Skip to content
Molina Operations Meeting Survey
Molina Operations Meeting Survey
Your feedback is important, and You Matter to Molina. As a valued partner, please complete and submit the survey below. This survey will take approximately 3-5 minutes to complete. Thank you!
OK
*
1.
Name of Hospital:
(Required.)
*
2.
Please rate your satisfaction level on each item below:
(Required.)
Dissatisfied
Somewhat Dissatisfied
Neutral
Somewhat Satisfied
Satisfied
How would you rate the meeting?
Dissatisfied
Somewhat Dissatisfied
Neutral
Somewhat Satisfied
Satisfied
Comment (specific feedback):
Did the Molina Representative(s) meet your expectations?
Dissatisfied
Somewhat Dissatisfied
Neutral
Somewhat Satisfied
Satisfied
Comment (specific feedback):
Knowledge of the Molina Representative(s) on the subject matter?
Dissatisfied
Somewhat Dissatisfied
Neutral
Somewhat Satisfied
Satisfied
Comment (specific feedback):
Did the subject matter meet your needs?
Dissatisfied
Somewhat Dissatisfied
Neutral
Somewhat Satisfied
Satisfied
Comment (specific feedback):
Were all of your concerns addressed?
Dissatisfied
Somewhat Dissatisfied
Neutral
Somewhat Satisfied
Satisfied
Comment (specific feedback):
*
3.
Attendance at this meeting was well worth the time invested?
(Required.)
Yes
No
4.
If you answered "No" to attendance being well worth the time invested, please provide additional comments:
5.
Do you have suggestions for future meetings?
*
6.
Do you believe your Molina Provider Services Representative is giving you quality service?
(Acceptable response times, resolution/escalation of issues, etc.)
(Required.)
Yes
No
Comment
7.
Is there anyone at Molina that you would like to recognize or bring to management's attention?
8.
Please share any comments, concerns, ideas or feedback (positive or negative):
*
9.
Are you interested in joining a regional Provider Engagement Council?
(Required.)
Yes
No
10.
If you answered "Yes" to joining a regional Provider Engagement Council, please provide your contact information below:
Group Name
Your Name
TIN
Email Address
Phone Number
Fax Number
11.
If you would like Molina to follow up with you on the feedback provided, please provide the contact information below:
Group Name
Your Name
TIN
Email Address
Phone Number
Fax Number
Comment
Current Progress,
0 of 11 answered
