Medicare Secret Shoppers

[Josh]

Here's a "Marketing Surveillance Summary Report" from CMS: http://www.cms.hhs.gov/ManagedCareMarketing/Downloads/Surveillance_Report_092309.pdf.

Has anyone had any run ins with these secret shoppers? I think there will be even more this season.

 

[AJAX]

Here's a "Marketing Surveillance Summary Report" from CMS: http://www.cms.hhs.gov/ManagedCareMarketing/Downloads/Surveillance_Report_092309.pdf.

Has anyone had any run ins with these secret shoppers? I think there will be even more this season.

I've been secret shopped. I think twice. But, definitely once. They are usually younger people, under 65. The one I had came in with her elderly mother.

I was conducting a seminar in OEP. The younger lady kept asking me about private/individual insurance. I politely explained that this seminar is about Medicare plans; I'm not here to talk about individual plans. To make a long story short, they try to trick you into non-compliance.

I wonder if they even know what is complaint, what can be said or not said. I often restate the CMS regulations, so they know either way. I don't want to be in a situation were I am misunderstood.

It's funny how the secret shoppers try to make you stumble. We definitely need to be on top of our game.
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For the record, I passed.

 

[Tom Highway]

I've been secret shopped. I think twice. But, definitely once. They are usually younger people, under 65. The one I had came in with her elderly mother.

I was conducting a seminar in OEP. The younger lady kept asking me about private/individual insurance. I politely explained that this seminar is about Medicare plans; I'm not here to talk about individual plans. To make a long story short, they try to trick you into non-compliance.

I wonder if they even know what is complaint, what can be said or not said. I often restate the CMS regulations, so they know either way. I don't want to be in a situation were I am misunderstood.

It's funny how the secret shoppers try to make you stumble. We definitely need to be on top of our game.
- - - - - - - - - - - - - - - - - -
For the record, I passed.

I think a sales event we did on Monday was secret shopped. I didn't personally give the talk at the event, but I was there as the licensed agent. As I pulled into the parking lot, a younger guy got out of his car, and I said good morning and went on in to the facility. At the door, I told them who i was and they showed me back to the room where we were doing the presentation, and the guy said that's what he was here for too.

He asked a couple of strange questions, and hung around outside talking on his cell phone. He took one of my cards and told me he'd definitely be "following up" but I haven't heard from him. His car had out of state license plates on it.

 

[policy doctor]

He asked a couple of strange questions, and hung around outside talking on his cell phone.

What kind of strange questions? Getting intrigued here.

 

[Tom Highway]

He asked a couple of strange questions, and hung around outside talking on his cell phone.

What kind of strange questions? Getting intrigued here.

Well, just questions that were not the typical things you'd get at an event. He was definitely not the demographic nor age of all the people at this event, and he didn't seem to know any of the other people. All of the rest of the people there seemed to know each other and seemed to hang around the center together regularly.

The questions were sort of off topic, and if not handled correctly, could trip up the person giving the talk, or let it go off course into some things we probably shouldn't get into.

 

[policy doctor]

Methinks you're hiding something 'cause you're not forthright on those questions, see.

 

[Tom Highway]

Methinks you're hiding something 'cause you're not forthright on those questions, see.

Not really, I just don't know for certain if he was a secret shopper or not, I just strongly suspect it at this point. He could have been somebody's son going there to try and learn about plans for a parent, and just had no knowledge of how medicare or MAPD works.

The things he asked could have been innocent (dare I say ignorant) questions with no intent, or they could have been asked to back the person doing the presentation into a corner. It could really go either way.

I'll let you know for sure, becuase if he was indeed a secret shopper, he'll have to file a report with CMS, which will have to be shared with the company, and then I'd find out about it. If and when I do, I'll put some of the more specific notes from it here.

How long do they usually take to notify plans of a secret shopper event?

 

[policy doctor]

How long do they usually take to notify plans of a secret shopper event?


I understand that is an ongoing job and why would they notify anybody if they are a SECRET SHOPPER ?

 

[retread]

FYI:

Secret Shopper report

 

[Josh]

How long do they usually take to notify plans of a secret shopper event?


I understand that is an ongoing job and why would they notify anybody if they are a SECRET SHOPPER ?

It's all over the place. They usually will only notify the plan if they did something wrong and it can be very difficult to pick out who the secret shopper was unless you were the one giving the presentation. Even at that, they mostly just recruit amateurs who have no idea what's going on which is why I've seen agents get written up for the most bogus things, it really has the feel of a good old fashioned witch hunt. Some of the secret shoppers feel like they're only doing their job if they're "getting dirt" on agents, so they'll make stuff up when it isn't there or try to make an issue out of something that isn't one.