Form 1034 2017 1034 Palmetto GBA Railroad Desktop Informational_10

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Overview

How to read this file
Welcome and Thank You Text
Model Questions
Custom Questions

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Sheet 1: How to read this file

Welcome and Thank You Text
The text you see here will appear at the top and bottom of your survey. Default text is included and you may modify this text as needed.
Model Questions
As discussed during the kick-off call, the model questions are part of the ForeSee methodology. For consistency within the model, these questions are standardized and have been tested and validated. Standardization of model questions allows benchmarking across companies/industries, and these questions are used in calculating scores and impacts.
Focus on the future behaviors; I’ve started with some that I believe are a good fit but we can certainly make adjustments. These are desired customer outcomes that are impacted by customer satisfaction.
Custom Questions
When reviewing the custom questions tab, keep in mind these questions are used for segmentation analysis of the model data. It is suggested that you add, delete or change custom questions over time, as your needs or business objectives change.
Focus Area #1: Achieving Actionable Data - Know what changes are being made based on the intelligence - Change Custom Questions so that stakeholders see a clear “must do”
Focus Area #2: Aligning Data to Business Strategies - Update your Custom Questions as business cycles change - Integrate Executive Level questions to evaluate initiatives
Focus Area #3: Strategic and Tactical Value - Influence Board Room Decisions - Change Operational Approaches - Mature Your Research

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Sheet 2: Welcome and Thank You Text

	The text you see here will appear at the top and bottom of your survey, examples below.
	Default text is included and you may modify this text as needed.
	Welcome and Thank You Text
		Welcome Text		Welcome Text - Tablet / Phone
		Thank you for visiting Palmetto GBA Railroad. You've been randomly chosen to take part in a brief survey to let us know what we're doing well and where we can improve. Please take a few minutes to share your opinions, which are essential in helping us provide the best online experience possible.		Thank you for visiting Palmetto GBA Railroad. You've been selected to participate in a brief survey to let us know how we can improve your experience. Please take a minute to share your opinions.
		Thank You Text		Thank You Text - Tablet / Phone
		Thank you for taking our survey - and for helping us serve you better. Please note you will not receive a response from us based on your survey comments. If you would like us to contact you about your feedback, please visit the Contact Us section of our website.		Thank you for taking our survey - and for helping us serve you better. We appreciate your input!
		Example Desktop		Example Mobile

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Sheet 3: Model Questions

Model Name		Palmetto GBA Railroad Desktop Informational					Red & Strike-Through: Delete
Model ID							Underlined & Italicized: Re-order
Partitioned		Yes - 2MQ					Pink: Addition
Date		10.10.2017					Blue: Reword
Model Version		17.2.G
	Label	Element Questions		Label	Satisfaction Questions		Label	Future Behaviors
		Look and Feel (1=Poor, 10=Excellent, Don't Know)			Satisfaction			Brand Confidence (1=Not At All Confident, 10=Very Confident)
1	Look and Feel - Appeal	Please rate the visual appeal of this site.	19	Satisfaction - Overall	What is your overall satisfaction with this site? (1=Very Dissatisfied, 10=Very Satisfied)	22	Brand Confidence	Please rate your level of confidence in Palmetto GBA Railroad Medicare.
2	Look and Feel - Balance	Please rate the balance of graphics and text on this site.	20	Satisfaction - Expectations	How well does this site meet your expectations? (1=Falls Short, 10=Exceeds)			Return (1=Very Unlikely, 10=Very Likely)
3	Look and Feel - Readability	Please rate the readability of the pages on this site.	21	Satisfaction - Ideal	How does this site compare to an ideal website? (1=Not Very Close, 10=Very Close)	23	Return	How likely are you to return to Palmetto GBA Railroad Medicare in the future?
		Site Performance (1=Poor, 10=Excellent, Don't Know)						Recommend Company (1=Very Unlikely, 10=Very Likely)
4	Site Performance - Loading	Please rate how quickly pages load on this site.				24	Recommend Company	How likely are you to recommend Palmetto GBA Railroad Medicare to someone else?
5	Site Performance - Consistency	Please rate the consistency of speed from page to page on this site.
6	Site Performance - Completeness	Please rate how completely the page content loads on this site.
		Navigation (1=Poor, 10=Excellent, Don't Know)
7	Navigation - Organized	Please rate how well this site is organized.
8	Navigation - Options	Please rate the options available for navigating this site.
9	Navigation - Layout	Please rate how well the site layout helps you find what you need.
		Information Browsing (1=Poor, 10=Excellent, Don't Know)
10	Information Browsing - Sort	Please rate the ability to sort information by criteria that are important to you on this site.
11	Information Browsing - Narrow	Please rate the ability to narrow choices to find the information you are looking for on this site.
12	Information Browsing - Features	Please rate how well the features on the site help you find the information you need.
		Site Information (1=Poor, 10=Excellent, Don't Know)
13	Site Information - Thoroughness	Please rate the thoroughness of information provided on this site.
14	Site Information - Understandable	Please rate how understandable this site’s information is.
15	Site Information - Answers	Please rate how well the site’s information provides answers to your questions.
	IF Applicable	Site Images (1=Poor, 10=Excellent, Don't Know)
16	Site Images - Realistic	Please rate how realistic the images are on this site.
17	Site Images - Views	Please rate the ability to see the desired views of things you wanted to review.
18	Site Images - Details	Please rate how well the site images show item details.

