Beneficiary Travel Self Service System (BTSSS) Survey Question updates

Clearance for A-11 Section 280 Improving Customer Experience Information Collection

BTSSS_Change Request

Beneficiary Travel Self Service System (BTSSS) Survey Question updates

OMB: 2900-0876

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BTSSS Survey Change Requests

V3 DRAFT 9/20/2024

Working Draft, Pre-Decisional, Deliberative document – Internal VA Use Only




The Veterans Health Administration (VHA) utilizes the Beneficiary Travel Self Service System (BTSSS) for Veterans to submit their Beneficiary Travel reimbursement applications. The responses you provide will help direct the future of this program so we would greatly appreciate your candid feedback. Thank you for your service.


This voluntary survey should take approximately 5 minutes to complete.


How many times per month do you file a claim for beneficiary travel mileage reimbursement?

    • Less than once a month

    • 1-2 times per month

    • 3-5 times per month

    • More than 5 times per month.

Which of the following healthcare facilities do you most frequently receive care at? (Select only one option)

  • VA - VA Medical Center

  • VA - VA Outpatient Clinic (OPC/CBOC)

  • Non-VA - Care in the Community



What is your comfort level with using a mobile phone, computer, or tablet for filing beneficiary travel reimbursement? (Select only one option)


  • Uncomfortable

  • Somewhat comfortable

  • Very Comfortable



Do you need additional training or instruction on how to submit a beneficiary travel claim electronically?

  • Yes

  • No

Where do you most often go for help with filing beneficiary travel claims? (Select only one option)

  • My local VA

  • Online – VA.gov

  • Beneficiary Travel Self Service System (Help Guide within application)

  • VA/VSO community events

  • Other_______________

Rank the following in order of importance when filing a beneficiary travel claim. Drag and drop each option to rank.



Shape1

Ease of submission




Time to payment (how fast I get paid)




Ability to track my claim status



Ability to file a claim 24/7 (any time I want!)



Other





What areas in the Beneficiary Travel Self Service System would you like to see improved? (Select all that apply)

  • Register/Login

  • Claim submission process

  • Mileage expense & mapping calculation tool

  • Adding Attachments

  • Profile update requests (to include updating EFT information)

  • N/A – I have never used the Beneficiary Travel Self Service System



It's easy to use the Beneficiary Travel Self Service System <Logic: Will not appear if “What areas in the Beneficiary Travel Self Service System would you like to see improved” is “N/A – I have never used the Beneficiary Travel Self Service System” >



I'm likely to recommend the Beneficiary Travel Self Service System to a fellow Veteran/beneficiary. <Logic: Will not appear if “What areas in the Beneficiary Travel Self Service System would you like to see improved” is “N/A – I have never used the Beneficiary Travel Self Service System” >










What is your preferred method to submit a Beneficiary Travel claim?   (Select only one option)

  • I prefer to file a claim online from my own device during check-in for my appointment at the VA facility.

  • I prefer to file a claim online from my own device – at my convenience – outside the VA facility (e.g. home/residence).

  • I prefer to file a claim from an on-premises device (e.g. tablet or kiosk like device) at my local VA facility.

  • I prefer to file a paper claim and submit it to my local VA facility.





I trust VA to fulfill our country's commitment to Veterans. Required


Would you like to provide additional feedback with a compliment, concern or recommendation about your experience(s) with beneficiary travel reimbursement?


Please select a response from the following options. Select all that apply. Required

Compliment <Logic text box only appears if Veteran selects compliment >

Concern <Logic text box only appears if Veteran selects concern >





Recommendation <Logic text box only appears if Veteran selects recommendation >


If additional information is needed, can VA contact you about your feedback? Required



    • Yes, VA can contact me about my experience.

  • No, I do not want VA to contact me about my experience.

VA Burden Statement: An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB control number for this project is 2900-0876, and it expires 02/28/2026. Public reporting burden for this collection of information is estimated to average 5 minutes per respondent, per year, including the time for reviewing instructions, searching existing data sources, gathering, and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate and any other aspect of this collection of information, including suggestions for reducing the burden, to VA Reports Clearance Officer at [email protected]. Please refer to OMB Control No. 2900-0876 in any correspondence. Do not send your completed VA Form to this email address. 

Privacy Notice: By filling out this survey, you are authorizing VA database access to retrieve Veteran contact information to follow up with you accordingly for purposes of service recovery, potential crisis, or to learn more about feedback you have shared regarding your experience with VA. Your contact information and response may be referred to the Veterans Crisis Line if an automated review indicates your response may be concerning. The Veterans Crisis Line may contact you for follow up as a result of that referral. VA may utilize individual Veteran survey data from this survey or other sources to ensure the final scores truly and accurately represent the experiences of Veterans. This collection of information is authorized by 38 U.S.C. Section 301.

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleBTSSS Survey Revisions
AuthorWeller, Andrew J. (BAH)
File Modified0000-00-00
File Created2025-05-19

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