Each year, the Centers for Medicare & Medicaid Services (CMS), the regulatory government organization that oversees health insurance providers’ Medicare practices, puts every customer care Medicare vendor to the test. Because CMS has the authority to revoke a company’s ability to sell their Medicare insurance plans, a poor showing can be devastating for the insurance providers they represent.
CMS’s goal is to ensure compliance with a set of prescriptive protocols when dealing with customers’ Medicare insurance inquiries and issues. It is a highly regulated process requiring vendor expertise in all facets of Medicare insurance, which they then gauge and rank relative to the industry.
Our client is a major regional health insurance company whose Medicare insurance plans account for a considerable percentage of their total revenue. They came to Harte Hanks after their incumbent customer care partner received an unimpressive annual CMS score of 2.5 out of 5.0, which pushed the company’s score so low they risked losing their ability to sell Medicare. Our immediate mission was to raise our client’s scores through better execution, knowledge, and reconnaissance of how to navigate through the CMS testing process.