1. Please provide an email address for verification purposes. Responses that do not include a valid email address will not be counted. We will not use your address for any other purpose, nor will we pass it along to any third party.
 Total Respondents  
0
(skipped this question)  0
2. For purposes of this survey, the health plan or organization I represent can best be described as (check all that apply):
 Response PercentResponse Total
 Traditional Indemnity Insurance Program
 0%0
 Health Maintenance Organization (HMO)
 0%0
 Preferred Provider Organization (PPO)
 0%0
 Point of Service (POS)
 0%0
 Long Term Care
 0%0
 Dental HMO
 0%0
 Dental PPO
 0%0
 Vision Only
 0%0
 Pharmacy
 0%0
 Medicare Managed Care Plan
 0%0
 Medicaid
 0%0
 Medicare Carrier
 0%0
 Medicare Fiscal Intermediary
 0%0
 Other (please specify)
 0%0
Total Respondents  0
(skipped this question)  0
3. Number of Institutional providers (Hospitals and other facilities) participating in this plan (or plans)?
 Response PercentResponse Total
  0
0%0
  1 – 10
0%0
  11 – 25
0%0
  26 – 100
0%0
  101-500
0%0
  501+
0%0
  Not Sure/Don't know
0%0
Total Respondents  0
(skipped this question)  0
4. Number of Professional Providers (all types) participating in this plan?
 Response PercentResponse Total
  0
0%0
  250 or less
0%0
  251-1,000
0%0
  1,001 – 10,000
0%0
  10,001 – 50,000
0%0
  More than 50,000
0%0
  Not Sure/Don't know
0%0
Total Respondents  0
(skipped this question)  0
5. Total Number of covered lives enrolled under this plan?
 Response PercentResponse Total
  Less than 100,000
0%0
  100,000 – 500,000
0%0
  500,001 – 3,000,000
0%0
  3M – 10M
0%0
  More than 10M
0%0
  Not sure/Don't know
0%0
Total Respondents  0
(skipped this question)  0
6. Total number of claims received on a monthly basis?
 Response PercentResponse Total
  Less than 10,000
0%0
  10,001 – 50,000
0%0
  50,001 – 500,000
0%0
  500,001 – 1 million
0%0
  1M – 5M
0%0
  5M-10M
0%0
  More than 10M
0%0
  Not Sure/Don't know
0%0
Total Respondents  0
(skipped this question)  0
7. Please check all X12N transactions which you currently conduct electronically (either receive, transmit and/or process):
 Response PercentResponse Total
 837 Health Care Claim: Professional
 0%0
 837 Health Care Claim: Institutional
 0%0
 837 Health Care Claim: Dental
 0%0
 835 Health Care Payment Advice
 0%0
 270/271 Health Care Eligibility/Benefit Inquiry and Response
 0%0
 276/277 Health Care Claims Status Inquiry and Response
 0%0
 277 Health Care Claim Status: Unsolicited (or Claim Acknowledgment)
 0%0
 278 Health Care Services Review: Request for Review and Response
 0%0
 834 Benefit Enrollment and Maintenance
 0%0
 820 Payroll Deducted and Other Group Premium Payment for Insurance Products
 0%0
 Not Sure/Don't know
 0%0
 Other (please specify)
 0%0
Total Respondents  0
(skipped this question)  0
8. Does your health plan rely on outside vendors to provide software or services for any of the X12N transactions?
 Response PercentResponse Total
  Yes
0%0
  No
0%0
  Not sure
0%0
Total Respondents  0
(skipped this question)  0
9. For all lines of business, what is the approximate percentage of claims that require additional documentation (attachments) in order to be processed?
 Response PercentResponse Total
  Less than 1%
0%0
  1 to 5%
0%0
  5 to 10%
0%0
  11 to 20%
0%0
  21 to 30%
0%0
  31 to 50%
0%0
  More than 50%
0%0
  Not Sure/Don't know
0%0
Total Respondents  0
(skipped this question)  0
10. For each claim/attachment type listed below, rate the frequency your health plan requests or requires that they be submitted to pay a claim. If the row does not apply to your line of business, check N/A.
