Aetna Better Health of Florida OB/GYN Survey

Survey

Aetna Better Health would like to obtain more information regarding our obstetrician (OB) physician network to improve services for mothers and infants.

Please take a moment to respond to this 2 minute survey.

Question Title

* 1. Group Information (all fields are required)

Group Practice Name

Group TIN

Group NPI

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* 2. Practitioner Information (all fields are required)

Practitioner Name
(Last, First)

Practitioner Title

Practitioner NPI

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* 3. Submitter Information

First and Last Name

Title

Phone

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* 4. Does your practice provide Telemedicine/Telehealth services?

Yes

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* 5. Is the Practitioner a buprenorphine waivered practitioner from SAMHSA?

Yes

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* 6. Is the Practitioner a Black or African American woman?

Yes

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* 7. Is the Practitioner a Hispanic or Latino woman?

Yes

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* 8. Does the Practitioner fluently speak English and Spanish?

Yes