Compliance Call Recording

How to stay compliant with CMS rulings

| November 1, 2022
How to stay compliant with CMS rulings

Centers for Medicare and Medicaid Services (CMS) has announced new call recording requirements for Medicare calls effective October 1, 2022. This ruling mandates the recording of outbound and inbound calls, as well as the mandatory inclusion of specific verbal disclaimers. 

In the United States, all third-party marketing organizations (TPMOs) are subjected to this ruling. TPMOs are currently defined as: “organizations that are compensated to perform lead generation, marketing, sales, and enrollment related functions as a part of the chain of enrollment, that is the steps taken by a beneficiary from becoming aware of a Medicare plan or plans to making an enrollment decision. In addition, the proposed definition of TPMOs specifies that TPMOs may be first-tier, downstream or related entity (FDRs), as defined under 422.504(i) and 423.505(i), but TPMOs may also be other businesses which provide services to customers including an MA or Part D plan or an MA or Part D plan’s FDRs.”

On top of this, current and aspiring TPMOs should be well aware of the fact that call recordings should not only be kept for 10 years, but also for the entire lifespan of the policy it relates to. This equates to high data storage volumes and can be very costly.  

When it comes to call recording compliance, the above requirements are only scratching the surface, and organizations will do well to comply with them all. Regulatory compliance has become critical to business continuity, and failure to adhere is increasingly becoming more costly – as can be seen from the level of fines being handed out to even top-tier banks. 

Regulations are increasing 

While the CMS arena is not yet so heavily regulated, it is bound to happen sooner rather than later. This is because many international regulations and laws come into play whenever consumer data is handled. 

For example, the payment card industry data security standard (PCI DSS) is a global information security standard designed to reduce payment card fraud by increasing security controls around cardholder data. These regulations may seem worlds removed, but let’s bring it a little closer to home. 

The health insurance portability and accountability Act (HIPAA) is a federal law that regulates the disclosure and use of protected health information (PHI). While it is true that the US does not have a comprehensive data protection law at the federal level, the US continues to regulate data privacy through a mix of laws passed at the state and federal levels.

The point is this; we live in a digital age, and data protection laws are becoming the norm. It is no longer a question of whether a specific law will apply to your business, but when. It could be years, but it also could happen within mere months. So the question is, how does your business plan to protect itself and its customers when the inevitable happens?

The future-proof solution

There is no reason to fear the change that is bound to happen. Many industries have long since been coping with far more restrictive and firm regulations. Businesses that operate in the world’s most heavily regulated industries rely on digital solutions to protect their ever-increasing volumes of data. 

That’s where a solution like CallCabinet comes in. CallCabinet is the original, and continues to be the most comprehensive cloud-native compliance call recording, quality assurance automation and unlimited voice analytics solution available. 

Due to its cloud nature, it offers unlimited storage and integrates seamlessly with virtually all major unified communications (UC), IP-PBX and telephony platforms.  Whether your organization uses Microsoft Teams, Cisco or Zoom, CallCabinet ensures that every conversation stays compliant with every regulation. 

It’s a future-proof solution, meaning you never have to worry about updating your systems according to the latest regulatory change (and they do change more frequently than one might think). But the real genius of this platform goes far beyond call recording. 

The real value of call recording data

We mentioned the mandatory CMS disclaimer at the start of this article. More specifically, every call should include the following: “We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.”

Normally, adapting a new disclaimer will require staff training and many man-hours of scanning through recordings (should you have these recordings in place) to ensure that the disclaimer is indeed shared when it should be. Don’t forget that this part of quality assurance usually comes with some degree of human error, as there are often simply too many recordings to monitor daily.  

CallCabinet’s advanced recording package contains a conversation analytics feature that automatically scans every recording according to the criteria you want. This means that not only will you have real-time data on whether the disclaimer was included, but you’ll also have valuable business intelligence at your fingertips. 

Every call is actively monitored for what was said as well as how it was said, sentiment, emotional cues and so much more. You can even set it to listen for specific industry keywords and phrases, and all this data can easily be shared with your other systems such as CRMs. 

Of course, this would drastically improve your customer experience (CX) and your staff morale. CallCabinet makes it easier to do agent evaluation and training, which leads to higher retention rates and overall employee well-being. Not to mention the vast amounts of time and associated costs it will save you. 

It’s smart business

When regulations come knocking, it’s time to consider the future of your company. It’s time to consider CallCabinet.

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