30628 Q_Novitas-JH_Web_Browse_20170221_DOT

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Overview

Welcome & Thank You Text
New Model
Custom Qs
CQs (8-31-17)

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Sheet 1: Welcome & Thank You Text

Model Instance Name:					Red & Strike-Through: Delete
CMS - Novitas JH MAC					Pink: Addition
MID: 1MNYhFF1ok8UlENs08EQlA==					Blue: Reword
Date:	5/13/2016
	Welcome and Thank You Text
		USE ALTERNATE TEXT FOR WELCOME, STANDARD FOR TY
		Welcome Text			Welcome Text - Alternate
		We'd welcome your feedback! (return) Thank you for visiting the Novitas Solutions, Inc. You have been selected to participate in a brief customer satisfaction survey to let us know how we can improve your experience. The feedback you provide will help Novitas Solutions enhance its Web site and server you better in the future. (return) The survey is designed to measure your entire experience, please look for it at the conclusion of your visit.			**PLEASE SEE BELOW IN EXAMPLE DESKTOP**
		Thank You Text			Thank You Text - Alternate
		Thank you for your time in completing this survey. Your input is very valuable and will be taken into consideration.			Thank you for taking our survey - and for helping us serve you better. We appreciate your input!
		Example Desktop (shows text locations)			Example Desktop (shows text locations)
					Rate Your Website Experience
					You've been selected to participate in a customer satisfaction survey to help us improve your website experience.
					The survey will take 2-3 minutes, and will appear at the conclusion of your visit.
					Buttons: No Thanks, Yes, I'll Help!

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Sheet 2: New Model

Model Instance Name:
CMS - Novitas JH MAC v2
F8kAAs51UopAYkNpdMB9tA4C
Partitioned? Yes		2MQ
Date:		1/26/2017
#REF!
Model questions utilize the ACSI methodology to determine scores and impacts
		ELEMENTS (drivers of satisfaction)			CUSTOMER SATISFACTION			FUTURE BEHAVIORS
	MQ Label			MQ Label			MQ Label
		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.	21	Satisfaction - Overall	What is your overall satisfaction with this site? (1=Very Dissatisfied, 10=Very Satisfied)	24	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.	22	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.	23	Satisfaction - Ideal	How does this site compare to your idea of an ideal site? (1=Not Very Close, 10=Very Close)	25	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.				26	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: Custom Qs

