Information Collection

Account Manager Satisfaction Survey (CMS-10748)

IC 257114 under ICR 202211-0938-011 · OMB 0938-1185.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CMS-10748 Account Manager Satisfaction Survey (CMS-10748)	Form
Form CMS-10748 Account Manager Satisfaction Survey Account Manager Satisfaction Survey (CMS-10748)	Form
CMS-10748 Account Manager Satisfaction Survey Account Manager Satisfaction Survey.docx	Form
CMS-10748 Account Manager Satisfaction Survey Account Manager Satisfaction Survey.docx	Form
CMS-10748 - Fast Track Supporting Statement (2020 version 3).docx CMS-10748 - Fast Track Supporting Statement (2020 version 3)	IC Document
CMS-10748 - Fast Track Supporting Statement (2020 version 3).docx CMS-10748 - Fast Track Supporting Statement (2020 version 3)	IC Document

IC Title:

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	CMS-10748				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 300

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	300	300
Annual IC Time Burden (Hours)	50	50
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
CMS-10748 - Fast Track Supporting Statement (2020 version 3)		11/25/2022

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

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