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We are asking affiliated providers who receive referrals from the IME to complete this Provider Satisfaction Survey. The purpose of the survey is to provide DMHAS and the IME with information that [A1] can be used to help  assess and improve the provider experience of the IME . We are requesting that each provider complete one survey at each service site. Your feedback is very much appreciated.

Your responses are anonymous and will be used for program evaluation purposes only.  To collect the most accurate information, we request that the staff person who works most often with the IME complete the questionnaire.

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* 1. Do you know how to contact the Interim Managing Entity  (IME)?

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* 2. What level of care does your facility provide at this site? You can select multiple levels of care.

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* 3. In what county does your facility operate at this site 

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* 4. Accuracy of client information included in referral from the IME 

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* 5. IME representative is able to answer my questions

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* 6. IME representative responds to my needs or concerns in a timely manner

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* 7. My call was answered in a timely manner

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* 8. Courteousness and professionalism of care coordinators/IME provider representatives

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* 9. Overall satisfaction with IME provider representatives

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* 10. The IME Prior Authorization Process is timely

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* 11. I receive similar clinical feedback on my requests from multiple IME reviewers

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* 12. The IME Prior-Authorization (PA) process is easy to understand and navigate

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* 13. The IME helps me resolve problems related to obtaining a prior authorization

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* 14. I know who to contact for specific concerns, such as technical issues or issues related to billing

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* 15. When the PA request is on Hold for More information, the process is timely

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* 16. IME reviewers have good clinical knowledge

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* 17. Has the IME ever denied or modified denied a prior authorization request from you site? Is yes, please complete the following

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* 18. After denying a level of care PA request, the IME offered to assist our agency to find another level of care for the client Strongly disagree

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* 19. I understand the IME reconsideration and/or appeal process

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* 20. I have used the IME reconsideration process

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* 21. I have used the IME appeals process

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* 22. Clarity of communication materials from the Division of Mental Health and Addiction Services (DMHAS)

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* 23. Usefulness of communication materials from the Division of Mental Health and Addiction Services (DMHAS)

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* 24. Timely communication of changes in policies/ procedures from DMHAS

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* 25. Usefulness of procedural IME-related information available on the DHS website

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* 26. Between July 1st, 2015 and today, has your census increased?

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* 27. Overall, what impact do you feel the IME has had on your office’s practice?

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* 28. Do you have any additional comments you wish to share about the IME?

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* 29. Thank you!

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