Working in any healthcare field, such as Medicare Advantage services, comes with its own separate challenges. These challenges won’t get any easier, it seems—new rules will now require agents making calls related to Medicare Advantage and Part D to record their calls starting on October 1st.
The rules apply to calls with existing patients as well as prospective clients, which will require a pretty big shift for telecommunications centers. However, adjusting to these changes will be easy enough with the right tools, even for agents who rely on cellular phones to make these calls.
But First.. Who Made This Rule and Why?
This new rule came from the Centers for Medicare and Medicaid Services, or CMS. The new ruling comes after CMS reclassified Medicare Advantage agents and brokers as “third-party marketing organizations,” or TPMOs. This means that the agents are not directly affiliated with Medicare but engage in activities that market access to Medicare.
CMS says that it is implementing this rule to protect consumers after several complaints about misleading advertising relating to Medicare Advantage plans or Part D services. Since most agents were not directly affiliated with Medicare, there was no way for CMS to engage in oversight and monitor whether fraudulent claims were being made.
However, agents argue that fraudulent claims are a very low portion of Medicare Advantage agencies and often happen with separate marketing agencies running untruthful TV ads, not the agencies themselves. The agents argue that new rules will only put more work on brokerages and make it even harder for people to access the plans that they need.
What’s clear is that right now there is no point in discussing whether the new rule is just or not. What matters is preparing your company for the change so that you can continue doing the important work you are doing.
How Can Software Help With This?
One of the best tools in the telecommunications game is software. There is a software program for every need or challenge, including compliance with CMS regulations. The right software, such as Talkroute, can help you record calls with clients and prospects. Whether you are making those calls from a cellular phone, PC, or web browser, Talkroute’s apps make sure all of your calls are recorded.
Talkroute’s apps can also manage other aspects of recording phone calls, such as storing phone calls and managing data in a way that ensures HIPAA compliance. Whether you choose Talkroute or another provider, check that the software you end up using has experience with sensitive medical issues. Ask about the other clients that the company serves—if it works with others in the same sphere, you are probably on the right track.
Instead of thinking about the rules change as a burden, think of it as an opportunity to push your business to even better heights and protect yourself and your agents. The right software will not only record and store all of your calls, but it will also list the duration of each segment of the call and communicate the expected scope of an appointment or scheduled call. That will prove that your agents cover all relevant information in their contact with the public.
What Other Things Should Your Compliance Software Cover?
The right software that you should choose to follow the new CMS regulations will cover a lot more than just recording phone calls since the regulations are also far more extensive than just recording calls.
For example, your compliance software can store a list of talking points and playbooks to minimize the risk of human error when your agents communicate with beneficiaries. The stored information should be checked for accuracy and relevance. This will also help existing clients and potential customers because they will be guaranteed to have up-to-date information about the benefits that they can access.
Call-recording compliance software can even make it easier to integrate other forms of communication. Some software will help you communicate with callers about how you are using their information and that you will be sharing information with licensed agents for an appointment.
Compliance in the Form of a Disclaimer?
Recording phone calls is not the only change to CMS regulations that Medicare Advantage agencies need to think about. Here are some other changes that you will need to comply with starting October 1st.
One is providing a disclaimer. The most frequent complaint CMS reported from consumers who interacted with Medicare Advantage agencies is that they were misled about what plans were available to them. Put the CMS standard disclaimer on your website, which reads:
“We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all your options.”
This disclaimer will help you comply with CMS regulations and protect you from potential complaints from customers who misunderstood your service. Display the disclaimer in an easy-to-read location and on any written communication that your company sends out to the public.
What If You’re an IMO?
If you’re an Independent Marketing Organization, or IMO, then call recording software is even more beneficial. If you outsource your calls to other third-parting marketing organizations, having a system in place to monitor those calls ensures the communications that are done in your name share accurate information and are not misleading when talking to clients.
Recording those calls can also help you monitor for compliance with CMS’s rules, so you are not on the hook for any oversights down the line that catch you by surprise.
Any time you outsource work, the benefit of freeing up your time comes with the tradeoff of potential liabilities. Protect yourself, your customers, and your agents, with phone recording software.
Complying with the CMS Rule Changes
Although the rule changes and reclassification from the Centers for Medicare and Medicaid Services came as a surprise to many Medicaid Advantage agencies, you have some time to prepare before the rule change goes into effect on October first. The right software provider, such as Talkroute can help you comply with these rules by recording calls, storing recordings, and ensuring compliance with all regulations including disclaimers across multiple platforms.
Stephanie is the Marketing Director at Talkroute and has been featured in Forbes, Inc, and Entrepreneur as a leading authority on business and telecommunications.
Stephanie is also the chief editor and contributing author for the Talkroute blog helping more than 100k entrepreneurs to start, run, and grow their businesses.