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Providing Quality Care
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Provider Performance Education Satisfaction Survey
Date of Provider Performance Meeting
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Practice TIN Number
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Office Point of Contact Name
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Office Point of Contact Title
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Provider Consultant Name
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1. Please rate the Provider Consultant's review and explanation of new health plan policy updates.
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2. Please rate the Provider Consultant's training on the Provider Secure Provider Portal.
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3. Please rate the Provider Consultant's review of your practice's EDI/paper claim submission frequency.
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4. Please rate the Provider Consultant's verification of the provider and practitioner demographics.
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5. Please rate the Provider Consultant's review of the practice's membership panel (new members, care gaps, etc.).
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6. Please rate the Provider Consultant's review and explanation of members enrolled in our Case Management and Disease Management programs.
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7. Please rate the Provider Consultant's review and explanation of your practice's HEDIS and EPSDT measures status.
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8. Please rate the Provider Consultant's review of your practice's membership ER utilization.
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9. Please rate the Provider Consultant's review of your practice's Rx Profile.
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10. Please rate the Provider Consultant's review of your access to care (appointment accessibility as well as after-hour accessibility) results.
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11. Please rate the Provider Consultant’s guidance on how to alleviate your practice's top claim denials.
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12. Please rate the Provider Consultant's review of your practice's Provider Incentive Reports (PMPM, STI, etc).
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