30628 Q_NordDmeJa_Web_Browse_20161227

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Overview

Welcome and Thank You Text
Model Qsts
Current CQs
CQs (1-3-17)

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Sheet 1: Welcome and Thank You Text

	Please use current Welcome and Thank you texts.
Welcome and Thank You Text
	Welcome Text			Thank You Text
	Thank you for visiting [Company/Site/Agency]. 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 taking our survey - and for helping us serve you better. We appreciate your input!
	Welcome Text - Alternate			Thank You Text - Alternate
	Thank you for visiting [Company/Site/Agency]. You have been randomly selected to take part in this survey that is being conducted by ForeSee on behalf of the [Company/Site/Agency]. Please take a few minutes to give us your feedback. All results are strictly confidential.			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 web site.

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Sheet 2: Model Qsts

Model Name		CMS Noridian DME MAC A V2					Red & Strike-Through: Delete
Model ID		Q0dhZ5w5VshdsAIIU8BdMw4C					Underlined & Italicized: Re-order
Partitioned		Yes - 2MQ					Pink: Addition
Date		11/10/2016					Blue: Reword
	Label	Element Questions		Label	Satisfaction Questions		Label	Future Behaviors
		Look and Feel (1=Poor, 10=Excellent, Don't Know)			Satisfaction			Primary Resource (1=Not Very Likely, 10=Very Likely)
1	Look and Feel - Appeal	Please rate the visual appeal of this site.	16	Satisfaction - Overall	What is your overall satisfaction with this site? (1=Very Dissatisfied, 10=Very Satisfied)	19	Primary Resource	How likely are you to use this site as your primary resource for getting information on Medicare?
2	Look and Feel - Balance	Please rate the balance of graphics and text on this site.	17	Satisfaction - Expectations	How well does this site meet your expectations? (1=Falls Short, 10=Exceeds)			Recommend (1=Not Very Likely, 10=Very Likely)
3	Look and Feel - Legibility	Please rate the legibility of the pages on this site.	18	Satisfaction - Ideal	How does this site compare to your idea of an ideal site? (1=Not Very Close, 10=Very Close)	20	Recommend	How likely are you to recommend this site to someone else?
		Site Performance (1=Poor, 10=Excellent, Don't Know)						Likelihood to Return (1=Not Very Likely, 10=Very Likely)
4	Site Performance - Loading	Please rate how quickly pages load on this site.				21	Return	How likely are you to return to this site?
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.
13		Site Information (1=Poor, 10=Excellent, Don't Know)
	Site Information - Thoroughness	Please rate the thoroughness of information provided on this site.
14	Site Information - Relevant	Please rate how relevant this site’s information is.
15	Site Information - Answers	Please rate how well the site’s information provides answers to your questions.

