Each year, the Centers for Medicare and Medicaid Services (CMS) conducts the Call Center Monitoring Study, evaluating Medicare Part C and D plans on their ability to provide effective communication, including language access.
The study directly impacts Star Ratings, which can influence federal funding and a plan’s marketability. Ensuring fast and seamless access to interpreters is crucial, as test calls assess both accessibility and accuracy.
LanguageLine has developed a 5-Step Methodology for 5-Star Success, designed to help Medicare plans optimize their performance in the CMS Call Center Monitoring Study. Our proven strategies have helped numerous plans achieve top-tier results, improving efficiency and reducing risks associated with compliance.
The 5-Step Methodology for 5-Star Success
Step 1: Dedicated CMS-Specific Line
A dedicated CMS-specific line ensures that test calls and real beneficiary calls are connected to the appropriate language services as quickly as possible.
By collaborating with us, your organization can establish a dedicated toll-free number that directs calls seamlessly to a LanguageLine Certified Interpreter. This specialized routing eliminates unnecessary delays, ensures compliance with CMS requirements, and enhances the overall caller experience.
A streamlined, well-managed call flow can significantly improve Star Ratings by ensuring accessibility within the required time frames.
Step 2: CMS Call Tree (IVR in Tested Languages + “All Other Languages” Option)
An optimized Interactive Voice Response (IVR) system is critical for CMS compliance.
We can implement a CMS Call Tree that allows agents to quickly select the correct language, reducing misroutes and wait times. A properly configured IVR system also ensures that calls in Spanish, Mandarin, Cantonese, French, Vietnamese, and Tagalog—the tested CMS languages—are handled efficiently.
Additionally, having an “All Other Languages” option helps accommodate callers with different language needs. Plans that adopt this approach see reduced call-handling times and fewer errors, improving their accuracy and accessibility scores.
Step 3: Share Plan Job Aids with LanguageLine
For interpreters to provide the best service, they must be familiar with your plan’s terminology, benefits, and common inquiries. Sharing plan job aids, FAQs, prescription drug names, and benefit descriptions with LanguageLine ensures that interpreters are well-prepared to assist callers.
These resources are integrated into our training programs and quality assurance measures, helping interpreters deliver more accurate and efficient assistance.
By equipping interpreters with essential plan-specific knowledge, your organization enhances the caller experience and ensures compliance with CMS accuracy standards.
Step 4: Train, Train, Train!
Well-trained call center agents can make the difference between a low and high Star Rating. We offer proprietary CMS Call Center Agent Training designed to optimize performance in the CMS Call Center Monitoring Study. The training covers essential areas such as:
- CMS requirements and the Accuracy & Accessibility Study
- How to efficiently utilize LanguageLine services to minimize errors and delays
- Best practices for collaborating with interpreters
- Strategies for effective call management to reduce hold times
This training takes less than 30 minutes and is available remotely, making it easy to implement without disrupting daily operations. Agents who participate in this training are more confident in handling CMS test calls and real beneficiary interactions, leading to improved Star Ratings and overall service quality.
Step 5: Bi-Weekly “Touch Base” Meetings
Maintaining compliance and optimizing CMS performance requires ongoing evaluation and adjustments. We provide bi-weekly check-ins with your dedicated Account Executive to ensure continuous improvement. These meetings help in:
• Identifying areas for improvement based on recent test call performance
• Providing reporting and insights to enhance compliance strategies
• Resolving issues proactively before they impact Star Ratings
• Sharing best practices from other successful plans to refine call-handling procedures
Regular touch-base meetings keep your organization on track, ensuring that any challenges are addressed swiftly and that your call center remains compliant with CMS requirements.
Optimize Your CMS Strategy with LanguageLine
A strong Star Rating is not just a measure of service quality — it has direct financial implications. CMS awards bonus payments to plans with a 4-Star rating or higher, providing a 5% bonus in additional federal funding. In 2024, Medicare Advantage quality bonus payments amounted to $11.8 billion, underscoring the substantial value of maintaining a high rating.
LanguageLine’s support ensures that your plan is fully prepared for CMS test calls, maximizing your chances of achieving a 5-Star Rating and securing significant bonus payments.
We invite you to download our free e-Book today to learn more about our 5-Step Process, as well as other details on the perfect CMS strategy.