Provider Training Suggestion Box Survey

Passport by Molina Healthcare continuously evaluates our training programs to better equip our provider community with more of what you need and less of what you don't. Please provide your feedback on how we can best accomplish training activities for your office.

	1	2	3	4	5
Monday	Monday 1	Monday 2	Monday 3	Monday 4	Monday 5
Tuesday	Tuesday 1	Tuesday 2	Tuesday 3	Tuesday 4	Tuesday 5
Wednesday	Wednesday 1	Wednesday 2	Wednesday 3	Wednesday 4	Wednesday 5
Thursday	Thursday 1	Thursday 2	Thursday 3	Thursday 4	Thursday 5
Friday	Friday 1	Friday 2	Friday 3	Friday 4	Friday 5

Monday

Monday 1

Monday 2

Monday 3

Monday 4

Monday 5

Tuesday

Tuesday 1

Tuesday 2

Tuesday 3

Tuesday 4

Tuesday 5

Wednesday

Wednesday 1

Wednesday 2

Wednesday 3

Wednesday 4

Wednesday 5

Thursday

Thursday 1

Thursday 2

Thursday 3

Thursday 4

Thursday 5

Friday

Friday 1

Friday 2

Friday 3

Friday 4

Friday 5

	1	2	3	4	5
8am-10am	8am-10am 1	8am-10am 2	8am-10am 3	8am-10am 4	8am-10am 5
10am-12pm	10am-12pm 1	10am-12pm 2	10am-12pm 3	10am-12pm 4	10am-12pm 5
12pm-3pm	12pm-3pm 1	12pm-3pm 2	12pm-3pm 3	12pm-3pm 4	12pm-3pm 5
3pm-5pm	3pm-5pm 1	3pm-5pm 2	3pm-5pm 3	3pm-5pm 4	3pm-5pm 5
5pm-6pm	5pm-6pm 1	5pm-6pm 2	5pm-6pm 3	5pm-6pm 4	5pm-6pm 5

8am-10am

8am-10am 1

8am-10am 2

8am-10am 3

8am-10am 4

8am-10am 5

10am-12pm

10am-12pm 1

10am-12pm 2

10am-12pm 3

10am-12pm 4

10am-12pm 5

12pm-3pm

12pm-3pm 1

12pm-3pm 2

12pm-3pm 3

12pm-3pm 4

12pm-3pm 5

3pm-5pm

3pm-5pm 1

3pm-5pm 2

3pm-5pm 3

3pm-5pm 4

3pm-5pm 5

5pm-6pm

5pm-6pm 1

5pm-6pm 2

5pm-6pm 3

5pm-6pm 4

5pm-6pm 5

	1	2	3	4	5
In-person Workshop	In-person Workshop 1	In-person Workshop 2	In-person Workshop 3	In-person Workshop 4	In-person Workshop 5
Virtual Webinar	Virtual Webinar 1	Virtual Webinar 2	Virtual Webinar 3	Virtual Webinar 4	Virtual Webinar 5
One-on-One with your Provider Service Representative	One-on-One with your Provider Service Representative 1	One-on-One with your Provider Service Representative 2	One-on-One with your Provider Service Representative 3	One-on-One with your Provider Service Representative 4	One-on-One with your Provider Service Representative 5
Electronic Information (i.e.: quick reference guides, etc.)	Electronic Information (i.e.: quick reference guides, etc.) 1	Electronic Information (i.e.: quick reference guides, etc.) 2	Electronic Information (i.e.: quick reference guides, etc.) 3	Electronic Information (i.e.: quick reference guides, etc.) 4	Electronic Information (i.e.: quick reference guides, etc.) 5
Hardcopy Information (i.e.: quick reference guides, etc.)	Hardcopy Information (i.e.: quick reference guides, etc.) 1	Hardcopy Information (i.e.: quick reference guides, etc.) 2	Hardcopy Information (i.e.: quick reference guides, etc.) 3	Hardcopy Information (i.e.: quick reference guides, etc.) 4	Hardcopy Information (i.e.: quick reference guides, etc.) 5

In-person Workshop

In-person Workshop 1

In-person Workshop 2

In-person Workshop 3

In-person Workshop 4

In-person Workshop 5

Virtual Webinar

Virtual Webinar 1

Virtual Webinar 2

Virtual Webinar 3

Virtual Webinar 4

Virtual Webinar 5

One-on-One with your Provider Service Representative

One-on-One with your Provider Service Representative 1

One-on-One with your Provider Service Representative 2

One-on-One with your Provider Service Representative 3

One-on-One with your Provider Service Representative 4

One-on-One with your Provider Service Representative 5

Electronic Information (i.e.: quick reference guides, etc.)

