It’s that time of year again when The Centers for Medicare & Medicaid Services (CMS) begin placing test calls to audit health plan call centers. These calls are to ensure that Medicare Advantage (MA) and Medicare Prescription Drug plans (part C and D) offer clear communication quickly and accurately to its beneficiaries. 

What does this mean? 

There are two parts to this process. First is the Timeliness Study, which focuses on average hold times and disconnect rates. Over a four-week period, each organization is expected to maintain an average hold time of two minutes or less and an average disconnect rate of five percent or less. 

The second part is where your language service provider (LSP) plays a vital role – the Accuracy & Accessibility Study. This measures Part C and Part D prospective beneficiary call center telephone lines to determine interpreter availability for Limited English Proficient (LEP) callers, teletypewriter (TTY) efficiency, and the accuracy with which customer service representatives (CSR) convey plan information to their LEP consumer. This study runs from February through June and requires intense preparation and partnership with an experienced LSP.  

Questions to Ask:

• Does your LSP have a plan in place for CMS Testing? 
• What type of experience does your LSP have with CMS Test Call Season? 
• Does your LSP have qualified interpreters available in all the testing languages? 
• Does Your LSP have a dedicated team devoted to CMS testing season? Do you have a coordinated plan at your call center to surpass CMS Testing expectations? 

For many years, Language Services Associates (LSA) has been coordinating, planning, and establishing the best practices to meet CMS requirements and exceed expectations. Our team has grown considerably, researching, monitoring, and focusing our efforts on every detail. We have the tools you need for a successful CMS test call season, and we’re happy to put these tools to work for your call center. Partnering with LSA allows you to reap the benefits of an experienced LSP that offers creative solutions to unanticipated roadblocks during CMS test call season and beyond. 

How the Accuracy & Accessibility Study is Rated 

Once a CSR answers a call, it’s considered connected. At that point, the CSR has eight minutes to answer questions about plan benefits with the assistance of an interpreter. After this, a CSR must answer three general Medicare or plan-specific accuracy questions. If a caller *cannot communicate with a CSR via an interpreter, CMS labels the CSR “unavailable.” Failure to meet expectations can result in a lower star rating leading to lesser to no Quality Bonus Payments (QBP) – more on these later. 

“LSA is ready and prepared for the influx of CMS test calls that require strategic planning, focused training, and a close partnership with our clients and interpreters. Each year we formulate a plan tailored to each of our clients’ needs to ensure the highest quality outcomes, and another successful testing season. Our experience and dedicated team have allowed us to consistently go above and beyond expectations and offer the best results.”  – Jodi Bralow (Director of Contract Compliance at Language Services Associates)  

How Language Services Associates Will Help You Increase Your CMS Star Rating 

Language Services Associates has a robust program in place to seamlessly navigate CMS test call season, with an impressive track record to back it up. Our clients have a history of either maintaining or improving their star status by partnering with us, and they continue taking advantage of our unique approach each year. We’ll have your CMS calls answered in record time with an experienced interpreter fully prepared for CMS questions. 

We have a dedicated team devoted to CMS testing with the tools to offer guidance and support to attain a higher score and improve overall communication quality with LEP beneficiaries. Our staff is constantly monitoring, growing, planning, and keeping up to date with any changes or updates to CMS star rating protocols year-round. 

Our highly qualified interpreters, who’ve completed rigorous assessments, are prepped and provided with additional resources for CMS testing season. These interpreters understand the significance of these calls and are more than proficient in the terminology and nuances required to succeed. 

Careful coordination, open communication, and experience are key factors when choosing an LSP to partner with during CMS test call season. LSA expertly delivers on all three and invites you to contact us to determine the best course of action in attaining the highest star rating possible. 

How Does This Affect Your Organization?

• CMS Star Ratings 
• QBPs: Quality Bonus Payments 
• MA Rebates 
• Health Plan Reputation 

CMS ratings are done on a scale of one to five stars, with one being below average and five indicating a plan that truly excels. These results are available to the public during open enrollment as a guide to determine the best plan for beneficiaries to choose from.  

These results also determine the Quality Bonus Payments and MA rebate a plan will receive. Established in 2012, as part of the Affordable Care Act as an incentive to improve quality standards, QBPs and MA rebates are based on these CMS star ratings – the higher rating a plan receives the more funding they’re awarded. 

 

Languages to be Tested in 2023 

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

Contact Jodi Bralow (Director of Contract Compliance) JBralow@LSAweb.com to learn more about how LSA’s CMS Test Season process will help you reach your goals. 

About LSA 

Language Services Associates (LSA) offers a full suite of language interpretation solutions to help optimize the experience of limited English proficient customers and patients. Providing native language support improves the efficiency and productivity of staff, raises customer satisfaction levels, and builds loyalty. For more than 2,000 clients worldwide, in more than 230 languages, LSA provides a competitive differentiator in the healthcare, government, financial and banking, insurance, entertainment, hospitality, and manufacturing industries.