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Sheet 4: Custom Questions

Model Name		Palmetto GBA Railroad Desktop Informational				Red & Strike-Through: Delete
Model ID		0				Underlined & Italicized: Re-order
Partitioned		Yes - 2MQ				Pink: Addition
Date		10.10.2017				Blue: Reword
QID	QUESTION META TAG	Skip From	Question Text	Answer Choices	Skip To	Required Y/N	Type	Special Instructions	CQ Label
	Primary Reason: Healthcare		What is your primary reason for visiting this site today?	Download forms		Y	Radio button, one-up vertical	Skip Logic Group*	Visit Reason
				Learn of, or register for, workshops, seminars or other training events
				Find contact information
				Find general Medicare program information
				Research a specific question on Medicare policy or billing
				Access claim status and/or beneficiary eligibility
				Find information on fees or fee schedules
				Read Medicare publications such as newsletters, articles, etc.
				Find enrollment information
				Take an on-line training course
				Other	B
		B	Please explain briefly your primary reason for visiting this site.			N	Text area, no char limit	Skip Logic Group*	OE_Visit Reason
	Accomplish		Did you find what you were looking for?	Yes		Y	Radio button, one-up vertical	Skip Logic Group*	Looking For
				No	C
		C	No, I was looking for:			Y	Text area, no char limit	Skip Logic Group*	OE_Didn't Find
	Role: Healthcare		Which best describes you?	Provider of medical services		Y	Radio button, one-up vertical	Skip Logic Group*	Best Describes You
				Supplier of medical equipment or supplies
				Staff of a provider/supplier working primarily with billing/insurance
				Administrative staff of a provider/supplier
				Other staff of a provider/supplier
				Consultant or attorney
				Billing service
				Other	A
		A	Please explain briefly your role in visiting this site.			N	Text area, no char limit	Skip Logic Group*	OE_Best Describes You
	Visit Frequency		How often do you visit this site?	This is my first visit		Y	Drop down, select one		Visit Frequency
				Once every 6 months or less often
				Once every few months
				Monthly
				Weekly
				Daily or more often
JM Question			In the last 30 days, how many times have you visited this website?	This is my first time		Y	Radio button, one-up vertical		Visit Frequency
				Once or twice
				Three or four times
				More than once per week but not every day
				Every day
			Did you try to log in to Palmetto GBA Railroad Medicare today?	Yes	A	Y	Radio button, one-up vertical	Skip Logic Group*	Log In Attempt
				No
		A	Were you able to log in successfully?	Yes		Y	Radio button, one-up vertical	Skip Logic Group*	Log In Success
				No	C
		C	What prevented you from logging in to the site today?			N	Text area, no char limit	Skip Logic Group*	Why Not Log In
JM Question			Did you use the site-wide search feature on this site?	Yes		Y	Radio button, one-up vertical		Use Search
				No
			Did you use the search feature during your visit today?	Yes	Y	Y	Radio button, one-up vertical	Skip Logic Group*	Search Use
				No	N
				Don't recall
		Y	Please tell us about your experience with the site's search feature today. (Select all that apply.)	Results were not relevant/not what I wanted		Y	Checkbox, one-up vertical	Randomize	Search Experience
				Too many results/I needed to refine my search
				Not enough results				Skip Logic Group*
				Returned NO results
				Received error message(s)
				Search speed was too slow
				I experienced a different search issue:	A			Anchor Answer Choice
				I had no difficulty with search/results were helpful				Mutually Exclusive
		A	Please specify the search issue you experienced.			N	Text area, no char limit	Skip Logic Group*	Search Issue - Other
