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* 1. Would you agree the referral process is working to your satisfaction?

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* 2. Would you agree the customer services provided by the Care Management staff (Case Management & Utilization Management) are courteous, knowledgeable and resourceful?

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* 3. Would you agree that claims are processed according to contract?

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* 4. Would you agree, when claim issues arise, the claims staff is helpful in working toward resolution?

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* 5. Would you agree the services provided by the Network Relations Coordinators are courteous, resourceful
and responsive to requests?

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* 6. Would you agree you are satisfied with the overall services provided by Healthcare Resources NW?

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* 7. How can we improve our services?

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* 8. Name:

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* 9. Title:

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* 10. Clinic Name:

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