Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Survey

Documents and Forms

Document Name Document Type
Form OMB 3206-0274 Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Survey Form and Instruction
OMB 3206-0274 Consumer Assessment of Healthcare Providers and Systems 2022 CAHPS 5.1H Adult Commercial Survey.pdf Form and Instruction
OMB 3206-0274 Consumer Assessment of Healthcare Providers and Systems CAHPS Health Plan Survey 3206_0274 2022.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	OMB 3206-0274	Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Survey	CAHPS Health Plan Survey 3206_0274 2022.docx		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Fiscal Operations

Privacy Act System of Records
Title: OPM SORN CENTRAL-18-Federal Employees Health Benefits Program Claims Data Warehouse	FR Citation: 84 FR 12569

Number of Respondents: 73,505	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	73,505	73,505
Annual IC Time Burden (Hours)	18,376	18,376
Annual IC Cost Burden (Dollars)	197,728	197,728

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.