30628 Q_WPSJ5_Web_Browse_20180202_DOT

E-Government Website Customer Satisfaction Surveys

Q_WPSJ8_Web_Browse_20180212_DOT.xlsx

Mapping and Questionnaire Documents IA 30628 A4 (CMS)

OMB: 1090-0008

Document [xlsx]
Download: xlsx | pdf

Overview

Model Qsts
Current
CQs (2-12-18)
CQs (1-12-17)


Sheet 1: Model Qsts

Model Name
CMS - WPS J8 MAC



Red & Strike-Through: Delete
Model ID
UA4wdIoYVU8ZthBo5N5gIg4C



Underlined & Italicized: Re-order
Partitioned
2MQ Partitioning



Pink: Addition
Date
11/17/2016



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. 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
(1=Not Very Likely, 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 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.


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.
















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 - 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 2: Current

Model Name CMS - WPS GHA J8 v2




Red & Strike-Through: Delete


Model ID UA4wdIoYVU8ZthBo5N5gIg4C




Underlined & Italicized: Re-order

Partitioned Yes




Pink: Addition

Date 42691




Blue: Reword












QID QUESTION META TAG Skip From Question Text Answer Choices Skip To Required
Y/N
Type Special Instructions CQ Label
HDU7114Q001

What is your primary reason for visiting this site today? Access claim status and/or beneficiary eligibility
Y Radio button, one-up vertical OPS Group Visit Reason




Download forms









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









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 (please specify) B




HDU7114Q002

B Other - primary reason?

N Text field, <100 char OPS Group Other Visit Reason
HDU7114Q003


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





HDU7114Q004


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) B




HDU7114Q005

B Other - which best describes you?

N Text field, <100 char OPS Group OE_Best Describes
HDU7114Q006

Which best describes your area of interest? Medicare Part A
Y Radio button, one-up vertical
Area of Interest




Medicare Part B









Other





HDU7114Q012


Did you find what you were looking for on this website today? Yes
Y Radio button, one-up vertical Skip Logic Group Looking for




No A, B




HDU7114Q013

A What specifically were you seeking?

N Text field, <100 char Skip Logic Group Specifically Seeking
TAR0211586
B In what section of the website would you expect to have found what you were looking for? My Account
Y Radio button, one-up vertical Skip Logic Group Site Section




Claims









Claim Review









Overpayments









Appeals









Provider Enrollment









Policies









Fee Schedules and Reimbursement









Cost Report Audit









Training









Not sure





HDU7114Q015


How would you describe your navigation experience on this site today? (Please select all that apply.) Links often did not take me where I expected B Y Checkbox, one-up vertical Skip Logic Group Navigation Experience




Had difficulty finding relevant information/products









Links/labels were difficult to understand C








Too many links/navigational options to choose from









Had technical difficulties (error messages, broken links, etc.) D








Could not navigate back to previous information









I had a navigation difficulty not listed above: A








I had no difficulty navigating/browsing on this site


Mutually exclusive

HDU7114Q016

A Other navigation difficulty:

N Text area, no char limit Skip Logic Group OE_Navigation Experience
HDU7114Q017

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
HDU7114Q018
C What specific links/labels were difficult to understand?

N Text area, no char limit Skip Logic Group OE_links/labels
HDU7114Q019

D What type of technical difficulties did you encounter?

N Text area, no char limit Skip Logic Group OE_Tech Difficulties
HDU7114Q022


Are you registered to receive WPS GHA Medicare eNews messages? Yes, I am registered to receive WPS GHA Medicare eNews
Y Radio button, one-up vertical
Registered




No, I choose not to register for WPS GHA Medicare eNews









No, I was not aware that WPS GHA Medicare offered eNews





HDU7114Q024

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

N Text area, no char limit
OE_Improvement
HDU7114Q025


If you are over the age of 18 and would like WPS to respond to your feedback regarding this website, please provide your email address here.

