Outbound Enrollment Verification (OEV) – To call or not to call?
With the release of the 2015 Marketing Guidelines, CMS made a few key updates to the Outbound Enrollment Verification (OEV) Process. One of the most significant updates is that CMS now allows organizations to complete the OEV process via direct mail or email (if the beneficiary opted-in for email). This change actually provides significant opportunity for organizations. The way we see it, organizations will now need to choose one of two paths. The first path is to continue using outbound telephone calls to fulfill the CMS requirement. If your organization has developed and implemented an effective OEV process, by all means continue with this process. However, if you’re thinking “why would we continue the current process when our OEV process has been riddled with issues of non-compliance?” Well, we agree.
If your organization has seen significant and ongoing issues with the OEV process, this is your opportunity to change that by fulfilling the requirement via another mechanism. However, if you do choose this path, it is critical that your organization develop a top notch welcome call for those new members who would have previously received the OEV call. This first touch is key in terms of identifying any possible gaps in the member’s understanding of plan benefits and rules, identifying any issues of sales misconduct, as well as ensuring that your member retention program gets off on the right foot. Remember, it is always better (and less expensive) to retain a member than to obtain a member!
Please note: In CMS’ memo titled “Clarification of Medicare Marketing Guidelines and Additional Agent/Broker Compensation Guidance” that was released on August 13, 2014, CMS revises current guidance language to clarify that the OEV process applies exclusively to enrollments in which employed, captive or independent agents/brokers were involved.
Resources
On July 23, GHG leadership spoke about what provisions in the final guidelines will have the greatest impact on your organization and how plan sponsors can prepare for the upcoming changes. Download the recording >>
On September 10, join John Gorman, GHG’s Founder and Executive Chairman for an exploration of why assessing your current position and developing new strategies to drive profitable market share growth is crucial for continued success. Register now >>
On September 12, join us for GHG’s perspective on trends relating to CMPs, the CMS audit findings and oversight activities that have taken place in the last six to 12 months, as well as tips on how to avoid and remediate CMS findings.” Register today >>