Communicating with CMS - Survey Results

April 22, 2015

Category: General

We all know CMS makes you work hard for your money. There are many contributing factors that make getting the payment you deserve extremely challenging. But what is the most painful part and why? We turned this question out to you. We received 125 responses and the results were very interesting!

When we asked what kind of communication was the most stressful, most respondents (53%) said Audits and requests for additional documentation (ADRs), but First Level Appeals came in second with 22%.

 

Our second meaty question asked, “What is the toughest part about communicating with CMS?” Understanding the Requirements was the most popular choice at 34% of the answers. A total of 33% were challenged by the actual process, between finding the proper documentation, handling the logistics of submission, and meeting tight deadlines.

What was most surprising to us was the high number of respondents who selected “Other” for questions number one and two (15% and 23% respectively). The vast majority of those who went outside of the preset options indicated that the most challenging part of dealing with CMS was their customer service. Several people noted that there can be confusing inconsistencies between CMS employees as well as changes to requirements or interpretation of policies without notification.

Here are some representative responses we received to the request for more information upon selection of “Other”:

• “One person at CMS telling us one thing. Calling back the same day and talking to another person on staff only to be told something entirely different! Seriously?”
• “It is very difficult to get to a Level 2 for resolution to a denial.”
• “We mail documentation and then get messages back that the FAX did not come through completely.”
• “Dealing with people who don’t read what you send.”
• “The people we talk to ‘read between the lines’; or sometimes seem to make rules up!”
• “Lack of their own understanding between departments”

It sounds to us like CMS could use some best practices, proper documentation and a sound workflow system to assist with escalations!

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