Achieve 5 Stars on the CMS Secret Shopper Audits

The Centers for Medicare & Medicaid conducts annual evaluations of Medicare plan performance on a scale of 1-5. The objective is to assess the language accessibility of plan information with a specific focus on timeliness and clarity of information. We have developed a series of best practices and processes to ensure the best possible outcome of this audit. 

With 65+ million limited English proficient (LEP) individuals in the US, it is more important than ever to ensure your beneficiaries are in receipt of high-quality information and guidance when choosing the ideal plan for their specific health goals. This auditing period, which takes place from February to June each year, calculates star ratings based on five key criteria.

You Care About a 5-Star Rating and So Do We

Staff up annually in the languages CMS audits in

Priority call queues for plans subject to CMS audits

Healthcare subject matter interpreters with experience fielding CMS questions

CMS questions provided to interpreters prior to audit period

Audit-ready real-time reporting outlining adherence to CMS SLAs

Guarantee Compliance with CMS While Enhancing the Member Experience

  • Decrease overall ASA by up to 25%
  • Enhance member engagement by 15%
  • Decrease average call handle time by 12%
  • Increase customer service advocate experience by 20%
  • Enhanced reporting for invoice reconciliation