In 2020, a Chicago private health insurer fell under scrutiny after numerous safety concerns arose during open enrollment. The Centers for Medicare & Medicaid Services (CMS) determined that the insurer had threatened their patients’ health and safety with widespread system failures as well as sharing false information with prospective members. The CMS prohibited this insurer from enrolling new members and continuing their marketing. This is just one of many examples of what can go wrong when you provide inaccurate information to patients.

 

It is essential that Medicare Advantage companies ensure that their translated documents are accurate and in compliance with CMS regulations. The best way to do this is to select a translation vendor that completely understands the CMS regulations and practices effective risk management.

 

How to Stay in Compliance with Regulations/Deadlines

At CQ fluency, we know that our work won’t just need to pass your scrutiny, but it must adhere to standards set by authorities like the CMS. Of course, the sensitivity of the information requires the highest care. But, even with deadline pressure, some guidelines enable us to give excellent service. Here’s how we ensure we remain compliant with deadlines and regulations:

  1. CQ fluency assigns subject matter experts based on experience. This approach ensures that the person we give a task is qualified and has the resources to get the job done.
  2. Negotiate realistic deadlines and budgets: In the case of the Medicare Advantage Annual Enrollment Period (AEP), we have the deadline locked, so we can start working together more than a year in advance and help you with your outreach. By the time we get to October 15th, all the necessary materials will be ready.
  3. All work is proofread and double-checked: Even experienced translators make mistakes. The best way to manage human error is to have another set of eyes on the documents to ensure that the final text is 100% accurate.

At CQ fluency, we have a query management system set up to support our linguists. As a result, they can promptly flag and escalate translatability issues, improving their output.

How Do We Manage Risk?

We carry out annual internal audits, and bi-monthly SIPOC audits to assess our risks. Regular analysis of any gaps helps us to improve our process proactively. We are also ISO 9001 and 17100 quality systems certified and work hard to maintain that status. These certifications provide us with a systematic approach to organizational processes so that services consistently satisfy customers’ expectations. They also set requirements for translator qualifications, project management, technology resources, quality checks and customer satisfaction.

 

AEP Translations

Although the time allotted for health plan changes is set, it is easy to get overwhelmed when the time comes. We are scalable and anticipate the increased workload to ensure we allocate sufficient resources to help you meet that deadline.

Your clients need to be well informed before committing to a health plan for the year. They need to understand the changes to their network coverage, benefits, and prescription drug coverage. In addition, the deductibles need to be free of ambiguity.

Before commencing on the project, we can evaluate your plan and work with you to improve your processes. This approach ensures that the source documents are complete and available in good time., We provide alternative formats and accessibility services to maximize coverage.

We are experts in health insurance translation and have streamlined our AEP translation services to give you the best value for your money. If you have any questions or would like to get a quote for this or any of our services, contact us today. We’d love to hear from you.