Form CMS-10818 Call Scheduling

Generic Clearance for the Center for Clinical Standards and Quality IT Product and Support Teams (CMS-10706)

CMS-10818 Call Scheduling - CCSQ Suppot Central Survey Mock-ups

Center for Clinical Standards and Quality (CCSQ) Support Central Customer Satisfaction Survey (CMS-10818)

OMB: 0938-1397

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Customer Support
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Quality Program Websites
End-Stage Renal
Disease Quality
Reporting System
(EQRS)

HCQIS Access
Roles and Profile
(HARP)

Internet Quality
Improvement &
Evaluation System
(iQIES)

Hospital Quality
Reporting (HQR)

Quality
Improvement &
Evaluation System
(QIES)

Quality Payment
Program (QPP)

General CMS Information
CMS.gov

Quality Reporting Center

QualityNet

HARP

The official website of the Centers for
Medicare & Medicaid Services, including
information about Medicare, Medicaid, and
Medicare-Medicaid coordination, etc.

Resources to assist hospitals, inpatient
psychiatric facilities, PPS-exempt cancer
hospitals, and ambulatory surgical centers
with quality data reporting

Healthcare quality improvement news, resources
and data reporting tools and applications used
by healthcare providers and others

HCQIS Access Roles and Profile (HARP) is a
secure identity management portal provided
by the Centers for Medicare and Medicaid
Services (CMS)

HealthCare.gov

Medicare.gov

eCQI

Information for people who need health
insurance and want to apply for or enroll in
the Marketplace

Information for people with Medicare,
Medicare open enrollment, and benefits

Electronic Clinical Quality Improvement (eCQI)
Resource Center: The eCQM one-stop shop

Subscribe to a CMS Newsletter

Provide Site Feedback

Sign up to receive the latest news and updates
from the CCSQ Service Center or related programs.

Help us improve this website by providing
your feedback in a short survey.

Sign Me Up

Give Feedback

About

Programs

Accessiblity

Contact Us

Privacy Policy

QPP

Accessibility

Technical Support

iQIES/QIES
EQRS
HQR

IRequest
Have a Question
Support

About

Guided Tour

Contact Us

WELCOME TO CCSQ SUPPORT CENTRAL

Your one-stop shop for
Customer Support
Create a new ticket

Track an existing ticket

To send a question or issue to the Service Center, please click
the button below and complete the questions on the following
page. A ticket will be generated on your behalf and an agent will
contact you.

To track an existing ticket with the Service Center, enter your
email address and/or case number to receive an email with your
ticket status information.
Track Ticket

Create Ticket

Quality Program Websites
End-Stage Renal
Disease Quality
Reporting System
(EQRS)

HCQIS Access
Roles and Profile
(HARP)

Internet Quality
Improvement &
Evaluation System
(iQIES)

Hospital Quality
Reporting (HQR)

Quality
Improvement &
Evaluation System
(QIES)

Quality Payment
Program (QPP)

General CMS Information
CMS.gov

Quality Reporting Center

QualityNet

HARP

The official website of the Centers for
Medicare & Medicaid Services, including
information about Medicare, Medicaid, and
Medicare-Medicaid coordination, etc.

Resources to assist hospitals, inpatient
psychiatric facilities, PPS-exempt cancer
hospitals, and ambulatory surgical centers
with quality data reporting

Healthcare quality improvement news, resources
and data reporting tools and applications used
by healthcare providers and others

HCQIS Access Roles and Profile (HARP) is a
secure identity management portal provided
by the Centers for Medicare and Medicaid
Services (CMS)

HealthCare.gov

Medicare.gov

eCQI

Information for people who need health
insurance and want to apply for or enroll in
the Marketplace

Information for people with Medicare,
Medicare open enrollment, and benefits

Electronic Clinical Quality Improvement (eCQI)
Resource Center: The eCQM one-stop shop

Subscribe to a CMS Newsletter

Provide Site Feedback

Sign up to receive the latest news and updates
from the CCSQ Service Center or related programs.

Help us improve this website by providing
your feedback in a short survey.

Sign Me Up

Give Feedback

About

Programs

Accessiblity

Contact Us

Privacy Policy

QPP

Accessibility

Technical Support

iQIES/QIES
EQRS
HQR

IRequest
Have a Question
Support

About

Guided Tour

Contact Us

WELCOME TO CCSQ SUPPORT CENTRAL

Your one-stop shop for
Customer Support
Create a new ticket

Track an existing ticket

To send a question or issue to the Service Center, please click
the button below and complete the questions on the following
page. A ticket will be generated on your behalf and an agent will
contact you.