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Sheet 3: Current CQs

Model Name	CMS Noridian DME MAC A V2					Red & Strike-Through: Delete
Model ID	Q0dhZ5w5VshdsAIIU8BdMw4C					Underlined & Italicized: Re-order
Partitioned	Yes - 2MQ					Pink: Addition
Date	(1/2/2013)					Blue: Reword
QID	QUESTION META TAG	Skip From	Question Text	Answer Choices	Skip To	Required Y/N	Type	Special Instructions	CQ Label
HDU7104Q001	Role		Which best describes you?	Provider of medical services		Y	Radio button, one-up vertical	OPS Group	Best describes you
				Supplier of medical equipment or supplies
				Staff of provider/supplier working primarily with billing/insurance				CMS Required
				Administrative staff of a provider/supplier
				Other staff of a provider/supplier
				Consultant or attorney
				Billing service
				Other (please specify)	A
HDU7104Q002		A	Other - which best describes you?			N	Text field, <100 char	OPS Group	Other-Best Describes You
HDU7104Q003	Primary Reason		What is your primary reason for visiting this site today?	Access claim status and/or beneficiary eligibility		Y	Radio button, one-up vertical	Skip Logic Group	Visit Reason non-CMS
				Download forms
				Learn of, or register for, workshops, seminars or other training events				CMS Required
				Find contact information	B
				Find general Medicare program information	C
				Research a specific question on Medicare policy or billing	E
				Find information on fees or fee schedules	D
				Find out about a Local Coverage Determination (LCD)
				Read Medicare publications such as newsletters, articles,etc.
				Find enrollment information
				Take an on-line training course
				Other (please specify)	A
HDU7104Q004		A	Other - primary reason:			N	Text field, <100 char	Skip Logic Group	OE_Visit Reason non-CMS
HDU7104Q005		B	Who were you trying to contact?			N	Text area, no char limit	Skip Logic Group	OE_Who Contact
HDU7104Q006		C	What was the topic of program information you were looking for?			N	Text area, no char limit	Skip Logic Group	OE_Topic Program Info
HDU7104Q007		D	What code or type of fee schedule were you looking for?			N	Text area, no char limit	Skip Logic Group	OE_Code Fee Sched
HDU7104Q008		E	What specific question were you researching?			N	Text area, no char limit	Skip Logic Group	OE_Reearch Q
HDU7104Q009			How did you primarily look for information on this site today?	Browsed pages by clicking links		Y	Drop down, select one	Skip Group	Look for info
				Searched using the site search feature	B, D
				Used the site map	C
				Used the Noridian Portal
HDU7104Q010		B	What keywords did you use?			N	Text area, no char limit	Skip Group	Keywords
HDU7104Q011		D	Please tell us about your experience with the site's search feature today. (Please select all that apply.)	Search results were helpful		Y	Checkbox, one-up vertical	Skip Group	Search Experience
				Results were not relevant/not what I wanted
				Too many results/I needed to refine my search
				Not enough results
				Returned NO results
				Had technical difficulty
				I experienced a different search issue (please explain)	G
HDU7104Q012		G	Other search issue:			N	Text area, no char limit	Skip Group	OE_Search Experience
HDU7104Q013		C	Please tell us about your experience using the site map.			N	Text area, no char limit	Skip Group	Site Map Experience
HDU7104Q014			Did you find what you were looking for?	Yes		Y	Radio button, one-up vertical	Skip Logic Group	Did you find
				No	A
				I'm still searching	A
HDU7104Q015		A	What were you looking for that you were unable to find?			N	Text area, no char limit	Skip Logic Group	OE_Unabe to find
HDU7104Q016			Please select the contract that best describes what you are looking for.	Durable Medical Equipment (DME)		Y	Drop down, select one		Medicare Contract
				Medicare Part A
				Medicare Part B
				Other
HDU7104Q017			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				CMS Required
				Three or four times
				More than once per week but not every day
				Every day
HDU7104Q018	OE_Improve Experience		If you could identify one improvement to the website, what would that improvement be?			N	Text area, no char limit	CMS - NAS	open-Improvement
HDU7104Q019			If you are over the age of 18 and would like Noridian to respond to your feedback regarding this website, please provide your email address here.			N	Text field, <100 char		Feedback Email
HDU7104Q020			Did you experience technical difficulties when using our website or portal?	Yes	B	Y	Drop down, select one	Skip Logic Group	Tech Difficulties
				No
HDU7104Q021		B	What technical difficulties did you encounter?	Broken links		N	Drop down, select one	Skip Logic Group	Technical Difficulties - what
				Error loading pages
				Unable to login to my account
				The site was down
				Pages took too long to load
				Other	B1
HDU7104Q022		B1	Please specify the technical difficulty you had.			N	Text area, no char limit	Skip Logic Group	OE_Technical Difficulties - what
HDU7104Q023			How would you describe your navigation experience on this site today? (Please select all that apply.)	I had no difficulty navigating/browsing on this site		Y	Checkbox, one-up vertical	Skip Logic Group	Navigation Experience
				Links often did not take me where I expected	B
				Had difficulty finding relevant information/products
				Links/labels are difficult to understand	C
				Too many links/navigational options to choose from
				Had technical difficulties (error messages, broken links, etc.)
				Could not navigate back to previous information
				I had a navigation difficulty not listed above	A
HDU7104Q024		A	Other navigation difficulty:			N	Text area, no char limit	Skip Logic Group	OE_Navigation Experience
HDU7104Q025		B	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	OE_Links/Paths
HDU7104Q026		C	What specific links/labels were difficult to understand?			N	Text area, no char limit	Skip Logic Group	OE_links/labels

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Sheet 4: CQs (1-3-17)

