Information Collection

TRICARE Dual Eligible Fiscal Intermediary Contract Provider Satisfaction Survey

IC 191736 under ICR 201001-0720-001 · OMB 0720-0045.

Documents and Forms

Document Name Document Type
TDEFIC Provider Survey - final.pdf Other-Survey
TDEFIC IVR Provider Survey questions - final.doc Other-Survey

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	TRICARE Dual Eligible Fiscal Intermediary Contract Provider Satisfaction Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 32 CFR 199

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Survey			TDEFIC Provider Survey - final.pdf		No		Paper Only
Other-Survey			TDEFIC IVR Provider Survey questions - final.doc		No		Paper Only

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 46,800	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	46,800	46,800
Annual IC Time Burden (Hours)	11,700	11,700
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.