Explaination of Survey Questions

Explanations for Inclusion of Survey Questions
Q1.

According to our records, the complaint you filed was recently closed by the plan. Was
the complaint resolved?

This survey question will contribute to several of the proposed performance measure indicators.
The responses to the question will be the sole input for the “Resolution Completed/Complaint
Closure” indicator. This measure will relay the percentage of complaints that have been
resolved. These responses will also have a role in the “Resolution Satisfaction”, “Satisfactory
Resolution Timeliness”, “Issue Level Response Time Compliance”, and “Satisfactory Issue
Level Response Time Compliance” indicators. For the calculation of these indicators, only
complaints which have been resolved are appropriate. The survey responses to this question will
be used to determine which complaints have been resolved from the perspective of the
beneficiary.
Q2.

What was the resolution?

The open-ended responses to this survey question will be used in the “Resolution Veracity”
indicator. The survey responses will be compared to the resolution summary provided by the
plan in the CTM. Thereby, the indicator will indicate what percentage of a plan’s CTM
resolution descriptions agree with the experience described by the beneficiary.
Q3.

How satisfied are you with the resolution of your complaint?

The responses to this survey question will be used in multiple performance measures. Most
importantly, it will be the key contributor to the “Resolution Satisfaction” indicator. This
measure will represent beneficiaries’ level of satisfaction with the resolutions to their complaints.
Additionally, the responses to this survey question will be used to isolate complaints where the
beneficiary is satisfied with the final resolution in the “Satisfactory Resolution Timeliness” and
“Satisfactory Issue Level Response Time Compliance” indicators.
Q4.

Did the plan contact you about your complaint? This includes contact by telephone, mail,
email, or other means.

The “Contact with Beneficiary” indicator will rely upon this survey question for its data. This
indicator will provide the percentage of beneficiaries who were contacted by the plan subsequent
to the beneficiary’s complaint filing.
Q5.

Did you have to make more than one attempt to resolve your complaint before the plan
contacted you?

This survey question will be used to populate the “Repeat Complaints” indicators. This indicator
will specify the frequency with which beneficiaries had to file a repeat/duplicate complaint in
order to receive a response from the plan.
Q6.

How satisfied are you with the amount of time it took to resolve your complaint?

The responses to this survey question will be used to construct the “Satisfactory Resolution
Timeliness” plan indicators. This performance measure will describe how satisfied beneficiaries
are with the amount of time it took plans to come to a resolution.
Q7.

Now, please indicate how satisfied you are with the way your complaint was handled by
the plan.

This survey question will supply data for the construction of the “Resolution Handling”
indicator. This indicator will measure how satisfied beneficiaries are with the process
undertaken by plans to resolve their complaint.
Q8.

Why are you dissatisfied with the way your complaint was handled? Mark all that apply

While this survey question will not be used directly in any of the performance measures, it is still
a critical question for learning about how plans can improve their handling of complaints. This
question is asked of beneficiaries who indicate that they are not satisfied with how their
complaint was handled. They are able to specify why they are dissatisfied in this question.
Analysis of these responses will provide context for plans with low “Resolution Handling”
indicators.
Q9.

Based on your recent experience with this plan, are you planning to stay with this plan
when you have the opportunity to switch plans?

A question of the beneficiary’s satisfaction, the responses will indicate to what extent a
beneficiary’s experience with complaint resolution affects his/her opinion of the plan. If the
complaint resolution process was so unsatisfactory that the beneficiary is willing to switch plans,
it will provide context for plans with low “Resolution Handling” indicators. On the other hand,
analysis of these responses may show that even beneficiaries with unsatisfactory complaint
resolution experiences are not unhappy enough to actually switch plans.
Q10.

During the complaint process, what problems did you experience while you were waiting
for your complaint to be resolved? Mark all that apply

While a plan may meet CMS’s recommended time window for resolving a complaint, the
resolution time may still be too long to prevent a subsequent negative event. Thus, this question
asks about whether the beneficiary suffered any negative outcome between filing a complaint
and its resolution as a way of capturing whether plan worked quickly enough to ensure the safety
of the beneficiary. These responses will be used in the “Risk to Beneficiary” indicator. This
indicator calculates the percentage of beneficiaries who experienced a negative event and the
data will allow a greater understanding of the severity of the negative outcomes.