Are You Ready for the CMS Call Center Study?

The CMS Call Center Monitoring Study is a way that CMS evaluates your compliance with Medicare Advantage (MA) and Part D requirements, including your ability to assist limited-English-proficient callers. It deploys “secret shoppers,” who call and test your ability to communicate with prospective beneficiaries. An especially challenging area for many call centers is using the right interpretation call flows and professional interpretation services vendors to serve callers and convey complicated benefit information. Here’s how these secret shoppers evaluate your company:

• Their evaluations feed directly into your star ratings. Not meeting the accessibility threshold could warrant CMS corrective action
• Achieving a star rating of 4 or higher means you’ll likely be eligible to secure CMS Quality Bonus Payments (QBPs)
• Achieving a 5-star rating lets you use the CMS “High Performing” icon for Medicare Plan Finder and a year-round Special Enrollment Period

The stakes are high, but you can be ready with the right phone interpreter services vendor.

Train Agents on Best Practices for Working with Phone Interpreter Services

For five-star customer experiences, it’s crucial to train your agents to work optimally with interpreters. These are some common tactics that aren’t always intuitive:

• Speak in short sentences
• Talk at a moderate pace — neither too fast, nor excessively slow
• Enunciate and speak clearly
• Use simple language and words whenever possible
• Pause often, especially between sentences, to allow the interpreter to catch up
• Avoid using idioms, industry jargon, and slang
• Talk to the caller, never the interpreter
• Be open and ready to clarify things for the interpreter

If possible, give your agents some time to practice and become comfortable with interpreters, so they feel confident during customer calls. Keep in mind that working with an interpreter is a skill to learn.

Educate and Prepare Your Phone Interpreter Services Vendor

Getting the optimal performance from your interpreting services requires some preparation from your team. Create a “cheat sheet” for your over-the-phone interpreting services vendor to disseminate to their interpreters. Include important information they’ll use frequently, such as:

• Plan names
• Popular policy details and coverage options, including inclusions, exclusions, and optional riders or endorsements for additional protection.
• Explanations of how premiums are calculated and ways to lower premiums (discounts, bundling, etc.)
• Basic information on deductibles and limits
• Steps in the claims process, including required documentation and timelines.
• Policy terms and conditions for renewal, cancellation, and penalties or fees.
• Region and industry-specific legal requirements
• Common lifestyle and risk factors that may be relevant

Ask your phone interpreter services company to have their interpreters practice and prepare with this information so they’re ready to provide top-tier services to all callers in CMS-evaluated languages.

Use Phone Interpreter Services to Create a Line for CMS-Tested Languages

CMS evaluates insurance companies based on six commonly used languages in the U.S.:

• Cantonese
• Mandarin
• French
• Spanish
• Tagalog
• Vietnamese

Choose a trusted phone interpreter services provider with capacity to deliver high-quality interpreting services in those six languages. Consider assigning a line for any calls that may come through in those languages. Be mindful that the interpreter must successfully engage the customer on the line and answer the first question before 8 minutes to “pass” the call. This connection time is a key metric in CMS evaluations. Choose an interpreter service with fast connection times in these key languages.

Streamline Your Phone Interpreter Services and Call Flows

Create a call tree for each of the six CMS-tested languages (listed above). Create a separate line for speakers of any other language. With this approach, your team will avoid misrouting any potential CMS secret shopper calls. Misrouting can damage your CMS ratings, and by extension, your star ratings.

Hold Regular Check-in Meetings with your Phone Interpreter Services Provider

Achieve consistently improving results by meeting regularly with your telephone interpreter services company. Review feedback on interpreting and strategize on how to resolve any issues or challenges that may come up. Update the cheat sheet materials interpreters need and continue optimizing your own call flows, agent procedures, etc.

Get in touch

Have questions about phone interpretation services or AI interpreting? Need help finding the right interpreting solutions for your call center? Let’s get in touch.