		Y	Did you try using the site's navigational links before using the search feature today?	Yes, I navigated first		Y	Radio button, one-up vertical	Skip Logic Group*	Search or Nav First
				No, I went straight to the search feature
				Don't recall
		Y	Did the search feature help you to locate what you were looking for today?	Yes	B	Y	Radio button, one-up vertical	Skip Logic Group*	Search Help Locate
				Partially	B
				No	B
		B	Please describe in detail what you were primarily searching for.			N	Text area, no char limit	Skip Logic Group*	Search Detail OE
		Y	What specific search terms did you use to try to find the information/product?			N	Text area, no char limit	Skip Logic Group*	Search Terms OE
		Y	Were the search results relevant to your needs?	Yes		Y	Radio button, one-up vertical	Skip Logic Group*	Search Results Relevant
				Partially
				No
		Y	How many searches did you conduct to find the main thing you were looking for today?	One search		Y	Drop down, select one	Skip Logic Group*	Search Number
				Two
				Three
				Four or more
				Don't recall
		Y	What percentage of your searches on Palmetto GBA Railroad did you consider successful?	Less than 25%		Y	Drop down, select one	Skip Logic Group*	Search Successful Percent
				25% to 49%
				50% to 74%
				75% to 90%
				More than 90%
		Y	If you could make one improvement to the search feature, which of the following would you make?	EXAMPLE ANSWER CHOICES (customize this list to the site)		Y	Radio button, one-up vertical	Skip Logic Group*	Search Improvements
				Narrow results by a specific date
				Sort results by the most popular to least popular
				Narrow by searching within the first set of results I receive
				Search by document type, pdf, wav, etc.
				Other (please specify)	C
		C	Please specify your suggestion to improve search.			N	Text area, no char limit	Skip Logic Group*	Search Improvement - Other
		Y	Please rate your satisfaction with this site's search feature.	1 = Very dissatisfied		Y	Radio button, scale, no don't know	Skip Logic Group*	Search Satisfaction
				2
				3
				4
				5
				6
				7
				8
				9
				10 = Very satisfied
		Y	How can we make the search feature more useful to you?			N	Text area, no char limit	Skip Logic Group*	Search More Useful OE
		N	Why did you choose not to use the search feature today?	Didn't need it today		Y	Radio button, one-up vertical	Skip Logic Group*	Search Non-Use
				Used search feature on a previous site visit, but it wasn't useful
				Prefer to navigate the site instead
				Didn't know there was a search feature
				Other (please specify)	D
		D	Please specify why you did not use the search feature.			N	Text area, no char limit	Skip Logic Group*	Search Non Use - Other
			Have you used the site's search feature on a previous visit?	Yes		Y	Radio button, one-up vertical	Skip Logic Group*	Search Prior Use
				No
				Don't recall
			How did you look for information or navigate the site today? (Please select all that apply.)	Top navigation bar		Y	Checkbox, one-up vertical	Skip Logic Group*	Navigation Method
				Left navigation bar
				Search feature
				Clicked on links on the page
				Page bookmark or favorite link
				Site map
				A-Z index
				Google or other search engine
				Other (please specify)	A
				Don't recall				Mutually Exclusive
		A	Please tell us how else you looked for information.			N	Text field, <100 char	Skip Logic Group*	Navigation Method - Other
			Which of these method(s) led you to the information/product you were looking for? (Please select all that apply.)	Top navigation bar		Y	Checkbox, one-up vertical		Successful Nav Method
				Left navigation bar
				Search feature
				Clicked on links on the page
				Page bookmark or favorite link
				Site map
				A-Z index
				Google or other search engine
