Medicare Administrative Contractor (MAC) Provider Customer Experience (CMS-10720)

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (CMS-10415)

OMB: 0938-1185

IC ID: 238682

Information Collection (IC) Details

View Information Collection (IC)

Medicare Administrative Contractor (MAC) Provider Customer Experience (CMS-10720)
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10720 Overall Website Feedback Survey.docx CMS-10720.Final Overall Website Feedback Survey.docx Yes Yes Fillable Fileable
Form and Instruction CMS-10720 Final Overall Portal Feedback Survey (Spanish) CMS-10720.Final Overall Portal Feedback Survey (Spanish).docx Yes Yes Fillable Fileable
Form and Instruction CMS-10720 Final Overall Website Feedback Survey (Spanish).docx CMS-10720.Final Overall Website Feedback Survey (Spanish).docx Yes Yes Fillable Fileable
Form and Instruction CMS-10720 Final Overall Portal Feedback Survey.docx CMS-10720.Final Overall Portal Feedback Survey.docx Yes Yes Fillable Fileable

Health Health Care Services

 

35,000 0
   
Individuals or Households
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 35,000 0 35,000 0 0 0
Annual IC Time Burden (Hours) 1,750 0 1,750 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
CMS-10720.MAC Overall Site Experience Fast Track Request CMS-10720.MAC Overall Site Experience Fast Track Request.docx 11/22/2019
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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