PROVIDER/OFFICE STAFF SATISFACTION SURVEY

1. How do you verify eligibility? (Check all that apply)
Electronically through BlueCross BlueShield of Alabama
Electronically through a clearinghouse connection
By calling the member's plan
By calling BlueCross Blue Shield of Alabama
By calling the dedicated BlueCard toll free eligibility number (1-800-676-BLUE)
By calling the dedicated Federal Employee Program toll free eligibility number (1-800-492-8872)
Do not verify eligibility

2. When you call to verify contract or eligibility information, how satisfied are you with the information you receive?

BlueCross BlueShield BlueCard Program	BlueCross BlueShield Federal Employee Program	American Behavioral
a. Eligibility Very satisfied Satisfied Dissatisfied Very dissatisfied b. Copay, deductible Very satisfied Satisfied Dissatisfied Very dissatisfied c. Precertification requirements Very satisfied Satisfied Dissatisfied Very dissatisfied d. Verification of specialty coverage Very satisfied Satisfied Dissatisfied Very dissatisfied	a. Eligibility Very satisfied Satisfied Dissatisfied Very dissatisfied b. Copay, deductible Very satisfied Satisfied Dissatisfied Very dissatisfied c. Precertification requirements Very satisfied Satisfied Dissatisfied Very dissatisfied d. Verification of specialty coverage Very satisfied Satisfied Dissatisfied Very dissatisfied	a. Eligibility Very satisfied Satisfied Dissatisfied Very dissatisfied b. Copay, deductible Very satisfied Satisfied Dissatisfied Very dissatisfied c. Precertification requirements Very satisfied Satisfied Dissatisfied Very dissatisfied d. Verification of specialty coverage Very satisfied Satisfied Dissatisfied Very dissatisfied

Please Note: If you marked "dissatisfied" or "very dissatisfied," please provide additional information in the "Comments" section at the end of the survey. Please include your provider/office name, name of individual completing this survey, and date.

3a. How satisfied are you with the ease of getting claims paid accurately the first time?

BlueCross BlueShield BlueCard Program	BlueCross BlueShield Federal Employee Program	American Behavioral
Very satisfied Satisfied Dissatisfied Very dissatisfied	Very satisfied Satisfied Dissatisfied Very dissatisfied	Very satisfied Satisfied Dissatisfied Very dissatisfied

3b. How satisfied are you with the timeliness of each of these programs?

BlueCross BlueShield BlueCard Program	BlueCross BlueShield Federal Employee Program	American Behavioral
Very satisfied Satisfied Dissatisfied Very dissatisfied	Very satisfied Satisfied Dissatisfied Very dissatisfied	Very satisfied Satisfied Dissatisfied Very dissatisfied

Please Note: If you marked "dissatisfied" or "very dissatisfied," please provide additional information in the "Comments" section at the end of the survey.

4a. How do you submit claims for each of the following programs?

BlueCross BlueShield BlueCard Program	BlueCross BlueShield Federal Employee Program	American Behavioral
Electronically to host plan Paper claim through mail Other (Please Specify):	Electronically to host plan Paper claim through mail Other (Please Specify):	Electronically to host plan Paper claim through mail Other (Please Specify):

4b. What percentage of claims are submitted electronically, if any?

5. In the past 6 months, what percentage of your claims for each of the following programs required follow-up once submitted or resubmitted?

BlueCross BlueShield BlueCard Program	BlueCross BlueShield Federal Employee Program	American Behavioral
75-100% 50-74% 25-49% 5-24%	75-100% 50-74% 25-49% 5-24%	75-100% 50-74% 25-49% 5-24%

6. How satisfied were you with the timeliness in which claims issues that required follow-up in each of the following programs?

BlueCross BlueShield BlueCard Program	BlueCross BlueShield Federal Employee Program	American Behavioral
Very satisfied Satisfied Dissatisfied Very dissatisfied	Very satisfied Satisfied Dissatisfied Very dissatisfied	Very satisfied Satisfied Dissatisfied Very dissatisfied

Please Note: If you marked "dissatisfied" or "very dissatisfied," please provide additional information in the "Comments" section at the end of the survey.

7. How satisfied are you with the usefulness of the information packet you received regarding the BlueCross BlueShield Federal Employee and BlueCard programs from American Behavioral?

Information/cover letter	Application	Provider Agreement	Applicable Fee Schedule
Very satisfied Satisfied Dissatisfied Very dissatisfied	Very satisfied Satisfied Dissatisfied Very dissatisfied	Very satisfied Satisfied Dissatisfied Very dissatisfied	Very satisfied Satisfied Dissatisfied Very dissatisfied

Please Note: If you marked "dissatisfied" or "very dissatisfied," please provide additional information in the "Comments" section at the end of the survey.

8. Rate your overall satisfaction with each program.

BlueCross BlueShield BlueCard Program	BlueCross BlueShield Federal Employee Program	American Behavioral
Very satisfied Satisfied Dissatisfied Very dissatisfied	Very satisfied Satisfied Dissatisfied Very dissatisfied	Very satisfied Satisfied Dissatisfied Very dissatisfied

Please Note: If you marked "dissatisfied" or "very dissatisfied," please provide additional information below.

Comments: