This is a guest post by Scott Klonowski.
From the point of first contact all the way through the enrollment process, it’s critical to stay compliant with guidelines from the Centers for Medicare and Medicaid Services (CMS) and avoid noncompliance.
Noncompliance costs everyone money. Here are a few important ways to prevent and correct noncompliance:
Make Sure You Have Permission to Contact & Monitor Calls
According to CMS guidelines, agents cannot make unsolicited phone calls. Additionally, many parts of the U.S. require consent for calls to be recorded. It’s important to be up to speed on state and federal regulations and ensure your agents are using the right language to obtain consent—in both incoming and outgoing calls.
Follow CMS Marketing & Language Guidance
CMS has clear guidance on their website about presenting information to potential enrollees. Avoid any potential to mislead contacts and refrain from using absolutes or superlatives to describe Medicare plans and benefits. CMS also advises that the term “free” should be avoided when speaking about reduced costs or $0 premiums.
Keep Health Information Safe
The Healthcare Insurance Portability and Accountability Act (HIPAA) exists to ensure security and privacy of patient health information, including Social Security numbers, IP addresses, images of their faces, account numbers, and more. It’s important to make sure you all of your agents regularly receive proper training on HIPAA, and that your internal guidance restricts the ability to share personal health information with others.
Conduct Regular Reviews & Training
Training agents once and expecting them to remember every detail isn’t sustainable. Through regular compliance training and access to updated knowledge about policies and procedures, you can ensure that your staff is knowledgeable about policy, and also knows where to look for relevant information if they have questions.
It’s also important to monitor and audit adherence to the standards and programs in place. This helps inform your training, internal protocols, and other guidelines.
Streamline Your Processes
Often, reps get bogged down working with static scripts and navigating between screens or tools that aren’t talking to each other. But there’s a way to reduce stress, increase productivity, improve customer experience, and drive sales—all while ensuring compliance.
Cue offers a simple, integrated solution that streamlines workflows and tracks adherence to compliance requirements for insurance companies with phone-based sales and support reps. With dynamic and personalized scripts and real-time call and conversation analytics, both reps and their managers can operate with more support and peace of mind.
About the Author
Scott Klonowski began his journey in insurance as a captive agent in 1993. In 2002, he started Klonowski Agency where he focused primarily on selling and servicing group health plans to small businesses in Northeast Ohio.
After 10 years of growth, Scott recognized that a Human Resources Administrative platform that companies could use to manage their benefits, payroll, timekeeping, and paid time off all in one place was missing from the market. With just a concept and no prior experience in building software, Scott started My1HR in November 2011 with his friend and business partner Glenn Leppo. In 2013, they built connectivity to HealthCare.gov for individual quoting and enrollment, and soon after built a quoting enrollment platform for independent agents, INSXCloud. After helping thousands of independent brokers and agents, Scott sold The Klonowski Agency in 2015 and My1HR in 2018.
Scott now uses his experience working with companies of every size to help business owners find success. From new companies gearing up for rapid growth to mature ones looking to sell (and every stage in between), Scott mentors and provides professional support and guidance to business owners to help them set and achieve their goals.