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NOT ALL LEADS ARE GENERATED EQUAL Companies specializing in lead generation work hard to evaluate how well sources perform for different businesses and in various channels. Constant testing and analyses are necessary for lead optimization. Furthermore, consumers should know what to expect when they provide their information in a lead form. Transparency ensures prospects aren’t wondering why an agent is calling. There are also rules about how leads are generated for AEP. CMS prohibits: Additionally, CMS requires a record of a consumer’s agreement to speak with an agent during AEP. DIALING FOR CUSTOMERS Working leads usually means making a lot of phone calls. Robert Bache, founder and chief of sales for Senior Healthcare Direct, recommends calling every lead 12 times within the first four days of receiving it. However, agents need to remember that “If you have a lead and you call it four times but don’t call it again, don’t say that lead wasn’t any good,” Robert says. “You didn’t work it appropriately.” Robert also suggests leaving a voicemail message daily. He likes to use what he calls the “double tap” strategy. This is when a lead is called and then called again within five minutes. He explained that when people get a call from an unfamiliar number, they let SET YOURSELF UP FOR SUCCESS During the critical opening moments of contact, agents must take control of the conversation so it moves forward to the presumed closing. Avoid time-wasting, open-ended introductory questions like: Instead, assume the customer is short on time and needs solutions, and the agent is there to provide them. Of course, an agent needs to warmly build rapport, but it is more important to quickly demonstrate value. Rapport can still come later as the process continues. As you wrap your introduction, consider asking about the customer’s current coverage to dive into why you’re there. OUTBOUND SALES CALLS BASICS When you have a potential client on the line, consider these five steps to guide the discussion: Leads are the lifeblood for health care and financial sales professionals. Using these proven strategies will solidify agents’ relationships with their customers and create an efficient and rewarding experience for all parties.
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Like most good things, strong leads don’t simply come from nowhere — they have to be developed. And unless they are managed effectively, even the best leads can be difficult to close.
What are the New CMS Requirements?
The CMS Final Rule 2023 was announced in May 2022 and requires all Medicare and Medicaid marketing calls to be recorded and stored for at least 10 years.
Call Recording Requirements
The language is important here as CMS has confirmed it interprets “enrollment” as “marketing.” The call recording requirement applies to all healthcare agents who enroll beneficiaries in new plans. Healthcare agents and brokers will be required to record all “marketing” calls with beneficiaries in their entirety, including the enrollment process. This rule applies to both new and existing clients. The call recordings must then be stored in a HIPAA compliant manner for at least 10 years.
CMS considers a “marketing” call anything that falls under the “Chain of Enrollment,” which is defined as any events from the point when a beneficiary is made aware of an MA/PDP plan to the end of the enrollment process.
Some examples of what the new recording rules cover include:
- Contacting potential clients
- Scheduling appointments for new and current clients
- Collecting drug and provider lists
- Hosting informational meetings
- Enrolling clients by phone
Disclaimer
All agents will also be required to include the following disclaimer:
“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 your options.”
The disclaimer must be included in the following places:
- Verbally expressed within the first minute of a sales phone call
- Electronically conveyed when communicating with a beneficiary through email, online chat, or other electronic means
- Prominently displayed on the agent’s or broker’s website
- Included in all marketing materials, including print collateral (12-point font)
and television advertisements
Additionally, the following requirements must be included in all call recordings and appointment forms:
- Date of appointment
- Beneficiary and agent contact information
- Product types to be discussed
CMS has stated that there is no obligation to re-enroll current Medicare participants and their enrollment status will not be affected. Automatic enrollment will also not occur. That said, a new Scope of Appointment (SOA) is required if the beneficiary requests information about a plan not previously discussed.
NOTE: CMS has not laid out a compliance verification or auditing plan for the Final Rule 2023 changes.
How to Achieve Compliance
Ensuring agents can meet these new CMS requirements by October 1, 2022, comes down to two primary factors: technology and training.
PSM and YourMedicare have launched the Telephony system to agents nationwide. This new system gives agents the ability to make and receive calls through the YourMedicare SunFire platform. The system assigns agents a virtual phone number with a customizable area code, making the number more familiar for their clients.
Let’s address the new disclaimer CMS requires agents to state during the first minute of each call. With the YourMedicare SunFire platform, each call starts with a recording of the disclaimer, so there’s absolutely no need to worry about it.
Now is a great time to make sure you have access to SunFire's enrollment platform and have a solution in place to remain compliant.
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Guide: > Download the PDF Guide here |
