CMS Changes Outbound Enrollment Verification Calls!

I am sure that most of you have had recent notifications from carriers that CMS has changed their guidance for the Outbound Enrollment Verification (OEV) calls that newly enrolled Medicare Advantage plan members receive shortly after they submit an application.

CMS no longer requires insurance carriers to make telephonic contacts with the applicant to verify enrollment. As an option, insurers can accomplish this goal with a letter providing the same information that the OEV calls would provide.

Starting this AEP, carriers have the option to send a letter only and not conduct a phone call for the OEV process. A few carriers such as United Healthcare and Cigna-HealthSpring have indicated that they will no longer be making these OEV calls, and will start sending letters. Other carriers such as Regence BlueShield, Group Health, and SoundPath Health have not come to a complete decision, but have indicated they will most likely adopt the letter version for these OEV communications. Premera Blue Cross has indicated much success with their OEV calls to members. However they have decided to adapt to the letter version of the OEV call but will continue to place a phone call to new members. This call is not intended to serve the function of the OEV call, but to start the member off with a positive experience by welcoming them and helping them with any transition needs they may have.