N Text field, <100 char
Email


Sheet 3: CQs (2-12-18)

Model Name CMS - WPS GHA J8 v2




Red & Strike-Through: Delete


Model ID UA4wdIoYVU8ZthBo5N5gIg4C




Underlined & Italicized: Re-order

Partitioned Yes




Pink: Addition

Date 42691




Blue: Reword












QID QUESTION META TAG Skip From Question Text Answer Choices Skip To Required
Y/N
Type Special Instructions CQ Label
HDU7114Q001

What is your primary reason for visiting this site today? Access claim status and/or beneficiary eligibility
Y Radio button, one-up vertical OPS Group Visit Reason




Download forms









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









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 (please specify) B




HDU7114Q002

B Other - primary reason?

N Text field, <100 char OPS Group Other Visit Reason
HDU7114Q003


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





HDU7114Q004


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) B




HDU7114Q005

B Other - which best describes you?

N Text field, <100 char OPS Group OE_Best Describes
HDU7114Q006

Which best describes your area of interest? Medicare Part A
Y Radio button, one-up vertical
Area of Interest




Medicare Part B









Other





HDU7114Q012


Did you find what you were looking for on this website today? Yes
Y Radio button, one-up vertical Skip Logic Group Looking for




No A, B




HDU7114Q013

A What specifically were you seeking?

N Text field, <100 char Skip Logic Group Specifically Seeking


B In what section of the website would you expect to have found what you were looking for? My Account
Y Radio button, one-up vertical Skip Logic Group Site Section




Claims









Claim Review









Overpayments









Appeals









Provider Enrollment









Policies









Fee Schedules and Reimbursement









Cost Report Audit









Training









Not sure





HDU7114Q015


How would you describe your navigation experience on this site today? (Please select all that apply.) Links often did not take me where I expected B Y Checkbox, one-up vertical Skip Logic Group Navigation Experience




Had difficulty finding relevant information/products









Links/labels were difficult to understand C








Too many links/navigational options to choose from









Had technical difficulties (error messages, broken links, etc.) D








Could not navigate back to previous information









I had a navigation difficulty not listed above: A








I had no difficulty navigating/browsing on this site


Mutually exclusive

HDU7114Q016

A Other navigation difficulty:

N Text area, no char limit Skip Logic Group OE_Navigation Experience
HDU7114Q017

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
HDU7114Q018
C What specific links/labels were difficult to understand?

N Text area, no char limit Skip Logic Group OE_links/labels
HDU7114Q019

D What type of technical difficulties did you encounter?

N Text area, no char limit Skip Logic Group OE_Tech Difficulties
HAJ7059Q020

Does your place of business allow employees to access social media for business purposes? Yes
Y Radio button, one-up vertical
SM-Access at Work




No









Not Sure





HAJ7059Q021

Do you ever use a mobile device (smart phone or tablet) to view this website? Yes
Y Radio button, one-up vertical
Mobile or Tablet Access




No





HDU7114Q022


Are you registered to receive WPS GHA Medicare eNews messages? Yes, I am registered to receive WPS GHA Medicare eNews
Y Radio button, one-up vertical
Registered




No, I choose not to register for WPS GHA Medicare eNews









No, I was not aware that WPS GHA Medicare offered eNews





HDU7114Q024

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

N Text area, no char limit
OE_Improvement
HDU7114Q025


If you are over the age of 18 and would like WPS to respond to your feedback regarding this website, please provide your email address here.

N Text field, <100 char
Email


Sheet 4: CQs (1-12-17)

Model Name CMS - WPS J8 MAC



Red & Strike-Through: Delete
Model ID UA4wdIoYVU8ZthBo5N5gIg4C



Underlined & Italicized: Re-order
Partitioned Yes



Pink: Addition
Date 11/17/2016



Blue: Reword










QID Skip From Question Text Answer Choices Skip To Required
Y/N
Type Special Instructions CQ Label
HDU7114Q001
What is your primary reason for visiting this site today? Access claim status and/or beneficiary eligibility
Y Radio button, one-up vertical OPS Group* Visit Reason



Download forms


CMS Required




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








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 (please specify) A




HDU7114Q002 A Other - primary reason?

