The Government Accountability Office has said that just 4
percent of the 300 test calls it made to 34 Medicare call
centers were correct or complete, a deterioration of
performance over 2002 when it found that 85 percent of the
responses it received regarding calls it placed to Centers
for Medicare and Medicaid Services were inaccurate or
incomplete.
It said the call centers — operated by Medicare carriers —
need to improve communications with providers that deliver
medical care to beneficiaries.
GAO also found that the centers primary oversight tools do
not ensure accurate communication. It said it asked four
policy questions 75 times each to carrier call centers and
that the rate of correct and complete responses for
individual billing questions languished around 1 to 5 percent.
Fragmented information sources, confusing policy information
and difficulties in retaining the same representative
throughout the query, partially account for the lack of
accuracy, according to GAO-04-669.
It recommended more frequent testing and that CMS consider
adopting an industry practice of routing calls to
representatives who are better able to handle particular cases.
