Palmetto GBA Provider Experience Survey

Welcome!

We’re committed to providing you the highest level of customer service and desired experience. Your feedback helps us continue to improve the Provider Experience we deliver to you and across our Provider Community. When contact information is provided, we respond directly to your issues, concerns or comments.

This short survey can be completed in 5 minutes – Thank you for taking this survey!

Question Title

1. Please tell us your Provider type:

Clinical / Group Practice

Physician

Non-Physician Practitioner

Institutional Provider

Home Health

Hospice

Other (please specify)

Question Title

2. What Palmetto GBA Contract are you under?

Jurisdiction J ( Alabama, Georgia or Tennessee)

Jurisdiction M ( North Carolina, South Carolina Virginia, West Virginia or the 16 Home Health and Hospice states)

RRB Specialty MAC (Railroad Medicare)

Question Title

3. What was your most recent interaction with Palmetto GBA? Please select one, or all that apply

Claims Processing

Provider Enrollment

Redeterminations (Appeals)

Medical Reviews

Internet Self Service Portal

EDI

IVR

Provider Outreach & Education

Other (please specify)

Question Title

4. How did you contact us?

Telephone

Chat

Mail

Social Media - (Facebook, Twitter, LinkedIn)

Other (please specify)

Question Title

5. Overall, how satisfied are you with the recent service we provided?

Extremely Satisfied

Somewhat Satisfied

Neutral

Somewhat Dissatisfied

Extremely Dissatisfied

Question Title

6. Please tell us about your most recent experience. Please score all, or any areas where you wish to provide feedback

	Strongly Agree	Somewhat Agree	Neutral	Somewhat Disagree	Strongly Disagree
Ease of Access / Availability I got through with minimal effort and wait	Ease of Access / Availability I got through with minimal effort and wait Strongly Agree	Ease of Access / Availability I got through with minimal effort and wait Somewhat Agree	Ease of Access / Availability I got through with minimal effort and wait Neutral	Ease of Access / Availability I got through with minimal effort and wait Somewhat Disagree	Ease of Access / Availability I got through with minimal effort and wait Strongly Disagree
Customer Service I received courteous and friendly service	Customer Service I received courteous and friendly service Strongly Agree	Customer Service I received courteous and friendly service Somewhat Agree	Customer Service I received courteous and friendly service Neutral	Customer Service I received courteous and friendly service Somewhat Disagree	Customer Service I received courteous and friendly service Strongly Disagree
Knowledge & Support My inquiry or issue was fully understood - I received a complete, accurate response	Knowledge & Support My inquiry or issue was fully understood - I received a complete, accurate response Strongly Agree	Knowledge & Support My inquiry or issue was fully understood - I received a complete, accurate response Somewhat Agree	Knowledge & Support My inquiry or issue was fully understood - I received a complete, accurate response Neutral	Knowledge & Support My inquiry or issue was fully understood - I received a complete, accurate response Somewhat Disagree	Knowledge & Support My inquiry or issue was fully understood - I received a complete, accurate response Strongly Disagree
Explained Next Steps My additional needs were anticipated and next steps were explained to me	Explained Next Steps My additional needs were anticipated and next steps were explained to me Strongly Agree	Explained Next Steps My additional needs were anticipated and next steps were explained to me Somewhat Agree	Explained Next Steps My additional needs were anticipated and next steps were explained to me Neutral	Explained Next Steps My additional needs were anticipated and next steps were explained to me Somewhat Disagree	Explained Next Steps My additional needs were anticipated and next steps were explained to me Strongly Disagree
Issue Resolution My question, issue or problem was resolved during this contact	Issue Resolution My question, issue or problem was resolved during this contact Strongly Agree	Issue Resolution My question, issue or problem was resolved during this contact Somewhat Agree	Issue Resolution My question, issue or problem was resolved during this contact Neutral	Issue Resolution My question, issue or problem was resolved during this contact Somewhat Disagree	Issue Resolution My question, issue or problem was resolved during this contact Strongly Disagree

How can we improve your experience?

Question Title

7. To better assist you, please provide information related to this inquiry

CSA Name

And / Or Call Reference Number

Question Title

8. When you provide contact information, we respond directly to your issues, concerns or comments. If you would like us to contact you, please provide your contact information below:

Name

Facility Practice Name / Organization

NPI

Phone Number

Email Address