|
E-mail this page to a friend!
Medicare Giving Wrong Answers Says GAO Report
Most of the test calls made much earlier this year
Dec. 12, 2004 Last week the Government
Accountability Office released a report saying 29 percent of their
callers to the Medicare help line were given inaccurate answers and 10
percent got no answer at all. The calls, however, were primarily made
months earlier, before Medicare made efforts to improve the responses
and provide more information online and with local help.
In early December Medicare announced the
establishment of a new online enrollment center to help Medicare
beneficiaries enroll in the discount card program, aimed at reducing the
number of phone calls to 1-800-MEDICARE. In September, they had awarded
grants of $3.95 million to 700 organizations to assist with local
enrollment.
The report from GAO is entitled Medicare: Accuracy
of Responses from the 1-800-MEDICARE Help Line Should Be Improved. Most
of the calls were made prior to August.
The 1-800-MEDICARE help line provided accurate
answers to 61 percent of the 420 calls we made and inaccurate answers to
29 percent. We were not able to obtain any answers for the remaining 10
percent of our calls at the time we placed them, the report states.
Most of these calls were not answered because they were transferred to
other contractors responsible for processing Medicare claims that were
not open for business at the time we called or these calls were
inadvertently disconnected.
The training for CSRs meets CMSs requirements,
but it is not sufficient to ensure that CSRs are able to answer
questions accurately on the help line, reported the GAO.
Before handling calls, CSRs must complete about 2
weeks of classroom training; accurately answer two simulated calls
consecutively out of six; and score at least 90 percent on a written
exam.
In addition, all CSRs receive ongoing training.
However, the results from our calls indicate that the testing and
simulated call answering did not sufficiently measure whether
The GAO recommended that CMS (1) revise procedures
so that calls are not transferred to other contractors that are closed,
(2) assess current scripts and pretest new and revised scripts to ensure
that they are understandable, (3) provide more testing of CSRs ability
to accurately answer questions and use the results to target training
efforts as needed, and (4) monitor the accuracy rate for each frequently
asked question and use the results to modify scripts or provide
training, if necessary.
They also noted, CMS agreed with the
recommendations.
In March 1999, the Centers for Medicare & Medicaid
Services (CMS) implemented the telephone help line--1-800-MEDICARE--to
provide information about program eligibility, enrollment, and benefits.
The Medicare Prescription Drug, Improvement, and Modernization Act of
2003 (MMA) directed GAO to examine several issues related to this
24-hour help line and the customer service representatives (CSRs) who
staff it. In this report, GAO evaluated (1) the accuracy of the
information the help line provides, (2) the training given to CSRs, and
(3) CMS's efforts to monitor the accuracy of information provided
through the help line.
For more about the report
Click Here
For a pdf copy of the report
Click Here
Click to More Senior News on the
Front Page
Copyright: SeniorJournal.com |
