The results from this year’s AEP compliance programs were incredibly impressive.
San Diego, CA (PRWEB) February 07, 2013
Another successful Annual Election Period (AEP) is in the books for the 20+ healthcare insurance providers who utilized TrendSource Trusted Insight for their CMS Compliance Secret Shopping Programs. Over the course of this year's AEP season, TrendSource executed several thousand audits, reporting better than a 95% completion rate for all requested audit types, which included:
- Formal Marketing/Educational Events (91.1%)
- Informal/Kiosk Events (99.5%)
- Call Centers (100%)
- In-Home/Public Space 1:1 Appointments (93.3%*)
*Does not include cancelled audits due to scheduling issues
“The results from this year’s AEP compliance programs were incredibly impressive,” said Amber Gadzinksi, CMS Compliance Account Manager at TrendSource. “We made a lot of improvements to client reporting websites and other aspects of our service based on what we’ve learned over the past four (4) years of executing secret shop surveillance programs, so we were poised for success, but it was our secret shopper recruitment efforts that really made the difference.”
Here are some of the top violations identified through these secret shopper compliance audits:
- Enrollment kits were not provided or kits did not include all of the required items
- Information on Plan Ratings was not provided or fully discussed
- Event attendees were required to provide contact information
- Event sign-in sheets did not clearly state "optional"
- Election periods were not explained in full
- It was not explained how to request an exception/transition process applicable to new members of an MAPD or PDP when a drug they are taking is not on the plan formulary
- Step therapy was not explained
- Prior authorization was not explained
TrendSource executes yearlong CMS Compliance Secret Shop Programs, providing ongoing feedback to safeguard corporate integrity and remain compliant with the guidelines set forth by the Centers for Medicare & Medicaid Services (CMS). For more information about TrendSource Secret Shopper Compliance Programs, visit http://www.trendsource.com/services/cms.aspx or email trustedinsight(at)trendsource(dot)com. To learn more about becoming a secret shopper, complete the free online application at https://msi.trendsource.com/msi/agent.aspx or email medicareshop(at)trendsource(dot)com.
What is a Medicare Advantage Plan?
Medicare Advantage plans are health plan options (like an HMO) that are approved by Medicare and are offered by private insurance companies. They provide Medicare Part A, Part B, and often Part D (prescription drug) coverage under one policy. Medicare Advantage (MA) plans may also be referred to as “Part C”.
About TrendSource, Inc.
TrendSource provides business intelligence, customer experience insight, compliance solutions and a wide range of market research and data analysis programs. With over twenty years of experience, TrendSource’s customized solutions deliver results that quantify service gaps, provide prescriptive/corrective solutions, identify trends, and provide actionable solutions through enhanced reporting and analysis.
About MSI Services, Inc.
MSI Services is the exclusive Field Agent (secret shopper) database provider for TrendSource, Inc. While our employees and clients are associated with TrendSource, Field Agents are independent contractors for MSI Services. TrendSource employees utilize the MSI database to recruit Field Agents for specific projects. Learn more about MSI and how to become a Field Agent at http://www.trendsource.com/msi.
This year’s Annual Election Period (AEP) provided thousands of eligible seniors (55+) the opportunity to earn extra income by participating in Medicare marketing surveillance programs conducted for insurance companies. These secret shoppers remain instrumental in helping Medicare insurers detect prohibited activities by their sales representatives.