website Audits

 

And as technologies advance and new points of contact emerge, companies must also incorporate CMS Compliance Audits into them.

TrendSource CMS Compliance Audits for Medicare Advantage Plans

TrendSource has provided Medicare Advantage Plan CMS Compliance Audits for over a decade, helping companies manage their compliance efforts.

During AEP, managing compliance is particularly important. This is because if CMS catches companies in repeated violations, they can punish them with steep fines and even revoking their right to sell Medicare Advantage Plans.

Companies must avoid such repeated violations and CMS Compliance Audits for Medicare Advantage Plans help them achieve this. Furthermore, when caught in violation, companies can point to their rigorous CMS Compliance programs to show their best efforts at meeting federal requirements. Of course, punishments remain entirely in the hands of CMS, but a robust CMS Compliance Audit program can only help.

TrendSource relies on its expansive network of Field Agents around the country, who can quickly attend in-person events and make calls to call centers. From there, TrendSource’s Quality Assurance team quickly evaluates the report before releasing it to the client.

When presented with violations, clients can then take small-scale corrective action with their front-of-line staff to ensure future compliance. They can develop new training when necessary and even monitor particular employees for repeated violations or reward employees for perfect calls.

With AEP nearly upon us, TrendSource Medicare Advantage CMS Compliance Audits are an important part in every Advantage plan provider.