Halloween is coming, supposedly the scariest time of the year (though we would say Election Day the next week is even scarier). Yet, however frightening late October is for all of us, we must remember there is an even more terrorized group during Halloween: Medicare Supplement Providers.
You see, Supplement providers are in the middle of the Annual Election Period (AEP), wherein customers can opt to enroll in new plans. During this time of year, the Center for Medicare/Medicaid Services (CMS) monitors the interactions between consumers and Supplement Providers.
If, during these monitored interactions, Supplement Provider representatives violate CMS regulations, the Supplement Provider faces strict penalties including fines and even forfeiture of contract.
These are scary times indeed.
CMS Compliance Audits help companies prepare for these audits and also document their compliance efforts. Today, we are going to discuss CMS Event Compliance Audits.
How CMS Event Compliance Audits Work
CMS Event Compliance Audits mimic actual interactions between Supplement Providers’ salesforce and potential customers. These audits take place at both informal and formal event.
Essentially, mystery shoppers pose as Medicare-eligible consumers investigating their supplement options during the Annual Election Period (AEP) or as the children/caregivers of Medicare-eligible individuals.
At informal events, Field Agents drop in on sales associates working kiosks, booths, or other informational portals in public spaces such as drugstores and other retail locations, as well as community events. These events are informal by nature and Medicare-eligible consumers are encouraged to pop in, unannounced, to get information about particular supplemental plans.
With CMS Informal Event Compliance Audits, the Field Agent shows up to the informal event and inquires about the particulars of a supplemental plan, monitoring the sales agent’s responses.
At formal events, Field Agents arrive at a scheduled time for a formal presentation from the sales associate. The Field Agents monitor this presentation to ensure it stays within CMS guidelines, and also follow up with questions during the Q&A.
TrendSource CMS Compliance Audits
TrendSource has been helping Supplement Providers run CMS Compliance Audits for over a decade, building the industry experience and infrastructure to operate an efficient and incisive Audit program.
With CMS Event Compliance Audits, TrendSource’s Field Agents fit right into the crowd, do not draw attention to themselves, and monitor both the sales agent and the materials provided. They submit their reports within 24 hours of the event, at which point TrendSource’s QA team rapidly ensures their accuracy and depth before reporting the Audit on the client dashboard.
It’s scary out there for Supplement Providers, like being stranded in the dark. TrendSource CMS Compliance Audits turn on the lights.