Model Instance Name:
CMS - Novitas JH MAC v2
MID:	F8kAAs51UopAYkNpdMB9tA4C
Date:	1/27/2017
CMS - Novitas JH MAC v2 CUSTOM QUESTION LIST
QID	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
HAJ7210Q001		In the last 30 days, how many times have you visited this website?		This is my first time		Radio button, one-up vertical	Single	Y		Visit Frequency
				Once or twice
				Three or four times
				More than once per week but not every day
				Every day
HAJ7210Q002		Which best describes you?		Provider of medical services		Radio button, one-up vertical	Single	Y	Skip Logic 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	A
HAJ7210Q003	A	Please explain briefly:				Text area, no char limit		N	Skip Logic Group*	Other-Best Describes You
HAJ7210Q004		What is your primary reason for visiting this site today?		Download forms		Radio button, one-up vertical	Single	Y	Skip Logic Group*	Reason for visiting
				Learn of, or register for, workshops, seminars or other training events
				Find contact information
				Find general Medicare program information
				Access claim status and/or beneficiary eligibility
				Research a specific question on Medicare policy or billing
		d		Find information on fees or fee schedules
				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	B
HAJ7210Q005	B	Please explain briefly:				Text area, no char limit		N	Skip Logic Group*	Other-Primary Reason
HAJ7210Q006		What topics or features did you access today? (please check all that apply)		Appeals		Checkbox, one-up vertical	Multi	Y	Skip Logic Group*	Features or Topics
				Claims/Eligibility
				Educational Events
				Electronic Billing (EDI)
				Enrollment
				Fee Schedules
				Forms Catalog
				Medical Policy
				Medicare News & Articles
				Novitasphere
				Self-Service Tools (Fee Schedule Search, Enrollment Status, Policy Search)
				Other	C
				None of these/Not applicable					Mutually Exclusive
HAJ7210Q007	C	What other topics or features did you access?				Text area, no char limit		N	Skip Logic Group*	Other Feature
HAJ7210Q008		Did you use any search features located on the Novitas site today?		Yes	A, B	Radio Button, one-up vertical	Single	Y	Skip Logic Group	Search Usage
				No
HAJ7210Q009	A	Which search features did you use?		Regular Entire Site search box (top right corner of pages) using keywords	C, D	Checkbox, one-up vertical	Multi	Y	Skip Logic Group	Type of Search
				Medical Policy/LCDs search tool
				Fee Schedule Code Search
				Enrollment Status Tool
				Other
HAJ7210Q010	B	Did you try using the site's navigational links before using the search feature today?		Yes, I navigated or browsed the site first		Radio Button, one-up vertical	Single	Y	Skip Logic Group	Search First
				No, I went straight to the search feature
				Don't recall
HAJ7210Q011	C	Please tell us which search term(s) you used:				Text field, <100 char		N	Skip Logic Group	Search_Terms
HAJ7210Q012	D	Which best defines your experience with the site's regular search feature today (excluding Medical Policy/LCD search)?		Search results were helpful		Checkbox, one-up vertical	Multi	Y	Mutually Exclusive	Search Experience
				Results were not relevant/not what I wanted	E				Skip Logic Group
				Too many results/I needed to refine my search	E
				Not enough results	E
				Returned NO results	E
HAJ7210Q013	E	Please briefly describe your search experience.				Text area, no char limit		N	Skip Logic Group	Search OE Experience
HAJ7210Q014		Were you able to accomplish your goal by visiting our website today?		Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group*	Accomplish Goal
				No	J
HAJ7210Q015	J	Please explain what you were unable to accomplish on the website:				Text area, no char limit		N	Skip Logic Group*	Reason for Visit
HAJ7210Q016		Do you have any suggestions to help us make our web site better?				Text area, no char limit		N		Improvement
HAJ7210Q017		Did you use Novitasphere (our web-based access portal for claims and eligibility) today?		Yes	Q, K, R	Radio button, one-up vertical	Single	Y	Skip Logic Group*	Portal Usage
				No
HAJ7210Q018	Q	What is your primary reason for coming to the Novitasphere portal today?		Retrieve benefits and eligibility information		Radio button, one-up vertical	Single	Y	Skip Logic Group*	Portal Reason
				View Claim Summary information
				Retrieve claims status information
				Submit claims
				Perform a Claim Correction/Reopening
				Obtain a duplicate remittance advice
				Access my Novitasphere mailbox
				Download reports (999, 277CA, 835)
				Other
HAJ7210Q019	K	How often do you use Novitasphere?		Daily		Radio button, one-up vertical	Single	Y	Skip Logic Group*	Portal Visits
				Weekly
				Monthly or less often
HAJ7210Q020	R	Did you accomplish what you wanted to do in Novitasphere?		Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group*	Portal Accomplish
				No	Y
HAJ7210Q021	Y	What were you unable to accomplish in Novitasphere?				Text area, no char limit		Y	Skip Logic Group*	Portal Unable
HAJ7210Q022		If you are over the age of 18 and were unable to accomplish your goal today, may we contact you to offer further assistance?		Yes	C	Radio button, one-up vertical	Single	N	Skip Logic Group*	Contactable
				No
HAJ7210Q023	C	Please provide us with your full name along with an e-mail address and telephone number where you can be reached:				Text area, no char limit		Y	Skip Logic Group*	Contact Info

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Sheet 4: CQs (8-31-17)

