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What are CMS Compliance Event Audits?
TrendSource 08/30/2022
2 Minutes

Last week we discussed the ins and outs of CMS Translator Phone Call Audits. Today, we are going to look at TrendSource’s CMS Compliance Audits for in-person events (informal and formal) and 1:1 appointments.

Like CMS phone calls, these interactions are governed by strict CMS regulations. In these in-person settings, it is particularly challenging for salespeople to answer questions off-the-cuff, making it easy to accidentally fall on the wrong side of CMS mandates. This is why a robust CMS compliance program is so important, both during AEP and year-round.

What are CMS Informal Event Audits?

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CMS Informal Event Audits are compliance audits that evaluate Medicare supplement provider salespeople’s adherence to CMS regulations during informal events.

Informal events are open-invitation events without a formal presentation component. Much like a popup event, CMS informal events typically take place either at kiosks or in mobile units. Oftentimes, they are integrated into locations seniors often visit, including: drugstores, senior centers, and public events like farmers markets (among others).

TrendSource Field Agents attend these informal events, posing as Medicare-eligible consumers with questions about supplemental packages.

What are CMS Formal Event Audits?

cms outdoor event compliance audit

CMS Formal Event Audits are compliance audits that evaluate Medicare supplement provider salespeople’s adherence to CMS regulations during formal events.

Formal events are like informal events but are appointment/registration based instead of an open-invitation format. They are typically held in restaurants, auditoriums, and other gathering spaces. Formal events include a scripted presentation followed by a question-and-answer session.

TrendSource Field Agents register for and attend these events, observing both the formal presentation and the question-and-answer session that follows.

What are CMS Appointment Audits?

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CMS Appointment audits are compliance audits that evaluate Medicare supplement provider salespeople’s adherence to CMS regulations during 1:1 appointments.

In 1:1 appointment, salespeople for Medicare Supplement providers typically meet potential clients in public places or in a salesperson’s office. These appointments are governed by the same rules that regulate formal and informal events.

In CMS Appointment Audits, TrendSource Field Agents pose as potential customers, evaluating the salesperson’s compliance with CMS guidelines during the meeting.

TrendSource CMS Compliance Audits

cms compliance audit event

TrendSource has offered CMS compliance audits for over a decade, helping our clients monitor their sales force and institute small-scale corrective actions when this sales force falls outside of CMS regulations. CMS has the power to institute all sorts of punitive actions including hefty fines and even revocation of contract.

With in-person events in particular, it is understandably easy for salesforce members to slip into non-compliant answers, when in the heat of the moment with a live audience. TrendSource CMS Compliance Audits turn these slipups into teachable moments, not punishable behavior.

Do not wait for CMS to catch your company out of compliance. Plan ahead and institute year-round CMS compliance audits.

Learn More About CMS Compliance Audits


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