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SIR Physician Volunteer Feedback: CMS WISeR Model
1.
Name
2.
In which state do you practice?
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia (DC)
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Other, if multiple states or US territory (please specify)
3.
Practice Setting
Academic
Private
Hospital-employed
OBL
ASC
Hybrid
Other (please specify)
4.
Overall, how would you rate your experience volunteering with WISeR?
1 = Very difficult
5 = Very smooth
Clear
5.
What aspects of your WISeR volunteer experience have been most positive?
6.
Have you encountered any significant challenges while volunteering?
7.
Do you have experience with prior authorization procedures for other payors?
Yes
No
8.
If yes, how does WISeR compares to other payors’ prior authorization processes.
9.
How easy has it been to integrate WISeR tasks (prior authorizations, reviews) into your clinical workflow?
1 = Very difficult
5 = Very easy
Clear
10.
Have WISeR processes affected your ability to provide timely care?
Yes
No
11.
If yes, please describe.
12.
Do you feel WISeR supports appropriate clinical decision-making for targeted services?
Yes
No
13.
Please explain.
14.
How user-friendly are the WISeR electronic tools and portals?
1 = Not user-friendly
5 = Very user-friendly
Clear
15.
Have you experienced any technology-related issues that impacted your workflow?
Yes
No
Somewhat
16.
Please explain.
17.
Do you understand how determinations are made (AI vs. human review)?
Yes
No
Somewhat
18.
How clear has communication from CMS, MACs, or the WISeR team been?
1= very unclear communication
1= very unclear communication, 5= clear communication
Clear
19.
Have you received adequate support when questions arise?
Yes
No
Somewhat
20.
What type of ongoing support would be most helpful for physician volunteers?
21.
Has participation in WISeR increased your administrative workload?
Yes
No
22.
If yes, please explain.
23.
Are documentation and submission requirements manageable in your practice setting?
Yes
No
Somewhat
24.
Overall, do you believe WISeR adds value to patient care and clinical practice?
Yes
No
Somewhat
25.
Please explain.
26.
What improvements would you recommend to enhance the WISeR volunteer experience?
27.
Additional comments, concerns, or suggestions: