Every year between October and December, Medicare recipients are encouraged to investigate and select a Medicare Supplement Plan in what is known as the Annual Election Period (AEP). During this period, the Center for Medicare/Medicaid Services (CMS) closely monitors the ways in which Supplement Providers discuss their plans with consumers.
If these interactions violate CMS regulations, the Supplement Provider faces strict punishments ranging from fine all the way to loss of contract.
This is why Supplement Providers regularly operate CMS Compliance Audits, to help them identify vulnerable points in their extended salesforce, to document their compliance efforts, and to institute small scale corrective actions before violations can be caught by CMS.
Today, we are discussing CMS Appointment Compliance Audits.
CMS Appointment Compliance Audits
CMS Appointment Compliance Audits mimic actual CMS appointments, with a Field Agent (mystery shopper) posing as a Medicare-eligible consumer investigating Medicare Supplements, or as the child of a Medicare-eligible consumer inquiring on their behalf.
During these appointments, Field Agents listen to the sales associate discuss the particulars of Supplement plans, asking pertinent questions and taking note of all provided materials.
They monitor for CMS violations, such as making absolute statements or improperly answering hard questions for example.
These Audits document companies’ compliance efforts while also allowing them to make small scale corrective efforts before these violations are caught and punished by CMS.
TrendSource CMS Appointment Compliance Audits
For over a decade, TrendSource has been working with Medicare Supplement Providers to document and monitor their compliance with CMS regulations, helping them avoid costly penalties. Among the array of Compliance Audits TrendSource offers, CMS Appointment Compliance Audits are the most detailed and intensive.
Yet, with Field Agents’ attention to detail and rapid reporting, Audits are submitted to TrendSource within 24 hours of the appointment and then rapidly turned around by TrendSource QA before being reported on the client dashboard.
Supplement Providers have long relied on TrendSource for their CMS Compliance needs and, as we push through another AEP, those providers are better protected against CMS punitive actions.
