522 CMS Palmetto GBA J11 Mac 4-6-11.xlsx

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Overview

ACSI Model
Current Custom Qsts

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Sheet 1: ACSI Model

Model Instance Name:
CMS Palmetto GBA J11 MAC
MID: xVtkhQ8Yh84FUFVxYcpsBg==
Date:	2/24/2011
	ELEMENTS (drivers of satisfaction)		CUSTOMER SATISFACTION		FUTURE BEHAVIORS
	Content (1=Poor, 10=Excellent, Don't Know)		Satisfaction (1=Poor, 10=Excellent)		Likelihood to Return (1=Not Very Likely, 10=Very Likely)
1	Please rate the accuracy of information on this site.	21	What is your overall satisfaction with this site?	24	How likely are you to return to this site?
2	Please rate the quality of information on this site.	22	How well does this site meet your expectations?
3	Please rate the freshness of content on this site.	23	How does this site compare to your idea of an ideal website?		Recommend (1=Not Very Likely, 10=Very Likely)
	Functionality (1=Poor, 10=Excellent, Don't Know)			25	How likely are you to recommend this site to someone else?
4	Please rate the usefulness of the services provided on this site.
5	Please rate the convenience of the services on this site.				Primary Resource (1=Not Very Likely, 10=Very Likely)
6	Please rate the ability to accomplish what you wanted to on this site.			26	How likely are you to use this site as your primary resource for getting information on Medicare?
	Look and Feel (1=Poor, 10=Excellent, Don't Know)
7	Please rate the ease of reading this site.
8	Please rate the clarity of site organization.
9	Please rate the clean layout of this site.
	Navigation (1=Poor, 10=Excellent, Don't Know)
10	Please rate the degree to which the number of steps it took to get where you want is acceptable.
11	Please rate the ability to find information you want on this site.
12	Please rate the clarity of the site map/directory.
13	Please rate the ease of navigation on this site.
	Site Performance (1=Poor, 10=Excellent, Don't Know)
14	Please rate the speed of loading the page on this site.
15	Please rate the consistency of speed on this site.
16	Please rate the reliability of site performance on this site.
	Search (1=Poor, 10=Excellent, Don't Know)
17	Please rate the usefulness of search results on this site.
18	Please rate how this site provides comprehensive search results.
19	Please rate the organization of search results on this site.
20	Please rate how the search feature helps you to narrow the results to find the information you want.

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Sheet 2: Current Custom Qsts

