ASGE UnitedHealthcare Advance Notification Program Survey Question Title * 1. What is your role with the practice or in the endoscopy unit? Medical Director Physician Nurse Manager Nurse Practice Manager Billing/Coding Other Question Title * 2. What is your site of service? [check all that apply] Hospital Ambulatory Surgery Center Office Question Title * 3. Do you have a contract with UnitedHealthcare (UHC)? Yes No Unsure Question Title * 4. Approximately what percentage of your commercially insured patient are covered by UHC? 0% 1-10% 11-20% 21-40% 41-60% 61-80% 81-100% Question Title * 5. Do you plan on closing your panel to UHC? Yes No Unsure Question Title * 6. Will you participate in UHC’s Advance Notification Program? Yes No Unsure Question Title * 7. Do you currently have enough information on UHC’s Advance Notification Program to make an informed decision on participation in the program? Yes No Unsure Question Title * 8. Do you have the staff in place or would you need to build a team to support participation in the UHC Advance Notification, assuming you would be participating? Yes, we have sufficient staff in place No, we would need to build a team I do not have enough information to know. Question Title * 9. How did you first learn about UHC’s plans to implement a prior authorization program for endoscopy services? ASGE ACG AGA A colleague UHC Media Other Question Title * 10. Please indicate your assessment of ASGE’s level of communications about UHC and the Society's advocacy efforts to stop the advance notification program? Too much information Right amount of information Not enough information Question Title * 11. Would you be interested in periodically participating in listening sessions such as this in the future? Yes No Question Title * 12. Was this session helpful? Yes No Done