CMS Event and Appointment Compliance Audits

Helping Medicare Supplement Providers ensure their frontline sales force remains compliant with Center for Medicare/Medicaid Services (CMS) requirements while conducting informational events and 1:1 appointments, in-person or online

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Document and Measure Sales Force Compliance with CMS Regulations

Year-round CMS Compliance audits help Medicare Supplement Providers stay on top of their sales force’s compliance with CMS regulations. By catching potential violations before a CMS audit, Providers can implement small-scale corrective action rather than face steep penalties and even forfeiture of contract.

A robust CMS Compliance program documents a company’s compliance efforts, demonstrating to regulators that the Provider is conducting good faith due diligence efforts to ensure its sales force follows CMS guidelines.

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CMS Informal and Formal Event Audits

Particularly during the Annual Election Period (AEP), Medicare Supplement Providers’ sales forces conduct informal and formal informational events for seniors (and their authorized family members) considering their Medicare Supplement options. These events are typically broken into two groups:

Informal events are open-invitation and do not include a formal presentation. Instead, they are more akin to popup events, either at kiosks or in mobile units, and are featured in locations seniors often frequent: drugstores, senior centers, and public events (among others).

Formal events, on the other hand, are conducted in restaurants, auditoriums, and other gathering spaces. Attendees often preregister for these events, which typically include a presentation and a question-and-answer session.

TrendSource will dispatch Field Agents to both informal and formal events, where they blend in with other attendees and discretely audit the sales representative running the event. Agents check for required materials, answers to hard questions, and translator supplements. They further evaluate how representatives field hard questions and monitor if they tread into absolute statements.

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CMS Appointment Audits

Medicare Supplement Providers’ sales representatives take 1:1 appointments with potential customers, especially during AEP. These appointments occur in public places or in a representative’s office and are governed by the same rules regulating informational events.

In CMS Appointment Audits, TrendSource dispatches Field Agents to pose as potential customers and evaluate the salesperson’s compliance with CMS guidelines. They document all materials provided by the sales representative, as well as monitor the sales representative’s answers to hard questions and use of absolute statements.

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How TrendSource does Informal and Formal CMS Event Audits

TrendSource has over a decade of experience running in-person and online evaluations of CMS events and appointments. Importantly, the Field Agents TrendSource uses for these programs are age-appropriate, meaning they visibly qualify for Medicare or have a parent who already does. This assures their anonymity during their evaluations, observing sales representatives in their element as they conduct events and appointments.

This is only possible with the support of TrendSource’s robust, national database of Field Agents, which means TrendSource can guarantee 100% coverage, 100% of the time. Wherever a Medicare Supplement Provider dispatches a salesperson, TrendSource has Field Agent nearby, ready to evaluate them.

Finally, TrendSource’s Quality Assurance Team has the knowledge and efficiency to ensure that reports are prompt and accurate.

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