As we begin AEP 2022, Medicare Supplement Providers are in constant contact with potential customers at a variety of touchpoints, including phone calls, formal and informal events, and 1:1 appointments. In order to accommodate this influx of consumers, Supplement Providers expand their sales force, meaning that oftentimes relatively newer employees are immediately in prime time, on the front lines and in CMS’s crosshairs.
That’s right, CMS—the Center for Medicare and Medicaid Services—turns up the intensity on its monitoring during the Annual Election Period (AEP). This higher level of CMS scrutiny makes it all the more dangerous for newer employees and the companies they represent, who can be severely penalized if they are caught violating the strict rules governing Medicare Supplement Providers.
This is why Providers run CMS Compliance Audits, to help monitor their sales force and limit their risk for CMS violations. TrendSource offers several types of CMS Compliance Audits; today we will be looking at CMS Call Center Audits
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CMS Call Center Audits for AEP 2022
CMS Call Center Audits mimic real life inbound phone calls to Medicare Supplement Providers’ call centers. Mystery shoppers pose as Medicare-eligible consumers or children of eligible consumers inquiring on their parents’ behalf.
During these calls, mystery shoppers monitor whether call center sales force workers violate any of CMS regulations regarding interactions between supplement providers and consumers. This can include monitoring if the call center employee:
- Answers Hard Questions
- Makes Absolute Statements
- Offers to connect the caller to a translator if necessary
- Pressures callers into certain supplement packages
- Much, much more
The call center employee never knows they are talking to a mystery shopper as part of a CMS Call Center Audit. Instead, they believe they are interacting with a typical consumer.
This allows the mystery shopper to evaluate the call center employee and submit their report to TrendSource regarding the agents’ compliance with CMS regulations.
TrendSource CMS Call Center Audits
TrendSource has offered CMS Call Center Audits for over a decade, turning the monitoring program into an efficient and invaluable means for Supplement Providers to monitor, measure, and document their compliance efforts. When mystery shoppers observe violations, they can be corrected by their superiors without facing punishment from CMS.
With a rapid turnaround time, Providers have access to CMS Compliance Audit results quickly enough to institute corrective actions with their frontline employees.
Call Center Audits are accurate, rapid, and effective means of evaluating frontline call center employees and avoiding costly CMS punishments, during AEP and year-round.