N Text field, <100 char OPS Group* Other Visit Reason
HDU7114Q003
In the last 30 days, how many times have you visited this website? This is my first time
Y Radio button, one-up vertical CMS Required Visit Frequency



Once or twice








Three or four times








More than once per week but not every day








Every day





HDU7114Q004
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


CMS Required




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




HDU7114Q005 A Other - which best describes you?

N Text field, <100 char OPS Group* OE_Best Describes
HDU7114Q006
Which best describes your area of interest? Medicare Part A
Y Radio button, one-up vertical
Area of Interest



Medicare Part B








Other





HDU7114Q007
Are you a C-SNAP user? Yes A Y Radio button, one-up vertical Skip Logic Group* C-SNAP User



No B




HDU7114Q008 A Did you log-in today? Yes
N Radio button, one-up vertical Skip Logic Group* Log-In



No, I didn't need to log-in to find what I was looking for








No, I was unable to log-in C




HDU7114Q009 C What trouble were you experiencing while trying to log-in to C-SNAP?

N Text area, no char limit Skip Logic Group* Log-In Trouble
HDU7114Q010 B Why are you not a C-SNAP user? I can find what I need without being registered
N Radio button, one-up vertical Skip Logic Group* Not Registered



I tried to register, but was unable to D







I don't know what C-SNAP is





HDU7114Q011 D What problems were you facing when trying to register for C-SNAP?

N Text area, no char limit Skip Logic Group* Registration Trouble?
HDU7114Q012
Did you find what you were looking for on this website today? Yes
Y Radio button, one-up vertical Skip Logic Group* Looking for



No A, B




HDU7114Q013 A What specifically were you seeking?

N Text area, no char limit Skip Logic Group* Specifically Seeking
HDU7114Q014 B In what section of the website would you expect to have found what you were looking for? C-SNAP (Self-Service Portal)
Y Radio button, one-up vertical Skip Logic Group* Expected Section



Policy








Fees








Training








Claims








Departments








News








Resources








FAQs








Forms








Not Sure





HDU7114Q015
How would you describe your navigation experience on this site today? (Please select all that apply.) Links often did not take me where I expected B Y Checkbox, one-up vertical Skip Logic Group* Navigation Experience



Had difficulty finding relevant information/products








Links/labels were difficult to understand C







Too many links/navigational options to choose from








Had technical difficulties (error messages, broken links, etc.) D







Could not navigate back to previous information








I had a navigation difficulty not listed above: A







I had no difficulty navigating/browsing on this site


Mutually exclusive

HDU7114Q016 A Other navigation difficulty:

N Text area, no char limit Skip Logic Group* OE_Navigation Experience
HDU7114Q017 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
HDU7114Q018 C What specific links/labels were difficult to understand?

N Text area, no char limit Skip Logic Group* OE_links/labels
HDU7114Q019 D What type of technical difficulties did you encounter?

N Text area, no char limit Skip Logic Group* OE_Tech Difficulties
HDU7114Q020
Does your place of business allow employees to access social media for business purposes? Yes
Y Radio button, one-up vertical
SM-Access at Work



No








Not Sure





HDU7114Q021
Do you ever use a mobile device (smart phone or tablet) to view this website? Yes
Y Radio button, one-up vertical
Mobile or Tablet Access



No





HDU7114Q022
Are you registered to receive WPS GHA Medicare eNews messages? Yes, I am registered to receive WPS GHA Medicare eNews
Y Radio button, one-up vertical
Registered



No, I choose not to register for WPS GHA Medicare eNews








No, I was not aware that WPS GHA Medicare offered eNews





HDU7114Q023
Have you used the FYI Database on the WPS GHA Medicare website? Yes, I have used the FYI Database
Y Radio button, one-up vertical
FYI Database



No, I choose not to use the FYI Database








No, I was not aware of the FYI Database





HDU7114Q024
If you could identify one improvement to this website, what would that improvement be?

N Text area, no char limit
OE_Improvement
HDU7114Q025
If you are over the age of 18 and would like WPS to respond to your feedback regarding this website, please provide your email address here.

N Text field, <100 char
Email
File Typeapplication/vnd.openxmlformats-officedocument.spreadsheetml.sheet
File Modified0000-00-00
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