Model Instance Name:
CMS Palmetto GBA J11 MAC
MID: xVtkhQ8Yh84FUFVxYcpsBg==
Date:	4/05/2012
CMS Palmetto GBA J11 MAC CUSTOM QUESTION LIST
CQID	Skip Logic Label	Question Text		Answer Choices (limited to 50 characters)	Skip to	Type (select from list)	Single or Multi	Required Y/N	Special Instructions	CQ Label
SAC1415		Which best describes you?	SAC1415A001	Provider of medical services		Radio buttons	Single	Y	Skip Group	Best Describes You
			SAC1415A002	Supplier of medical equipment or supplies
			SAC1415A003	Staff of a provider/supplier working primarily with billing/insurance
			SAC1415A004	Administrative staff of a provider/supplier
			SAC1415A005	Other staff of a provider/supplier
			SAC1415A006	Consultant or attorney
			SAC1415A007	Billing service
			SAC1415A008	Other	A
SAC1416	A	Please explain briefly your role in visiting this site.				Text area, no char limit	Single	N	Skip Group	OPS_Best Describes You
SAC1417		What is your primary reason for visiting this site today?	SAC1417A001	Download forms		Radio buttons	Single	Y	Skip Group	Visit Reason
			SAC1417A002	Learn of, or register for, workshops, seminars or other training events
			SAC1417A003	Find contact information
			SAC1417A004	Find general Medicare program information
			SAC1417A005	Research a specific question on Medicare policy or billing
			SAC1417A006	Access claim status and/or beneficiary eligibility
			SAC1417A007	Find information on fees or fee schedules
			SAC1417A008	Find out about a Local Coverage Determination (LCD)
			SAC1417A009	Read Medicare publications such as newsletters, articles, etc.
			SAC1417A010	Find enrollment information
			SAC1417A011	Take an on-line training course
			SAC1417A012	Other	B
SAC1418	B	Please explain briefly your primary reason for visiting this site.				Text area, no char limit	Single	N	Skip Group	OPS_Visit Reason
SAC1419		Did you find what you were looking for?	SAC1419A001	Yes		Radio button, one-up vertical	Single	Y	Skip Group	Looking For
			SAC1419A002	No	C
SAC1420	C	No, I was looking for:				Text area, no char limit	Open	Y	Skip Group	Didn't Find
SAC1421		Did you use the site-wide search feature on this site? (open text box in the upper right)	SAC1421A001	Yes	D, E	Radio button, one-up vertical	Single	Y	Skip Group	Use Search
			SAC1421A002	No
SAC1422	D	How would you rate the helpfulness of the site-wide search?	SAC1422A001	Very helpful		Radio button, one-up vertical	Single	Y	Skip Group	Rate Search
			SAC1422A002	Somewhat helpful
			SAC1422A003	Fair
			SAC1422A004	Somewhat unhelpful	F
			SAC1422A005	Very unhelpful	F
SAC1423	F	Which of the following describes your experience with the site-wide search?	SAC1423A001	Search difficult to use		Radio button, one-up vertical	Single	Y	Skip Group	Search Experience
			SAC1423A002	Received too few results	G
			SAC1423A003	Received too many results
			SAC1423A004	Search results were not what I was looking for	H
			SAC1423A005	Could not sort or refine results
			SAC1423A006	Other	I
SAC1424	G	What search term(s) did you use?				Text area, no char limit	Single	N	Skip Group	Terms - Too Few
SAC1425	H	What search term(s) did you use?				Text area, no char limit	Single	N	Skip Group	Terms - Not What Look For
SAC1426	I	Please briefly explain your experience with the site-wide search.				Text area, no char limit	Single	N	Skip Group	Other_Search Experience
SAC1427	E	What one improvement to the site-wide search feature would be most beneficial?				Text area, no char limit	Single	N	Skip Group	Other-Search Improvement
ACQwil0012024		Do you use E-mail Updates (listserv)?	ACQwil0012024A01	Yes		Radio button, one-up vertical	Single	N		Use Listserv
			ACQwil0012024A02	No, but please show me the link to sign up after I submit this survey
SAC1428		In the last 30 days, how many times have you visited this website?	SAC1428A001	This is my first time		Radio buttons	Single	Y		Visit Frequency
			SAC1428A002	Once or twice
			SAC1428A003	Three or four times
			SAC1428A004	More than once per week but not every day
			SAC1428A005	Every day
SAC1429		Please rank the top 3 factors that brought you to the website today. (Rank 1 = Most important) Rank 1	SAC1429A001	Message or recommendation from a friend on a social network		Drop down, select one	Single	Y	Rank Group	SV - Rank 1
			SAC1429A002	Video I saw on YouTube					Adjust Template/Style Sheet
			SAC1429A003	Internet blogs or discussion forums					Randomize
			SAC1429A004	Advertising on social networks (Facebook, LinkedIn, Twitter)
			SAC1429A005	Message directly from Palmetto GBA on a social network
			SAC1429A006	Mobile phone text messages or alerts
			SAC1429A007	Instant Message from a friend or colleague
			SAC1429A008	Typed in the URL
			SAC1429A009	Bookmarked the website
			SAC1429A010	Search engine results
			SAC1429A011	Word of mouth recommendation from someone I know
			SAC1429A012	Link from the CMS website
			SAC1429A013	Listserv or email updates from Palmetto GBA
			SAC1429A014	Mobile apps
			SAC1429A015	None of the above					Anchor
			SAC1429A016	Don't know					Anchor
			SAC1429A017	Other					Anchor
SAC1430		Rank 2	SAC1430A001	Message or recommendation from a friend on a social network		Drop down, select one	Single	N	Rank Group	SV - Rank 2
			SAC1430A002	Video I saw on YouTube					Adjust Template/Style Sheet
			SAC1430A003	Internet blogs or discussion forums					Randomize
			SAC1430A004	Advertising on social networks (Facebook, LinkedIn, Twitter)
			SAC1430A005	Message directly from Palmetto GBA on a social network
			SAC1430A006	Mobile phone text messages or alerts
			SAC1430A007	Instant Message from a friend or colleague
			SAC1430A008	Typed in the URL
			SAC1430A009	Bookmarked the website
			SAC1430A010	Search engine results
			SAC1430A011	Word of mouth recommendation from someone I know
			SAC1430A012	Link from the CMS website
			SAC1430A013	Listserv or email updates from Palmetto GBA
			SAC1430A014	Mobile apps
			SAC1430A015	None of the above					Anchor
			SAC1430A016	Don't know					Anchor
			SAC1430A017	Other					Anchor
SAC1431		Rank 3	SAC1431A001	Message or recommendation from a friend on a social network		Drop down, select one	Single	N	Rank Group	SV - Rank 3
			SAC1431A002	Video I saw on YouTube					Adjust Template/Style Sheet
			SAC1431A003	Internet blogs or discussion forums					Randomize
			SAC1431A004	Advertising on social networks (Facebook, LinkedIn, Twitter)
			SAC1431A005	Message directly from Palmetto GBA on a social network
			SAC1431A006	Mobile phone text messages or alerts
			SAC1431A007	Instant Message from a friend or colleague
			SAC1431A008	Typed in the URL
			SAC1431A009	Bookmarked the website
			SAC1431A010	Search engine results
			SAC1431A011	Word of mouth recommendation from someone I know
			SAC1431A012	Link from the CMS website
			SAC1431A013	Listserv or email updates from Palmetto GBA
			SAC1431A014	Mobile apps
			SAC1431A015	None of the above					Anchor
			SAC1431A016	Don't know					Anchor
			SAC1431A017	Other					Anchor
SAC1432		If you heard about the website from a social network, please specify the site.	SAC1432A001	Facebook			Single	N	Skip Group	Heard About On Site
			SAC1432A002	LinkedIn
			SAC1432A003	YouTube
			SAC1432A004	Twitter
			SAC1432A005	Mobile apps
			SAC1432A006	Other, please specify	J
SAC1433	J	Please specify the other social network.				Text area, no char limit	Single	N	Skip Group	OPS_Heard About
SAC1434		Please select your location and contract: (please select all that apply)	SAC1434A001	South Carolina – Part A		Checkbox, one-up vertical	Multi	Y		Location
			SAC1434A002	South Carolina – Part B
			SAC1434A003	North Carolina – Part A
			SAC1434A004	North Carolina – Part B
			SAC1434A005	Virginia – Part A
			SAC1434A006	Virginia – Part B
			SAC1434A007	West Virginia – Part A
			SAC1434A008	West Virginia – Part B
			SAC1434A010	Home Health and Hospice
			SAC1434A009	Not applicable
SAC1436		If you are over the age of 18 and would like to be contacted by Palmetto GBA regarding your feedback, please provide your e-mail address and/or phone number.				Text area, no char limit	Open	N		Contact Me
SAC1437		If you could change anything about our site, what would it be?				Text area, no char limit	Open	N		Change One Thing