				None of these				Mutually Exclusive
				Don't recall				Mutually Exclusive
			How would you describe your browsing experience on the site today? (Please select all that apply.)	Links often did not take me where I expected	L	Y	Checkbox, one-up vertical	Skip Logic Group*	Navigation Experience
				I had difficulty finding relevant information
				Links and labels were difficult to understand	U
				There were too many links or navigation options to choose from				Randomize
				I had technical difficulties (error messages, broken links, etc.)	T
				I could not navigate back to previous information
				I had a different navigation difficulty	A			Anchor Answer Choice
				I had no difficulty navigating the site				Mutually Exclusive
		A	Please specify your navigation difficulty.			N	Text area, no char limit	Skip Logic Group*	Navigation Experience - Other
		L	Please describe any specific navigation links or paths that did not take you where they should have.			N	Text area, no char limit	Skip Logic Group*	Navigation Not Expected OE
		U	What specific links or labels were difficult to understand?			N	Text area, no char limit	Skip Logic Group*	Nav Links and Labels OE
		T	Please describe the technical difficulty you encountered (include as much detail as possible).			N	Text area, no char limit	Skip Logic Group*	Navigation Technical Issue OE
			Describe the issue(s) you experienced while navigating this site. Please be as specific as possible.			N	Text area, no char limit	Skip Logic Group*	Navigation Issues OE
			What specific ways can we improve your experience navigating/browsing on this site?			N	Text area, no char limit		Navigation Improvement OE
			Which of the following technical problems, if any, occurred during your visit? (Please select all that apply.)	Site error message	B	Y	Checkbox, one-up vertical	Skip Logic Group*	Technical Problems
				Incomplete load of a site page
				Inconsistent page loads
				Other (please specify)	A
				No technical problems occurred				Mutually Exclusive
		A	What other type of technical problems did you experience today?			N	Text area, no char limit	Skip Logic Group*	Technical Problems Other
		B	Please describe the error message you received.			N	Text area, no char limit	Skip Logic Group*	Technical Error Messages
			Which of the following issues, if any, did you experience while reviewing information? (Please select all that apply.)	Information was not up to date		Y	Checkbox, one-up vertical	Skip Logic Group*	Information Issues
				Information did not answer my questions	B
				Information was not presented in a concise format
				Wording was not clear
				Text was difficult to read
				Other (please specify)	A
				No issues reviewing information occurred				Mutually Exclusive
		A	Please describe the issue you experienced reviewing information.			N	Text area, no char limit	Skip Logic Group*	Other Information Issues
		B	What information were you looking for that you could not find?			N	Text area, no char limit	Skip Logic Group*	Information Looking For
			How long have you been a Railroad Medicare provider or supplier?	Less than 6 months		Y	Radio button, one-up vertical		Provider Length of Service
				6-11 months
				1-2 years
				3-5 years
				More than 5 years
			How many claims did you submit to Palmetto GBA Railroad Medicare in the past 12 months:	Less than 100		Y	Radio button, one-up vertical		Claims Submitted
				More than 100
			If you would like to be contacted by Palmetto GBA Railroad Medicare regarding your feedback, please provide your email address and/or phone number.			N	Text area, no char limit		OE_Contact Me
			If you could change anything about our site, what would it be?			N	Text area, no char limit		OE_Change One Thing