№ lp_2_3_48776
File format: docx
Character count: 3226
File size: 60 KB
A healthcare provider form used for documenting clinical criteria and prescribing Synagis® for Medicaid recipients under certain medical conditions.
Note:
Year
Topic:
Medicaid, Prescription Drugs, Clinical Criteria
Document Type:
Form
Organization / Institution:
New York Medicaid
Target Audience:
Healthcare providers, prescribers
Price: 8 / 10 USD
The file will be delivered to the email address provided at checkout within 12 hours.
The file will be delivered to the email address provided at checkout within 12 hours.
Don’t have cryptocurrency yet?
You can still complete your purchase in a few minutes:- Buy Crypto in a trusted app (Coinbase, Kraken, Cash App or any similar service).
- In the app, tap Send.
- Select network, paste our wallet address.
- Send the exact amount shown above.
The final amount may vary slightly depending on the payment method.
The file will be sent to the email address provided at checkout within 24 hours.
The product description is provided for reference. Actual content and formatting may differ slightly.
Year:
2025
Region / City:
Not specified
Subject:
Health plan enrollee experience survey
Document Type:
Survey script
Organization / Institution:
Not specified
Author:
Not specified
Target Audience:
Health plan enrollees
Period of validity:
July – December 2024
Approval Date:
Not specified
Modification Date:
Not specified
Year:
2023
Region / City:
Not specified
Theme:
Healthcare, Health Plans
Document Type:
Survey Script
Issuing Organization:
Centers for Medicare & Medicaid Services (CMS)
Author:
Not specified
Target Audience:
Enrollees in Qualified Health Plans
Period of Validity:
2023
Approval Date:
Not specified
Modification Date:
Not specified
Year:
2021
Region / City:
United States
Theme:
Health plan enrollee experience survey
Document Type:
Survey script
Organization / Institution:
QHP Issuer
Author:
Not specified
Target Audience:
QHP enrollees
Period of Action:
July through December 2020
Approval Date:
Not specified
Modification Date:
Not specified
Year:
2024
Survey period:
July–December 2023
Topic:
Health insurance enrollee experience
Program:
Qualified Health Plan (QHP)
Document type:
Survey questionnaire
Target population:
Qualified Health Plan enrollees
Geographic context:
United States
Content sections:
Health plan information, customer service, forms and accessibility, confidence in insurance knowledge, overall rating, discrimination experiences, recommendations, demographic information
Response format:
Multiple-choice scales and rating scales
Year:
2026
Region / City:
Not specified
Subject:
Exception requests for variations from QHP Enrollee Survey requirements
Document Type:
Instructional Form
Organization / Institution:
Not specified
Author:
Not specified
Target Audience:
Vendors conducting the QHP Enrollee Survey
Period of Action:
Not specified
Approval Date:
Not specified
Date of Changes:
Not specified
Year:
2026
Document type:
Internet survey script
Survey name:
Qualified Health Plan (QHP) Enrollee Experience Survey
Language:
English
Data collection mode:
Internet survey
Reference period:
July–December 2025
Reference period length:
6 months
Target population:
Qualified Health Plan enrollees
Subject area:
Health insurance enrollee experience
Regulatory authority:
Centers for Medicare & Medicaid Services
OMB control number:
0938-1221
OMB approval expiration:
September 30, 2026
Estimated completion time:
10 minutes
Survey sponsor:
Health plan issuers under QHP program
Data use purpose:
Enrollee experience measurement
Geographic scope:
United States
Document section:
Programming specifications and survey instructions
Source type:
Federal survey instrument documentation
Year:
2025
Region / City:
N/A
Theme:
Healthcare, Health Plans
Document Type:
Survey
Agency / Organization:
Centers for Medicare & Medicaid Services (CMS)
Author:
N/A
Target Audience:
Enrollees of Qualified Health Plans
Period of Validity:
From July to December 2024
Approval Date:
N/A
Date of Changes:
N/A
Year:
2022
Region / City:
Not specified
Theme:
Healthcare, Health Insurance Surveys
Document Type:
Telephone Interview Script
Organization:
Not specified
Author:
Not specified
Target Audience:
Enrollees of Qualified Health Plans
Period of validity:
From July to December 2021
Approval Date:
Not specified
Date of changes:
Not specified
Year:
2022
Region / City:
United States
Theme:
Health care survey
Document Type:
Survey script
Organization / Institution:
Centers for Medicare & Medicaid Services (CMS)
Author:
Not specified
Target Audience:
Enrollees of Qualified Health Plans (QHP)
Effective Period:
2021-2022
Approval Date:
11/30/2023
Revision Date:
Not specified
Survey Format:
Online
Data Collection Method:
Internet survey
OMB Approval Number:
0938-1221
Year:
2022
Region / City:
United States
Topic:
Health Plan Enrollee Experience Survey
Document Type:
Vendor Participation Form
Organization:
Centers for Medicare & Medicaid Services (CMS)
Author:
CMS Project Team
Target Audience:
Vendors applying for participation in the QHP Enrollee Survey
Period of Action:
2022
Approval Date:
Not specified
Modification Date:
Not specified
Year:
2022
Region / City:
United States
Topic:
Qualified Health Plan Enrollee Experience Survey
Document Type:
Vendor Participation Notice
Organization / Institution:
CMS (Centers for Medicare & Medicaid Services)
Author:
CMS
Target Audience:
Prospective vendors for the 2022 QHP Enrollee Survey
Effective Period:
July 15, 2021 - July 30, 2021
Approval Date:
July 30, 2021
Date of Changes:
None
Year:
2021
Region / City:
Not specified
Theme:
Quality Healthcare Programs, Enrollee Surveys
Document Type:
Instruction and Form
Organ / Institution:
Centers for Medicare & Medicaid Services (CMS)
Author:
Not specified
Target Audience:
Vendors involved in QHP Enrollee Survey
Period of Validity:
Not specified
Approval Date:
Not specified
Date of Changes:
Not specified
Year:
2020
Region / city:
Not specified
Topic:
Health plan enrollee experience
Document type:
Survey
Organization / institution:
Not specified
Author:
Not specified
Target audience:
Health plan enrollees
Period of validity:
July – December 2019
Approval date:
Not specified
Date of changes:
Not specified
Note:
Year
Subject:
Health Care / Hepatitis C Treatment
Document Type:
Medical Form
Target Audience:
Health Care Providers