Checklist for new Centers for Medicare & Medicaid Services requirements

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One of the new compliance rules released by the Centers for Medicare & Medicaid Services (CMS) was the requirement to record phone calls. Health plans and their TPMOs must record all conversations with customers who want to discuss Medicare Advantage and Part D prescription drug plans. They must also store these call recordings for a minimum of 10 years. The long-term storage of calls ensures they have documentation of their member interactions in case of a potential complaint that CMS would investigate.

Additionally, the required disclaimer language must be communicated to a beneficiary during the first minute of a recorded call or within other written or digital communications. And third-party marketers must report disciplinary actions (non-compliance) to insurers and other first-tier entities.

8 ways to exceed CMS call recording requirements and improve member engagement

As many impacted payers and health plans have begun to assess their response to the new call recording requirements, many have identified gaps in their current and forward-planning capabilities. In addition, due to their internal assessments, most have also prioritized the need to reinvent the holistic member experience.

To accomplish this, payers will focus on how additional engagement capabilities will help deliver context-driven, personalized member encounters. This collective effort is necessary to maintain member brand loyalty and retain staff. These eight solution-focused measures will help your organization exceed the CMS requirements and modernize your approach to member engagement:

  1. Automated and customizable call recording
  2. Integrated and secure recorded call archiving
  3. Omnichannel routing & experience
  4. Conversational AI capabilities
  5. Intuitive call monitoring & coaching tools
  6. Easy and fast resource expansion
  7. Seamless support of remote or hybrid staff
  8. Integrated collaboration tools

Get the full downloadable checklist here. 

The mandated call recording Final Rule from CMS was just one of many regulatory changes this year. Focus on the shared implementation measures. You will exceed the CMS mandate and reimagine member engagement. You will also future-proof your communications capabilities for the many upcoming changes and requirements!

Are you ready to get started automating and consolidating your communications? Give Global CTI a call for a free audit to see how you can comply with CMS regulations and potentially increase efficiencies across your organization!

Shared from our partners at RingCentral, January 2023.

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