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* 1. What delivery service do you use? Choose all that apply.

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* 2. How would you rate your courier service?

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* 3. Do you find the information on the WPHL website helpful?

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* 4. Evaluate the following statements as they pertain to how your business receives information from the WPHL.

  Strongly Disagree Disagree Niether Disagree nor Agree Agree Strongly Agree N/A
We are currently satisfied with how we receive reports.
Faxed reports work well for our business.
Mailed reports work well for our business.
We would like to receive electronic reports.
We are capable of receiving HL7 messaging.
We are capable of sending HL7 messaging.
We would be willing to use an online order entry system (web portal) for placing WPHL test orders.
We would be willing to access WPHL results online through a web portal.

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* 5. How do you currently receive your WPHL result reports?

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* 6. How would you like to receive your WPHL result reports?

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* 7. Do you handle your own Information Technology or do you work with a vendor/partner for Information Technology?

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* 8. Do you currently have HL7 interfaces with any other laboratories or health care organizations?

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* 9. Which Laboratory Information Management System (LIMS or LIS) do you use?

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* 10. Which Electronic Medical Record software (or Practice Management System) do you use?

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* 11. Evaluate the following statements as they pertain to how your business receives reimbursement for testing performed by the WPHL.

  I receive I do not receive
Federal funds.
State funds.
We utilize Knowyo vouchers.
We collect from patients directly.
We collect from third party payers.
We do not collect for laboratory testing.

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* 12. Evaluate the following questions as they pertain to your business and WPHL billing.

  Strongly Agree Agree Disagree Strongly Disagree N/A
Our business is not affected by whether or not the WPHL can bill the lab fee to our patient's insurance.
We would prefer for the WPHL to bill insurance companies when our patients have insurance.
We would like the WPHL to bill Medicaid directly.
We would prefer that the WPHL bill our patients directly for the lab fee.
Our business is not affected by whether or not the WPHL can bill the lab fee to our patients directly.
We would prefer that the WPHL bill our laboratory directly for billable reference testing fees.

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* 13. If the WPHL were to add a test, which would you most likely order from WPHL? (Please rank 1 being most beneficial to 5 being least beneficial).

***Note: the test name position will change as you rank them.

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* 14. I would like to see a test that was not mentioned above added to the WPHL's capabilities.

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* 15. Are you satisfied with the level of service that you get from the WPHL?

T