Electronic Information (i.e.: quick reference guides, etc.) 1

Electronic Information (i.e.: quick reference guides, etc.) 2

Electronic Information (i.e.: quick reference guides, etc.) 3

Electronic Information (i.e.: quick reference guides, etc.) 4

Electronic Information (i.e.: quick reference guides, etc.) 5

Hardcopy Information (i.e.: quick reference guides, etc.)

Hardcopy Information (i.e.: quick reference guides, etc.) 1

Hardcopy Information (i.e.: quick reference guides, etc.) 2

Hardcopy Information (i.e.: quick reference guides, etc.) 3

Hardcopy Information (i.e.: quick reference guides, etc.) 4

Hardcopy Information (i.e.: quick reference guides, etc.) 5

	Not important at all	Somewhat Important	Neutral	Important	Very Important
Claims Information	Claims Information Not important at all	Claims Information Somewhat Important	Claims Information Neutral	Claims Information Important	Claims Information Very Important
Coding Information	Coding Information Not important at all	Coding Information Somewhat Important	Coding Information Neutral	Coding Information Important	Coding Information Very Important
Incentive Program Information	Incentive Program Information Not important at all	Incentive Program Information Somewhat Important	Incentive Program Information Neutral	Incentive Program Information Important	Incentive Program Information Very Important
State and Federal Updates	State and Federal Updates Not important at all	State and Federal Updates Somewhat Important	State and Federal Updates Neutral	State and Federal Updates Important	State and Federal Updates Very Important
Prior Authorization Information and Updates	Prior Authorization Information and Updates Not important at all	Prior Authorization Information and Updates Somewhat Important	Prior Authorization Information and Updates Neutral	Prior Authorization Information and Updates Important	Prior Authorization Information and Updates Very Important
Clinical Information	Clinical Information Not important at all	Clinical Information Somewhat Important	Clinical Information Neutral	Clinical Information Important	Clinical Information Very Important
Quality Information and Updates	Quality Information and Updates Not important at all	Quality Information and Updates Somewhat Important	Quality Information and Updates Neutral	Quality Information and Updates Important	Quality Information and Updates Very Important

Not important at all

Somewhat Important

Neutral

Important

Very Important

Claims Information

Claims Information Not important at all

Claims Information Somewhat Important

Claims Information Neutral

Claims Information Important

Claims Information Very Important

Coding Information

Coding Information Not important at all

Coding Information Somewhat Important

Coding Information Neutral

Coding Information Important

Coding Information Very Important

Incentive Program Information

Incentive Program Information Not important at all

Incentive Program Information Somewhat Important

Incentive Program Information Neutral

Incentive Program Information Important

Incentive Program Information Very Important

State and Federal Updates

State and Federal Updates Not important at all

State and Federal Updates Somewhat Important

State and Federal Updates Neutral

State and Federal Updates Important

State and Federal Updates Very Important

Prior Authorization Information and Updates

Prior Authorization Information and Updates Not important at all

Prior Authorization Information and Updates Somewhat Important

Prior Authorization Information and Updates Neutral

Prior Authorization Information and Updates Important

Prior Authorization Information and Updates Very Important

Clinical Information

Clinical Information Not important at all

Clinical Information Somewhat Important

Clinical Information Neutral

Clinical Information Important

Clinical Information Very Important

Quality Information and Updates

Quality Information and Updates Not important at all

Quality Information and Updates Somewhat Important

Quality Information and Updates Neutral

Quality Information and Updates Important

Quality Information and Updates Very Important

Provider Training Suggestion Box

Question Title

* 1. Please rank your desired training days with 1 being the most desirable and 5 being the least desirable:

Question Title

* 2. Please rank your desired training time with 1 being the most desired and 5 being the least

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* 3. Please indicate your time zone:

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* 4. Pleas rank the training method that best fits your schedule with 1 being the most desirable and 5 being the least desirable:

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* 5. Please rank the below topics in order of importance to you and your practice:

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* 6. Please provide other training topics and/or methods you would like to see from Passport: