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/A