Appendix B1 2021_survey_initial_cover_letter_english_clean

2021 Survey

INITIAL COVER LETTER

[THE HEADING ABOVE IS NOT TO BE INCLUDED ON THE LETTER SENT TO BENEFICIARIES]

[VENDOR LETTERHEAD]
Dear [FIRST LAST]:

[VENDOR RETURN ADDRESS]

[LAST DATE OF 1ST SURVEY MAILING]

As a person with Medicare, you deserve to get the highest quality medical care when you need
it, from doctors, nurses and other health care clinicians you interact with in the health care
system. The Centers for Medicare & Medicaid Services (CMS) is the federal agency that
administers the Medicare program. To help CMS evaluate the quality of the care provided under
Medicare, they need to hear directly from Medicare patients. CMS developed the Consumer
Assessment of Healthcare Providers and Systems (CAHPS) Survey in order to receive
feedback from Medicare patients.
[VENDOR NAME] is working with CMS to conduct this survey and contacting you because you
were randomly selected to receive the enclosed survey. The survey asks questions about your
experience with a specific provider you visited within the last 6 months. Visits with this
provider may have been in person, by phone, or by video call. In order to evaluate the quality
of care provided to Medicare patients, it is important for CMS to hear about your experience.
CMS values your input.
Participation in the survey is voluntary; you do not have to participate. Your decision to
participate or not to participate will not affect your Medicare benefits in any way. If you
choose to participate, it will take you about 13 minutes to fill out the survey. The information you
provide in the survey will be kept private by law. Your information will not be shared with anyone
other than personnel authorized by CMS. Your completed survey will not be shared with any of
your health care providers.
If you have any questions about the survey, please call us toll-free at [VENDOR NUMBER],
between 9:00 am to 6:00 pm [VENDOR TIME ZONE], Monday through Friday. Please take
this opportunity to help CMS learn about the quality of care you receive. Thank you in
advance for your participation.
Sincerely,
[SIGNED BY SENIOR LEADER AT VENDOR ORGANIZATION]