Call Center Monitoring — Star Rating Measure Tips for Success

November 29, 2022

Call Center Monitoring is one of your first Star Rating measures of the new contract year. Starting in February 2023, CMS will measure interpreter and TTY availability as a metric for the CY24 Star Ratings. Monitoring calls will be placed on your prospective enrollee call center phone lines. These calls will measure interpreter availability, TTY functionality, and accuracy of plan information. The accuracy of information is not included in the Star Ratings.

There are two measures in the Star Ratings:

C28 – Call Center – Foreign Language Interpreter and TTY Availability, and
D01 – Call Center – Foreign Language Interpreter and TTY Availability

The higher the rate of access, the better the score. These measures have a weight of 4 for Measures Capturing Access, so effort should be made to ensure that interpreters are readily available, and your TTY system is functioning correctly. CMS describes access measures as those processes and issues that could create barriers to receiving needed care. CMS assigns the highest weight to the improvement measures, followed by patient experience/complaints and access measures, then outcome and intermediate outcome measures, and finally, process measures.

The Star Rating measure is the percent of time that TTY services and foreign language interpretation were available when needed by people who called the health plan’s prospective enrollee customer-service phone line. This is calculated as the number of completed contacts with the interpreter and TTY, divided by the number of attempted contacts. A completed contact with an interpreter, is defined as establishing contact with an interpreter and confirming that the customer service representative can answer questions about the plan’s Medicare Part C/Part D benefit within eight minutes. Completed TTY contact is defined as establishing contact with and confirming that the customer service representative can answer questions about the plan’s Medicare Part C/Part D benefit within seven minutes.

Tips for Call Center Monitoring Success

Provide basic services and information to individuals with disabilities upon request.
Make all plan materials and information available in alternate formats (e.g., braille, large print, audio, and data CDs, and in requested alternate languages), upon request.
Monitor your interpreter phone line for responsiveness and access.
Test your TTY line to ensure calls can be received and responses provided.
Train representatives to respond to the opening question of “Are you the right person to answer questions about….” with “Yes” or offer a warm transfer to the correct department.

Separately, CMS also monitors hold time and disconnect rate. Quarterly reports are posted in HPMS. This monitoring measures current enrollee call center performance, Monday – Friday, 8 AM – 8 PM, and pharmacy technical help desk call center performance Monday – Friday, 24 hours a day.

Tips for Call Center Monitoring Success

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