Medicare
Stop Sampling. Audit Every Medicare Call.
Calladhere is AI call auditing software for Medicare agencies and call centers. It checks 100% of your recorded sales calls against CMS rules and your own scorecard, for a fraction of the cost of manual QA.
TPMO Disclaimer
Scope of Appointment
Recorded-Line Notice
Plan Benefit Accuracy
Enrollment Verification
Permission to Contact
The Problem
Where Medicare Sales Compliance Breaks Down
What we hear from Medicare agency owners and compliance officers before they switch. Selling ACA plans too? See ACA call compliance.
Most Calls Go Unheard
Sampling covers 10 to 20% of calls. The rest go unheard until a complaint.
No QA in Place at All
Many agencies have no call auditing at all, and nothing to show a carrier when asked.
Feedback Comes Too Late
Agents hear about a miss weeks later, after repeating it on dozens of calls.
Manual QA Doesn’t Scale
Every new agent means more hours of listening. Coverage shrinks as your floor grows.
One Bad Call, Big Fallout
Complaints and CMS findings can cost an agency its carrier appointments and its ability to sell.
Commissions on the Line
Carriers can cut what they pay per deal over compliance issues, or end your contract outright.
Results
From a Floor of Reviewers to Three People
One agency had a floor of agents listening to 15 to 20% of its sales calls. Today three compliance agents cover every call across 3,000 to 5,000 deals a week, for about 64% less.
Call Auditing
Every Medicare call, scored against CMS rules
Manual QA means reviewers listening in real time to a fraction of your calls. Calladhere audits every recorded sales call against your Medicare scorecard, so nothing depends on sampling.
TPMO disclaimer checked before benefits are discussed
Scope of Appointment and plan discussion limits
Plan details checked against the enrolled policy
Violation Review
Fix violations before a carrier finds them
On a sampled floor, a skipped TPMO disclaimer or an out-of-scope plan discussion can go unnoticed until a complaint. With Calladhere, every flag lands in a review queue with the transcript moment and the AI’s reasoning, and the agent gets a clear next step.
Jump to the exact moment in the recording
Corrective actions your team defines
Agent acknowledgment on every violation
Agent Performance
Coach the misses that create CMS risk
Without data, coaching is guesswork and low performers fly under the radar. See scores and repeat misses for every agent, so managers coach the behaviors that put contracts at risk.
Scores by agent, team, and question
Repeat misses like a skipped disclaimer
Manager views scoped to their own agents
Reporting
Ready when a carrier audit lands
When a carrier asks for proof, most agencies dig through recordings and notes. Calladhere shows every call was reviewed, every violation handled, and every agent coached, with exports ready for review.
Live compliance and violation dashboards
Filter by agent, team, carrier, or plan type
One-click exports for carrier audits
The Difference
Manual Medicare QA vs. Calladhere
What changes when every call is audited automatically.
FAQ
What is a TPMO in Medicare sales?
A third-party marketing organization (TPMO) is any organization or individual, including independent agents and brokers, paid to do lead generation, marketing, sales, or enrollment for Medicare Advantage plans. CMS defines the term in 42 CFR 422.2260, and plans must oversee their TPMOs, including how sales calls are recorded and which disclaimers are read.
When must the TPMO disclaimer be read, and what does it say?
Under the CY2027 marketing rules that apply from October 1, 2026, a TPMO that sells plans for more than one Medicare Advantage organization must read the disclaimer on sales calls before any benefits are discussed. Earlier rules required it within the first minute of the call. It states how many organizations and products the agent represents and points callers to Medicare.gov or 1-800-MEDICARE.
What does CMS require for a Scope of Appointment?
Before a personal marketing appointment, the agent must agree on and record a Scope of Appointment (SOA) with the beneficiary, in writing for in-person meetings, and cannot market products outside that scope. As of the CY2027 marketing rules, CMS removed the 48-hour waiting period, so the appointment can happen any time after the SOA is completed.
How long must Medicare sales call recordings be kept?
CMS rules require plans to make sure their TPMOs record every marketing and sales call in full, including the audio of web-based calls. As of the CY2027 marketing rules, these recordings must be kept for at least 6 years, down from 10: audio for the first 3 years, then audio or complete, accurate transcripts for years 4 to 6. Enrollment records still fall under a 10-year rule.
How does Calladhere check these rules on every call?
Calladhere transcribes and audits 100% of your recorded Medicare sales calls against your own scorecard, with checks such as the TPMO disclaimer, Scope of Appointment, recorded-line notice, and plan benefit accuracy. Each flag lands in a review queue with the transcript moment and the AI’s reasoning, so QA can confirm or overturn it.
Can I customize the Medicare scorecard?
Yes. You can build custom question sets per carrier and plan type, and set a severity tier and leniency for each question. Prompt Sync turns QA feedback into sharper scorecards over time, and on Max audits a second AI model re-checks every question, so your QA team spends its time on real issues.
How many QA reviewers do I need if AI audits every call?
Far fewer than with sampling. One agency had a floor of reviewers listening to 15 to 20% of its sales calls. With Calladhere, three compliance agents now cover every call across 3,000 to 5,000 deals a week, for about 64% less than manual QA. AI audits each call, and the team reviews only the flags.
Ready to Audit
Every Medicare Call?
See how Calladhere can transform your
compliance workflow in a single demo.