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No Need to Fear Secret Shoppers

Time and again we hear it from agents considering doing sales meetings or other community events — “But what if a secret shopper comes?” While the concern is completely understandable given the potential ramifications of a CMS complaint, it’s also probably based more in fear than in reality.

Secret shoppers don’t find anything wrong the vast majority of the time – In 2014, 85.5% of the events that were secret shopped by CMS were found to be totally compliant. 85.5%! Do you have faith that you’re better than the bottom 14.5% of agents out there? We bet you do. If more than 85% of events can be pulled off with no compliance issues, so can yours.

They really don’t try to trap you – Secret shoppers may ask you a lot of questions, and they may be specifically asking questions related to areas of concern for CMS, but they won’t go out of their way to ask you the most obscure question possible and trick you into giving the wrong answer. Answer questions compliantly and be honest if you’re not sure of something.

There are example checklists you can look at – Every CMS secret shopper fills out the same survey and is looking for the same things. While CMS doesn’t make the most current one available to the public, you can click here to look at a sample from a prior year. If you know what they’re looking for, you know what you have to do.

Most deficiencies found were for easily avoidable infractions – In 2014, CMS secret shoppers found 305 deficiencies at the events they surveyed. Sixty-nine were for failing to provide and go over star ratings, and 67 were for failing to make available required information like the Summary of Benefits or provider directory when providing an enrollment form. These are easily prevented by making sure you have the necessary materials and that you go over the information required.

If you take a little time and some care, you can put together an informative, compliant event to help grow your business, without fear of a secret shopper lurking around every corner.

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