Model Instance Name:
CMS - Novitas JH MAC v2
MID:	F8kAAs51UopAYkNpdMB9tA4C
Date:	1/27/2017
CMS - Novitas JH MAC v2 CUSTOM QUESTION LIST
QID	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
HAJ7210Q001		In the last 30 days, how many times have you visited this website?		This is my first time		Radio button, one-up vertical	Single	Y		Visit Frequency
				Once or twice
				Three or four times
				More than once per week but not every day
				Every day
HAJ7210Q002		Which best describes you?		Provider of medical services		Radio button, one-up vertical	Single	Y	Skip Logic 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	A
HAJ7210Q003	A	Please explain briefly:				Text area, no char limit		N	Skip Logic Group*	Other-Best Describes You
HAJ7210Q004		What is your primary reason for visiting this site today?		Download forms		Radio button, one-up vertical	Single	Y	Skip Logic Group*	Reason for visiting
				Learn of, or register for, workshops, seminars or other training events
				Find contact information
				Find general Medicare program information
				Access claim status and/or beneficiary eligibility
				Research a specific question on Medicare policy or billing
		d		Find information on fees or fee schedules
				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	B
HAJ7210Q005	B	Please explain briefly:				Text area, no char limit		N	Skip Logic Group*	Other-Primary Reason
HAJ7210Q006		What topics or features did you access today? (please check all that apply)		Appeals		Checkbox, one-up vertical	Multi	Y	Skip Logic Group*	Features or Topics
				Claims/Eligibility
				Educational Events
				Electronic Billing (EDI)
				Enrollment
				Fee Schedules
				Forms Catalog
				Medical Policy
				Medicare News & Articles
				Novitasphere
				Self-Service Tools (Fee Schedule Search, Enrollment Status, Policy Search)
				Other	C
				None of these/Not applicable					Mutually Exclusive
HAJ7210Q007	C	What other topics or features did you access?				Text area, no char limit		N	Skip Logic Group*	Other Feature
HAJ7210Q008		Did you use any search features located on the Novitas site today?		Yes	A, B	Radio Button, one-up vertical	Single	Y	Skip Logic Group	Search Usage
				No
HAJ7210Q009	A	Which search features did you use?		Regular Entire Site search box (top right corner of pages) using keywords	C, D	Checkbox, one-up vertical	Multi	Y	Skip Logic Group	Type of Search
				Medical Policy/LCDs search tool
				Fee Schedule Code Search
				Enrollment Status Tool
				Other
HAJ7210Q010	B	Did you try using the site's navigational links before using the search feature today?		Yes, I navigated or browsed the site first		Radio Button, one-up vertical	Single	Y	Skip Logic Group	Search First
				No, I went straight to the search feature
				Don't recall
HAJ7210Q011	C	Please tell us which search term(s) you used:				Text field, <100 char		N	Skip Logic Group	Search_Terms
HAJ7210Q012	D	Which best defines your experience with the site's regular search feature today (excluding Medical Policy/LCD search)?		Search results were helpful		Checkbox, one-up vertical	Multi	Y	Mutually Exclusive	Search Experience
				Results were not relevant/not what I wanted	E				Skip Logic Group
				Too many results/I needed to refine my search	E
				Not enough results	E
				Returned NO results	E
HAJ7210Q013	E	Please briefly describe your search experience.				Text area, no char limit		N	Skip Logic Group	Search OE Experience
HAJ7210Q014		Were you able to accomplish your goal by visiting our website today?		Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group*	Accomplish Goal
				No	J
HAJ7210Q015	J	Please explain what you were unable to accomplish on the website:				Text area, no char limit		N	Skip Logic Group*	Reason for Visit
HAJ7210Q016		Do you have any suggestions to help us make our web site better?				Text area, no char limit		N		Improvement
HAJ7210Q017		Did you use Novitasphere (our web-based access portal for claims and eligibility) today?		Yes	Q, K, R	Radio button, one-up vertical	Single	Y	Skip Logic Group*	Portal Usage
				No
HAJ7210Q018	Q	What is your primary reason for coming to the Novitasphere portal today?		Retrieve benefits and eligibility information		Radio button, one-up vertical	Single	Y	Skip Logic Group*	Portal Reason
				View Claim Summary information
				Retrieve claims status information
				Submit claims
				Perform a Claim Correction/Reopening
				Obtain a duplicate remittance advice
				Access my Novitasphere mailbox
				Download reports (999, 277CA, 835)
				Other
HAJ7210Q019	K	How often do you use Novitasphere?		Daily		Radio button, one-up vertical	Single	Y	Skip Logic Group*	Portal Visits
				Weekly
				Monthly or less often
HAJ7210Q020	R	Did you accomplish what you wanted to do in Novitasphere?		Yes		Radio button, one-up vertical	Single	Y	Skip Logic Group*	Portal Accomplish
				No	Y
HAJ7210Q021	Y	What were you unable to accomplish in Novitasphere?				Text area, no char limit		Y	Skip Logic Group*	Portal Unable
HAJ7210Q022		If you are over the age of 18 and were unable to accomplish your goal today, may we contact you to offer further assistance?		Yes	C	Radio button, one-up vertical	Single	N	Skip Logic Group*	Contactable
				No
HAJ7210Q023	C	Please provide us with your full name along with an e-mail address and telephone number where you can be reached:				Text area, no char limit		Y	Skip Logic Group*	Contact Info