To track an existing ticket with the Service Center, enter your
email address and/or case number to receive an email with your
ticket status information.
Track Ticket

Create Ticket

Quality Program Websites
End-Stage Renal
Disease Quality
Reporting System
(EQRS)

HCQIS Access
Roles and Profile
(HARP)

Internet Quality
Improvement &
Evaluation System
(iQIES)

Hospital Quality
Reporting (HQR)

Quality
Improvement &
Evaluation System
(QIES)

Quality Payment
Program (QPP)

General CMS Information
CMS.gov

Quality Reporting Center

QualityNet

HARP

The official website of the Centers for
Medicare & Medicaid Services, including
information about Medicare, Medicaid, and
Medicare-Medicaid coordination, etc.

Resources to assist hospitals, inpatient
psychiatric facilities, PPS-exempt cancer
hospitals, and ambulatory surgical centers
with quality data reporting

Healthcare quality improvement news, resources
and data reporting tools and applications used
by healthcare providers and others

HCQIS Access Roles and Profile (HARP) is a
secure identity management portal provided
by the Centers for Medicare and Medicaid
Services (CMS)

HealthCare.gov

Medicare.gov

eCQI

Information for people who need health
insurance and want to apply for or enroll in
the Marketplace

Information for people with Medicare,
Medicare open enrollment, and benefits

Electronic Clinical Quality Improvement (eCQI)
Resource Center: The eCQM one-stop shop

Subscribe to a CMS Newsletter

Provide Site Feedback

Sign up to receive the latest news and updates
from the CCSQ Service Center or related programs.

Help us improve this website by providing
your feedback in a short survey.

Sign Me Up

Give Feedback

About

Programs

Accessiblity

Contact Us

Privacy Policy

QPP

Accessibility

Technical Support

iQIES/QIES
EQRS
HQR

IRequest
Have a Question
Support

About

Guided Tour

Contact Us

WELCOME TO CCSQ SUPPORT CENTRAL

Your one-stop shop for
Customer Support
Create a new ticket

Track an existing ticket

To send a question or issue to the Service Center, please click
the button below and complete the questions on the following
page. A ticket will be generated on your behalf and an agent will
contact you.

To track an existing ticket with the Service Center, enter your
email address and/or case number to receive an email with your
ticket status information.
Track Ticket

Create Ticket

Quality Program Websites
End-Stage Renal
Disease Quality
Reporting System
(EQRS)

HCQIS Access
Roles and Profile
(HARP)

Internet Quality
Improvement &
Evaluation System
(iQIES)

Hospital Quality
Reporting (HQR)

Quality
Improvement &
Evaluation System
(QIES)

Quality Payment
Program (QPP)

General CMS Information
CMS.gov

Quality Reporting Center

QualityNet

HARP

The official website of the Centers for
Medicare & Medicaid Services, including
information about Medicare, Medicaid, and
Medicare-Medicaid coordination, etc.

Resources to assist hospitals, inpatient
psychiatric facilities, PPS-exempt cancer
hospitals, and ambulatory surgical centers
with quality data reporting

Healthcare quality improvement news, resources
and data reporting tools and applications used
by healthcare providers and others

HCQIS Access Roles and Profile (HARP) is a
secure identity management portal provided
by the Centers for Medicare and Medicaid
Services (CMS)

HealthCare.gov

Medicare.gov

eCQI

Information for people who need health
insurance and want to apply for or enroll in
the Marketplace

Information for people with Medicare,
Medicare open enrollment, and benefits

Electronic Clinical Quality Improvement (eCQI)
Resource Center: The eCQM one-stop shop

Subscribe to a CMS Newsletter

Provide Site Feedback

Sign up to receive the latest news and updates
from the CCSQ Service Center or related programs.

Help us improve this website by providing
your feedback in a short survey.

Sign Me Up

Give Feedback

About

Programs

Accessiblity

Contact Us

Privacy Policy

QPP

Accessibility

Technical Support

iQIES/QIES
EQRS
HQR

We appreciate your feedback!

We appreciate your feedback!

*How would you rate your call scheduling experience?
How was your overall call scheduling experience today?

Excellent

Neutral

Bad

*Were the provided times slots and dates convenient for you?
Yes

No

Please specify:

*How easy was it to schedule a call request?

Easy

Normal

Challenging

Please specify:

*Which program are you affiliated with?
Please select the program you are apart of:
EPCS - Electronic Prescribing for Controlled Substances
EQRS - End Stage Renal Disease Quality Reporting System
HQR - Hospital Quality Reporting
iQIES/QIES - Quality Improvement/Internet Quality Improvement &
Evaluation System
QPP - Quality Payment Program
CCSQ Services and Operations Support - QualityNet IT Services,
HARP, CCSQ Atlassian, ServiceNow & Slack
Other: (Please specify)

*Would you use Call Scheduling again for your next visit?

Yes

Not Sure

No

Please specify:

*Can we contact you with further questions?
May we contact you if we have additional questions?
Yes.

Please provide your contact details below:
Full Name:

Email Address:

No, thank you.

Complete


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