Almost AlwaysFrequentlySometimesRarely NeverN/AResponse Average
Laboratory Results
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
Medications (not prescriptions)
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
Clinical Reports (examples include: anesthesia, arthroscopy, cardiac catheterization, colonoscopy consultation note, cytology report, discharge note, echo heart, EEG brain, endoscopy, flexible sigmoidoscopy, initial assessment, nursing, OB, procedure note, radiology, surgical pathology, visit note)
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
Alcohol-Substance Abuse Rehabilitation
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
Cardiac Rehabilitation
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
Medical Social Services Rehabilitation
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
Occupational Therapy Rehabilitation
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
Physical Therapy Rehabilitation
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
Speech Therapy Rehabilitation
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
Respiratory Therapy Rehabilitation
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
Psychiatric Rehabilitation
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
Skilled Nursing Rehabilitation
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
Emergency Department
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
Ambulance Service
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
Durable Medical Equipment (DME)
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
Home Health Services (skilled nursing in the home)
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
Periodontal Services
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
Children’s Preventive Health Services
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
Consent (for sterilization/hysterectomy)
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
Administrative/non clinical information
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
Total Respondents  0
(skipped this question)  0
11. List any other additional documentation or attachment information that is frequently required by your health plan for adjudication.
 Response PercentResponse Total
  1)
0%0
  2)
0%0
  3)
0%0
Total Respondents  0
(skipped this question)  0
12. When does your health plan usually receive the attachment/additional documentation?
Almost AlwaysFrequentlySometimesRarelyNever N/AResponse Average
The attachment information is submitted with the original claim
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
The attachment information is submitted after we make a specific request to the provider
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
The attachment information is submitted after we deny or pend the claim for insufficient information
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
Total Respondents  0
(skipped this question)  0
13. When your health plan requires additional documentation/attachments to adjudicate a claim, how do you generally notify providers?
Almost AlwaysFrequentlySometimesRarelyNeverN/AResponse Average
Paper/letter through postal service
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
Courier service
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
Phone call
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
email
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
Fax
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
EDI
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
DDE (Direct Data Entry)/Online
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
Total Respondents  0
(skipped this question)  0
14. When your health plan requires a claim attachment, how do providers most frequently submit the information ?
Almost AlwaysFrequentlySometimesRarelyNeverN/AResponse Average
Paper/letter through postal service
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
Phone call
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
email
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
Fax
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
EDI
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
DDE (Direct Data Entry)/Online
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
Total Respondents  0
(skipped this question)  0
15. How does your organization typically store the attachment documentation that is submitted today?
Almost AlwaysFrequentlySometimesRarelyNeverN/AResponse Average
Scan and save as image
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
Scan and save as text (via Optical Character Recognition)
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
Save as paper
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
Manually key in summary data from a hard copy document
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
Save in other electronic format (PDF, Word, etc.)
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
Discard/destroy the paper
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
Total Respondents  0
(skipped this question)  0
16. If attachment information is submitted electronically, what is the most common format or medium used by providers?
Almost AlwaysFrequentlySometimesRarelyNeverN/AResponse Average
Scanned images
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
Computer documents (e.g. MS word or other text file)
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
Reports printed by another application
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
Total Respondents  0
(skipped this question)  0
17. When your health plan receives unwanted or unneeded documentation/attachments, how do you notify providers to quit sending them?
Almost AlwaysFrequentlySometimesRarelyNeverN/AResponse Average
We publish attachment requirements
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
We send policy message to all providers
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
We send ad hoc message to individual providers
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
We establish rules in contracts
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
We refrain from communicating such rules or requests to providers
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0.00
Total Respondents  0
(skipped this question)  0
18. On average, what percent of denied claims are denied by your health plan because the provider did not submit the additional documentation, either at all, or on time?
 Response PercentResponse Total
  less than 5% of all denied claims
0%0
  6-20%
0%0
  21 to 50%
0%0
  51% or more
0%0
Total Respondents  0
(skipped this question)  0
19. For each type of claim, list the approximate percentage you are now receiving electronically (enter 0 for all paper, or N/A if you do not process this type of claim)
0%10%20%30%40%50%60%70%80%90%100%Don't knowN/AResponse Total
Institutional Claims
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0
Professional Claims
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0
Dental Claims
0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0% (0)0
Total Respondents  0
(skipped this question)  0