APTA CO: Medicaid Provider Survey

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* 1. In what setting do you practice?

Private Practice

Hospital Based (Inpatient)

Hospital Based (Outpatient)

Extended Care / Skilled Nursing

Home Health

School

Other (please specify):

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* 2. How long have you been a Colorado Medicaid Provider?

More than 5 years

More than a year

Six months

One month

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* 3. If your practice has unpaid/suspended/denied Medicaid claims, approximately how much are you owed?

Less than $10,000

$10,000 to $30,000

$30,000 to $50,000

$50,000 to $70,000

Greater than $70,000

N/A - no Medicaid claims in arrears

Specific amount owed to you, if known:

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* 4. Have you requested interim (advance) payments from Medicaid?

Yes, and we received payments

Yes, but we did not receive payments

Unsure

Comments:

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* 5. Have unpaid claims impacted your patients (select all that apply)?

No impact/No Change

I have had to stop seeing new patients

I have had colleagues tell me they cannot take patients due to the unpaid claims problem

Other (please specify)

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* 6. If your practice has experienced cash-flow problems, how have these been addressed? (Select all that apply)

No significant cash-flow problems due to unpaid/suspended/delayed Medicaid claims

We have taken interim payments from Medicaid

We have taken out a private loan

We have reduced staff salaries or employer retirement contributions

Please feel free to elaborate or identify other ways you have handled cash-flow challenges

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* 7. Considering your recent experience with Colorado interchange, please rank the following in order of concern (1 = lowest concern; 5 = highest concern)

Provider enrollment / re-validation

Determining a patient’s eligibility

Prior Authorization Request (PAR) process

Billing / Claims

Reimbursement / Payment

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* 8. Please rank the following in order of which Colorado interchange resources you frequently use (1 = lowest concern; 5 = highest concern)

Website and Help Function

Documents (e.g. billing manuals, newsletters, bulletins, etc.)

Call Center Assistance

Provider Outreach Representatives

Other resources not listed

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* 9. How much time each week are you on the Colorado interchange portal and/or Call Center?

2 hours or less

4-6 hours

7-9 hours

10+ hours

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* 10. Please rank your level of satisfaction on the following aspects of the Colorado interchange?

	0 = Very dissatisfied	1 = Slightly dissatisfied	2 = Satisfied	3 = Fairly Satisfied	4 = Very Satisfied	5 = No opinion
Website navigation	Website navigation 0 = Very dissatisfied	Website navigation 1 = Slightly dissatisfied	Website navigation 2 = Satisfied	Website navigation 3 = Fairly Satisfied	Website navigation 4 = Very Satisfied	Website navigation 5 = No opinion
Call Center experiences	Call Center experiences 0 = Very dissatisfied	Call Center experiences 1 = Slightly dissatisfied	Call Center experiences 2 = Satisfied	Call Center experiences 3 = Fairly Satisfied	Call Center experiences 4 = Very Satisfied	Call Center experiences 5 = No opinion
Provider Enrollment / Re-validation	Provider Enrollment / Re-validation 0 = Very dissatisfied	Provider Enrollment / Re-validation 1 = Slightly dissatisfied	Provider Enrollment / Re-validation 2 = Satisfied	Provider Enrollment / Re-validation 3 = Fairly Satisfied	Provider Enrollment / Re-validation 4 = Very Satisfied	Provider Enrollment / Re-validation 5 = No opinion
Checking Eligibility	Checking Eligibility 0 = Very dissatisfied	Checking Eligibility 1 = Slightly dissatisfied	Checking Eligibility 2 = Satisfied	Checking Eligibility 3 = Fairly Satisfied	Checking Eligibility 4 = Very Satisfied	Checking Eligibility 5 = No opinion
Prior Authorization process	Prior Authorization process 0 = Very dissatisfied	Prior Authorization process 1 = Slightly dissatisfied	Prior Authorization process 2 = Satisfied	Prior Authorization process 3 = Fairly Satisfied	Prior Authorization process 4 = Very Satisfied	Prior Authorization process 5 = No opinion
Claim submission	Claim submission 0 = Very dissatisfied	Claim submission 1 = Slightly dissatisfied	Claim submission 2 = Satisfied	Claim submission 3 = Fairly Satisfied	Claim submission 4 = Very Satisfied	Claim submission 5 = No opinion
Checking Claim status	Checking Claim status 0 = Very dissatisfied	Checking Claim status 1 = Slightly dissatisfied	Checking Claim status 2 = Satisfied	Checking Claim status 3 = Fairly Satisfied	Checking Claim status 4 = Very Satisfied	Checking Claim status 5 = No opinion
Claims processing time	Claims processing time 0 = Very dissatisfied	Claims processing time 1 = Slightly dissatisfied	Claims processing time 2 = Satisfied	Claims processing time 3 = Fairly Satisfied	Claims processing time 4 = Very Satisfied	Claims processing time 5 = No opinion
Claims payment	Claims payment 0 = Very dissatisfied	Claims payment 1 = Slightly dissatisfied	Claims payment 2 = Satisfied	Claims payment 3 = Fairly Satisfied	Claims payment 4 = Very Satisfied	Claims payment 5 = No opinion
Claims payment accuracy	Claims payment accuracy 0 = Very dissatisfied	Claims payment accuracy 1 = Slightly dissatisfied	Claims payment accuracy 2 = Satisfied	Claims payment accuracy 3 = Fairly Satisfied	Claims payment accuracy 4 = Very Satisfied	Claims payment accuracy 5 = No opinion
Reasons provided for suspended or denied claims	Reasons provided for suspended or denied claims 0 = Very dissatisfied	Reasons provided for suspended or denied claims 1 = Slightly dissatisfied	Reasons provided for suspended or denied claims 2 = Satisfied	Reasons provided for suspended or denied claims 3 = Fairly Satisfied	Reasons provided for suspended or denied claims 4 = Very Satisfied	Reasons provided for suspended or denied claims 5 = No opinion

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* 11. Regarding claim payment accuracy, if you are receiving payment for PT evaluation code 97161, please tell us the amount being paid:

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* 12. Regarding claim payment accuracy, if you are receiving payment for PT evaluation code 97162 please tell us the amount being paid:

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* 13. Regarding claim payment accuracy, if you are receiving payment for PT evaluation code 97163 (formerly 97001) please tell us the amount being paid:

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* 14. Regarding claim payment accuracy, if you are receiving payment for PT re-evaluation code 97164 (formerly 97002) please tell us the amount being paid:

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* 15. Please feel free to share any other concerns, comments or questions

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* 16. Contact Info (Optional. For internal use only)

Name

Practice Type (Employed, Solo, Owner, FQHC)

City/Town

Email Address

Phone Number