Model Name	CMS Noridian DME MAC A V2					Red & Strike-Through: Delete
Model ID	Q0dhZ5w5VshdsAIIU8BdMw4C					Underlined & Italicized: Re-order
Partitioned	Yes - 2MQ					Pink: Addition
Date	(1/2/2013)					Blue: Reword
QID	QUESTION META TAG	Skip From	Question Text	Answer Choices	Skip To	Required Y/N	Type	Special Instructions	CQ Label
HDU7104Q001	Role		Which best describes you?	Provider of medical services		Y	Radio button, one-up vertical	OPS Group	Best describes you
				Supplier of medical equipment or supplies
				Staff of provider/supplier working primarily with billing/insurance				CMS Required
				Administrative staff of a provider/supplier
				Other staff of a provider/supplier
				Consultant or attorney
				Billing service
				Other (please specify)	A
HDU7104Q002		A	Other - which best describes you?			N	Text field, <100 char	OPS Group	Other-Best Describes You
HDU7104Q003	Primary Reason		What is your primary reason for visiting this site today?	Access claim status and/or beneficiary eligibility		Y	Radio button, one-up vertical	Skip Logic Group	Visit Reason non-CMS
				Download forms
				Learn of, or register for, workshops, seminars or other training events				CMS Required
				Find contact information	B
				Find general Medicare program information	C
				Research a specific question on Medicare policy or billing	E
				Find information on fees or fee schedules	D
				Find out about a Local Coverage Determination (LCD) or policy
				Read Medicare publications such as newsletters, articles,etc.
				Find enrollment information
				Take an on-line training course
				Other (please specify)	A
HDU7104Q004		A	Other - primary reason:			N	Text field, <100 char	Skip Logic Group	OE_Visit Reason non-CMS
HDU7104Q005		B	Who were you trying to contact?			N	Text area, no char limit	Skip Logic Group	OE_Who Contact
HDU7104Q006		C	What was the topic of program information you were looking for?			N	Text area, no char limit	Skip Logic Group	OE_Topic Program Info
HDU7104Q007		D	What code or type of fee schedule were you looking for?			N	Text area, no char limit	Skip Logic Group	OE_Code Fee Sched
HDU7104Q008		E	What specific question were you researching?			N	Text area, no char limit	Skip Logic Group	OE_Reearch Q
HDU7104Q009			How did you primarily look for information on this site today?	Browsed pages by clicking links		Y	Drop down, select one	Skip Group	Look for info
				Searched using the site search feature	B, D
				Used the site map	C
				Used the Noridian Portal
HDU7104Q010		B	What keywords did you use?			N	Text area, no char limit	Skip Group	Keywords
HDU7104Q011		D	Please tell us about your experience with the site's search feature today. (Please select all that apply.)	Search results were helpful		Y	Checkbox, one-up vertical	Skip Group	Search Experience
				Results were not relevant/not what I wanted
				Too many results/I needed to refine my search
				Not enough results
				Returned NO results
				Had technical difficulty
				I experienced a different search issue (please explain)	G
HDU7104Q012		G	Other search issue:			N	Text area, no char limit	Skip Group	OE_Search Experience
HDU7104Q013		C	Please tell us about your experience using the site map.			N	Text area, no char limit	Skip Group	Site Map Experience
HDU7104Q014			Did you find what you were looking for?	Yes		Y	Radio button, one-up vertical	Skip Logic Group	Did you find
				No	A
				I'm still searching	A
HDU7104Q015		A	What were you looking for that you were unable to find?			N	Text area, no char limit	Skip Logic Group	OE_Unabe to find
HDU7104Q016			Please select the contract that best describes what you are looking for.	Durable Medical Equipment (DME)		Y	Drop down, select one		Medicare Contract
				Medicare Part A
				Medicare Part B
				Other
HDU7104Q017			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				CMS Required
				Three or four times
				More than once per week but not every day
				Every day
HDU7104Q018	OE_Improve Experience		If you could identify one improvement to the website, what would that improvement be?			N	Text area, no char limit	CMS - NAS	open-Improvement
HDU7104Q019			If you are over the age of 18 and would like Noridian to respond to your feedback regarding this website, please provide your email address here.			N	Text field, <100 char		Feedback Email
HDU7104Q020			Did you experience technical difficulties when using our website or portal?	Yes	B	Y	Drop down, select one	Skip Logic Group	Tech Difficulties
				No
HDU7104Q021		B	What technical difficulties did you encounter?	Broken links		N	Drop down, select one	Skip Logic Group	Technical Difficulties - what
				Error loading pages
				Unable to login to my account
				The site was down
				Pages took too long to load
				Other	B1
HDU7104Q022		B1	Please specify the technical difficulty you had.			N	Text area, no char limit	Skip Logic Group	OE_Technical Difficulties - what
HDU7104Q023			How would you describe your navigation experience on this site today? (Please select all that apply.)	I had no difficulty navigating/browsing on this site		Y	Checkbox, one-up vertical	Skip Logic Group	Navigation Experience
				Links often did not take me where I expected	B
				Had difficulty finding relevant information/products
				Links/labels are difficult to understand	C
				Too many links/navigational options to choose from
				Had technical difficulties (error messages, broken links, etc.)
				Could not navigate back to previous information
				I had a navigation difficulty not listed above	A
HDU7104Q024		A	Other navigation difficulty:			N	Text area, no char limit	Skip Logic Group	OE_Navigation Experience
HDU7104Q025		B	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	OE_Links/Paths
HDU7104Q026		C	What specific links/labels were difficult to understand?			N	Text area, no char limit	Skip Logic Group	OE_links/labels