VA Memo 1

V HA OHI Product Effectiveness

OMB 2900-XXXX
Estimated Burden: 5 min.

VHA Customer Satisfaction Survey of Non-VA Healthcare Providers

OMB 2900-XXXX

VHA Customer Satisfaction Survey of Non-VA Healthcare Providers

(VA Financial Service Center (FSC) Claim Processing)

Millennium Bill

Emergency Care Provider Satisfaction Survey

Veterans Health Administration (VHA)
Office of Health Information (OHI), Product Effectiveness

THE PAPERWORK REDUCTION ACT of 1995. This information is collected in accordance with section 3507 of the Paperwork Reduction Act of 1995. Accordingly, we may not conduct or sponsor, and you are not required to respond to a collection of information unless it displays a valid OMB number. We anticipate that the time expended by all individuals who complete this survey will average 5 minutes. This includes the time it will take to read instructions, gather the necessary facts and fill out the form. Customer satisfaction surveys are used to gauge customer perceptions of VA services as well as customer expectations and desires. The results of this survey will lead to improvement in the quality of service delivery by helping to shape the direction and focus of specific programs and services. Disclosure of information involves release of statistical data and other non-identifying data for the improvement of services within the VA healthcare system and associated administrative purposes. The information requested on this form is solicited under the authority of Title 38, U.S.C., Part I, Chapter 5, Section 527 that authorizes the collection of data that will allow measurement and evaluation of the Department of Veterans Affairs Programs. The purpose(s) for collecting the information is to evaluate the effectiveness of the Chief Business Office (CBO) pilot project claims processing centralization effort and performance measures for non-VA Healthcare providers. This survey information will be used to improve customer satisfaction with the claims process. The information you provide will be used by the Department of Veterans Affairs to conduct a third-party survey through collaborative efforts by the Office of Health Information, Product Effectiveness and Chief Business Office (CBO) in accordance with the Millennium Bill legislation (Title 38 U.S.C. Section 1725). Your obligation to respond is voluntary.

Mill Bill-FSC Claim Processing Pilot Program

Healthcare Provider Satisfaction Survey

The U.S. Department of Veterans Affairs (VA) would like to gather your opinions on recent changes to the medical care submission process for emergency medical care claims. These changes involve the submission of claims to the Financial Services Center in Austin, Texas rather than your local VA Medical Center. This survey is being conducted to evaluate the new claims submission process, and will be used in decisions about further improvements to the process.

It should take you approximately 5 minutes to complete the survey. However, you can save your survey responses at any time by closing your browser, and then finish the survey at a later time. Your participation is voluntary and your individual responses will remain anonymous with no identifiable information collected from you. Your participation is very important in helping us understand the new process and identify areas for improvement.

The OMB control number for this public information request is XXXX-XXXX. If you have questions about the survey, please send an email to {TBD EMAIL ADDRESS}

Thank you in advance for your participation!

1. How long have you been submitting emergency medical care claims to the VA for processing and payment?

Less than 1 year

1 – 3 years

4 – 5 years

Over 5 years

{If less than 1 year, then skip to the follow-up 1a below}

1a. In February 2009, the VA made a change to the emergency medical care claims process in which all claims are to be submitted to the Financial Services Center (FSC) in Austin, TX rather than the local VA Medical Center. Have you had experience submitting emergency care claims to the VA both before and after this process change?

Yes

No

{If “No”, then skip to the Recommendations for Improvement section}

Claims Adjudication and Process Satisfaction

Please indicate your level of agreement with the following statements.

2. The letter my office received regarding the VA’s new emergency medical care claims process clearly notified us of the change in protocol for submitting all emergency medical care claims for Veterans to the Financial Services Center (FSC) in Austin, TX.

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

Don’t know, did not see the letter

3. Since I began submitting claims to the Financial Services Center in Austin, Texas (FSC), I am now more satisfied with…

	Strongly agree	Agree	Neither agree nor disagree	Disagree	Strongly disagree
The VA’s overall timeliness of payment for emergency medical care claims
The Fee Schedules used by the VA to pay emergency medical care claims
The VA’s Explanation of Benefits (EOB) for emergency medical care claims
The VA’s eligibility determinations for emergency medical care claims payment
The number of medical services (on a line item basis) per emergency medical care claim the VA deems eligible for reimbursement
The number of paid emergency medical care claims processed by the VA within 30 days
The VA’s timeliness of response to claim appeals or Requests for Reconsideration I submitted
The emergency medical care claims customer support

4. Since I began submitting claims to the FSC, I am now more satisfied overall with the emergency medical care claims adjudication and reimbursement process.

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

Claims Processing Consolidation Impact

5. Since you began submitting claims to the FSC, have each of the following increased, decreased, or remained the same?

	Increased	Decreased	Remained the same	Don’t know
The number of emergency care claims denied by the VA
The number of emergency care claims partially paid by the VA
The number of duplicate emergency care claims processed by the VA

Recommendations for Improvement

6. How important do you think it is for the VA to develop an online web portal that provides you with the capabilities to review a claim’s status, search for claim documentation, and view an online Explanation of Benefits?

Extremely important

Very important

Somewhat important

Not important

Don’t know, no opinion

7. Please provide any comments or suggestions you have regarding the VA’s new emergency medical care claims process.

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

Survey Exit

Click the "Submit Survey" button below once to complete your response.

Thank you for participating in this survey!

VA FORM 10-0473
JUL 2010 4 of 4