Information Collection

Account Manager Satisfaction Survey (CMS-10748)

IC 257124 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
CMS-10748 Account Manager Survey 2- Survey Questionsrevised.docx	Form
CMS-10748 Account Manager Survey 2- Survey Questionsrevised.docx	Form
CMS-10748 - Fast Track Supporting Statement (2020 version 3) (1).docx CMS-10748 - Fast Track Supporting Statement (2020 version 3)	IC Document
CMS-10748 - Fast Track Supporting Statement (2020 version 3) (1).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	Account Manager Survey	2- Survey Questionsrevised.docx		Yes	Yes	Fillable Printable

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

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)	5	5
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)	CMS-10748 - Fast Track Supporting Statement (2020 version 3) (1).docx	11/25/2022

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