30628 Q_NordJf_Web_Browse_20161227

E-Government Website Customer Satisfaction Surveys

Q_NordJf_Web_Browse_20161227.xlsx

Mapping and Questionnaire Documents IA 30628 A4 (CMS)

OMB: 1090-0008

Document [xlsx]
Download: xlsx | pdf

Overview

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


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.
































































































Sheet 2: Model Qsts

Model Name
CMS Noridian JF V2



Red & Strike-Through: Delete
Model ID
xJNVdskEg8oJ19VsNM4QQg4C



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=Very Unlikely, 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 Site
(1=Very Unlikely, 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 Site How likely are you to recommend this site to someone else?


Site Performance (1=Poor, 10=Excellent, Don't Know)




Likelihood to Return
(1=Very Unlikely, 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.




































































































































Sheet 3: Current CQs

Model Name CMS Noridian JF V2



Red & Strike-Through: Delete
Model ID xJNVdskEg8oJ19VsNM4QQg4C



Underlined & Italicized: Re-order
Partitioned Yes - 2MQ



Pink: Addition
Date 11/10/2016



Blue: Reword










QID QUESTION META TAG Skip From Question Text Answer Choices Skip To Required
Y/N
Type Special Instructions CQ Label
HAJ7090Q001

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








Administrative staff of a provider/supplier







Other staff of a provider/supplier







Consultant or attorney








Billing service








Other (please specify) A



HAJ7090Q002
A Other - which best describes you?

N Text field, <100 char OPS Group Other-Best Describes You
HAJ7090Q003

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








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



HAJ7090Q004
A Other - primary reason?

N Text field, <100 char Skip Logic Group OE_Visit Reason non-CMS
HAJ7090Q005
B Who were you trying to contact?

N Text area, no char limit Skip Logic Group OE_Who Contact
HAJ7090Q006
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
HAJ7090Q007
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
HAJ7090Q008
E What specific question were you researching?

N Text area, no char limit Skip Logic Group OE_Reearch Q
HAJ7090Q009

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




HAJ7090Q010

Please select the contract that best describes what you are looking for. Medicare Part A
Y Drop down, select one
Medicare Contract




Medicare Part B








Durable Medical Equipment (DME)








Other




HAJ7090Q011

How did you primarily look for information on this site today? Browsed pages by clicking links
Y Drop down, select one Skip Logic Group Look for Info




Searched using the site search feature B, D







Used the site map C







Used the Noridian Portal




HAJ7090Q012
B What keywords did you use?

N Text area, no char limit Skip Logic Group Keywords
HAJ7090Q013
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 Logic 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



HAJ7090Q014
G Other search issue:

N Text area, no char limit Skip Logic Group OE_Search Experience
HAJ7090Q015
C Please tell us about your experience using the site map.

N Text area, no char limit Skip Logic Group Site Map Experience
HAJ7090Q016

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



HAJ7090Q017
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
HAJ7090Q018

If you could identify one improvement to the website, what would that improvement be?

N Text area, no char limit
Open-Improvement
HAJ7090Q019

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
HAJ7090Q020

Did you experience technical difficulties when using our website or portal? Yes B Y Drop down, select one Skip Logic Group Tech Difficulties




No




HAJ7090Q021
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



HAJ7090Q022
B1 Please specify the technical difficulty you had.

N Text area, no char limit Skip Logic Group OE_Technical Difficulties - what
HAJ7090Q023

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



HAJ7090Q024
A Other navigation difficulty:

N Text area, no char limit Skip Logic Group OE_Navigation Experience
HAJ7090Q025
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
HAJ7090Q026
C What specific links/labels were difficult to understand?

N Text area, no char limit Skip Logic Group OE_links/labels


Sheet 4: CQs (1-3-17)

Model Name CMS Noridian JF V2



Red & Strike-Through: Delete
Model ID xJNVdskEg8oJ19VsNM4QQg4C



Underlined & Italicized: Re-order
Partitioned Yes - 2MQ



Pink: Addition
Date 11/10/2016



Blue: Reword










QID QUESTION META TAG Skip From Question Text Answer Choices Skip To Required
Y/N
Type Special Instructions CQ Label
HAJ7090Q001

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








Administrative staff of a provider/supplier







Other staff of a provider/supplier







Consultant or attorney








Billing service








Other (please specify) A



HAJ7090Q002
A Other - which best describes you?

N Text field, <100 char OPS Group Other-Best Describes You
HAJ7090Q003

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








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



HAJ7090Q004
A Other - primary reason?

N Text field, <100 char Skip Logic Group OE_Visit Reason non-CMS
HAJ7090Q005
B Who were you trying to contact?

N Text area, no char limit Skip Logic Group OE_Who Contact
HAJ7090Q006
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
HAJ7090Q007
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
HAJ7090Q008
E What specific question were you researching?

N Text area, no char limit Skip Logic Group OE_Reearch Q
HAJ7090Q009

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




HAJ7090Q010

Please select the contract that best describes what you are looking for. Medicare Part A
Y Drop down, select one
Medicare Contract




Medicare Part B








Durable Medical Equipment (DME)








Other




HAJ7090Q011

How did you primarily look for information on this site today? Browsed pages by clicking links
Y Drop down, select one Skip Logic Group Look for Info




Searched using the site search feature B, D







Used the site map C







Used the Noridian Portal




HAJ7090Q012
B What keywords did you use?

N Text area, no char limit Skip Logic Group Keywords
HAJ7090Q013
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 Logic 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



HAJ7090Q014
G Other search issue:

N Text area, no char limit Skip Logic Group OE_Search Experience
HAJ7090Q015
C Please tell us about your experience using the site map.

N Text area, no char limit Skip Logic Group Site Map Experience
HAJ7090Q016

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



HAJ7090Q017
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
HAJ7090Q018

If you could identify one improvement to the website, what would that improvement be?

N Text area, no char limit
Open-Improvement
HAJ7090Q019

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
HAJ7090Q020

Did you experience technical difficulties when using our website or portal? Yes B Y Drop down, select one Skip Logic Group Tech Difficulties




No




HAJ7090Q021
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



HAJ7090Q022
B1 Please specify the technical difficulty you had.

N Text area, no char limit Skip Logic Group OE_Technical Difficulties - what
HAJ7090Q023

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



HAJ7090Q024
A Other navigation difficulty:

N Text area, no char limit Skip Logic Group OE_Navigation Experience
HAJ7090Q025
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
HAJ7090Q026
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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