With the Centers for Medicare and Medicaid Services (CMS) secret shopper period now in full swing, plans can review and adjust their current workflows based on the calls that have come in over the last several weeks. The goal of this period is to evaluate Medicare plan performance and accessibility, emphasizing call response times, clarity of information shared, and intervention times, such as connecting callers with an interpreter. To this end, a key facet of success within this season is ensuring interpreter services are hitting key SLAs, which includes answering the first three questions correctly and promptly connecting the caller with an interpreter within 60 seconds.

Having serviced Medicare Advantage plans for over 20 years, we have collected and analyzed language-specific data to facilitate informed decision-making when preparing call centers for CMS monitoring activities. In turn, plans can leverage these insights to predict their language demographics and implement a successful language services strategy throughout June. As part of this strategy, plans should:

Prepare for Prompt Response Times

Most inbound language calls during the CMS secret shopper period occur in the afternoon and evening hours. In fact, many of the calls are received within the final 60 minutes of the business day. To stay ahead of the curve, teams should partner with a language services vendor with an intricate understanding of operational considerations, such as adjusting interpreter schedules and offering additional hours to subject matter expert interpreters. These additional measures help ensure coverage across all major beneficiary languages during the late afternoon and evening hours, maximizing chances of success.

Provide Interpreters with the Questions

As part of a robust training program, plans should aim to provide their language service provider with a list of the new questions CMS has asked thus far. This can be shared with the interpreters to ensure they are educated on how to answer each question quickly and effectively. In most instances, plans will send a list of new questions once they are received, enabling interpreters to preemptively review and prepare answers in advance of the call. Plans should also open a feedback loop with interpreters to collect data on their experience with specific questions or highlight challenges that arose during the call. Based on this, training materials can be adapted and improved to mitigate future risks or delays in handling inbound calls. 

Conduct a Data-Based Call Volume Assessment

From a language mix perspective, plans can collate call data received from plans being serviced in all 50 states and US territories. Based on this collation, call centers will be able to prioritize languages with high demand while also providing critical insight into the distribution of languages and call volume trends across beneficiary bases. This enables call centers to anticipate the demand for specific language pairs and ensure adequate interpreter staffing. Currently, the volume of inbound calls can be broken down into the order below:

Struggling to achieve success in CMS call center monitoring? Guarantee compliance, five-star ratings, and ensure your beneficiaries receive the highest quality of call center support by leveraging CMS priority lines designed to service your secret shopper calls. 

Our subject matter experts are ready to assist in building a robust language services program. Enhance beneficiary engagement by 15% and seamlessly navigate the CMS call center requirements by connecting with us. Reach out to healthcare@transperfect.com to get started.