CMS-10833 QualityNet-EQRS Help Desk Customer Feedback Survey

PRA Disclosure Statement

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number.  The valid OMB control number for this information collection is 0938-XXXX (Expires XX/XX/XXXX).  This is a voluntary information collection. The time required to complete this information collection is estimated to average 5 minutes per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection.  If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: CMS, 7500 Security Boulevard, Attn: PRA Reports Clearance Officer, Mail Stop C4-26-05, Baltimore, Maryland 21244-1850. ****CMS Disclosure**** Please do not send applications, claims, payments, medical records or any documents containing sensitive information to the PRA Reports Clearance Office. Please note that any correspondence not pertaining to the information collection burden approved under the associated OMB control number listed on this form will not be reviewed, forwarded, or retained. If you have questions or concerns regarding where to submit your documents, please contact John Vancil – John.Vancil@cms.hhs.gov.

QualityNet-EQRS Help Desk Customer Feedback Survey

This survey is being conducted by Intelligentics on behalf of the QualityNet Help Desk (EQRS). The EQRS team has asked us to contact a select group of customers for a short survey about your recent experience in working with the QualityNet Help Desk. Your answers will be confidential and will help EQRS to improve service to clients like you. The survey should only take about 5-6 minutes of your time. Please click below to begin. THANK YOU FOR YOUR HELP!

(BEGIN SURVEY)

1. For each item below, please think back to your most recent contact with QualityNet Help Desk (EQRS) and rate the service you received.

	Very Satisfied 5	4	3	2	Very Dissatisfied 1	Not Applicable or No Opinion 0
Ease in navigating and finding your way around CROWNWeb	( )	( )	( )	( )	( )	( )
Performance of CROWNWeb in locating the records and reports you were looking for	( )	( )	( )	( )	( )	( )
Ease in finding the training material or instructions within MyCROWNWeb.org	( )	( )	( )	( )	( )	( )
Ease in finding the right phone number to contact the EQRS Service Center	( )	( )	( )	( )	( )	( )
Quickness in reaching a EQRS customer service representative	( )	( )	( )	( )	( )	( )
Courtesy and friendliness of the customer service representative	( )	( )	( )	( )	( )	( )
Taking time to listen carefully to your questions or concerns	( )	( )	( )	( )	( )	( )
Providing clear and knowledgeable answers to your questions	( )	( )	( )	( )	( )	( )
Effectiveness in resolving your question	( )	( )	( )	( )	( )	( )
Your general satisfaction with this particular call
(FOR ANY 101 TO 109 RATED 2 OR LOWER) Comments or suggestions for improvement	(open end)

2. Overall, how many contacts with the QualityNet Help Desk, whether website visits, phone calls or emails, were needed to resolve your question?

(1 ) 1

(2 ) 2

(3 ) 3

(4 ) 4 or more

(9 ) Not yet resolved (ANSWER Q2A)

Q2A How many contacts have you had so far?

(1 ) 1

(2 ) 2

(3 ) 3

(4 ) 4 or more

3. Overall, how much effort did you personally have to put forth to handle your request?

(5 ) Very Low Effort

(4 ) Low Effort

(3 ) Moderate Effort

(2 ) High Effort*

(1 ) Very High Effort*

*(FOR ALL Q3 RATED 2 OR 1) Q3com Can you comment about what took more effort on your part than it should have? (Open end)

4. Please rate your overall satisfaction with the service you received from the QualityNet Help Desk on this particular question or issue.

(5 ) Very Satisfied

(4 ) Satisfied

(3 ) Neutral

(2 ) Dissatisfied

(1 ) Very Dissatisfied

Thank you for your time and your help today!

2020 EQRS CE Survey, Draft2-final 4 Intelligentics, 6/30/2020