Embedded Files
Types of providers we will be calling.
UDEF01: PCP
1 = YES
2 = NO
UDEF02: SPECIALIST
1 = YES
2 = NO
UDEF08: BH Psychology/Psychiatry
1 = YES
2 = NO
UDEF09: BH Other
1 = YES
2 = NO
(TELEPHONE INTRODUCTION PAGE)
Hello, I'm _________________________ from Press Ganey, calling on behalf of Blue Cross Blue Shield of Montana. We
are conducting an annual regulatory survey of providers required to support Blue Cross and Blue Shield of Montana’s
continued provision of network accessibility to their members and your patients.
This short 7-10 minute survey is to be completed on behalf of the practice. The individual responding to this survey
must be familiar with appointment scheduling and office process.
This call may be monitored or recorded for quality and training purposes.
[INTERVIEWER NOTE: ONLY READ IF THEY ASK TO SPEAK TO BLUE CROSS BLUE SHIELD OF MONTANA ABOUT THIS
SURVEY:
If you want to know more about this study, please contact the BCBSMT Network Services Representatives.
They can be reached by phone at 406-437-6100, or via email at hcsx6100@bcbsmt.com.
S01. Does this practice schedule its own appointments or is another location responsible for setting the
appointments? [READ LIST]
1. The appointments are scheduled at this location.
2. The appointments are scheduled at a different location.
3. No appointments are scheduled. This location is a hospital or walk-in clinic.
4. NOT ASCERTAINED
(IF S01=1 OR 3, THEN SKIP TO S03.)
S02. What is the name, phone number, and email address for the person that schedules appointments for this
location?
Contact name: _________________________________________________
Work Phone number: __________________________________________
Email address: _________________________________________________
(IF S01=2, SKIP TO CLOSING AND DISPOSITION RECORD AS ’S01=2: DIFFERENT LOCATION’. MAKE THIS DISOPSITION
FINAL. RECORD IS NOT COMPLETE AND WILL NEED TO BE AVAILABLE TO CALL.)
S03. What is your name?
Name: _________________________________________________
S04. What is your title and/or position?
Title: _________________________________________________
(ASK ALL)
Section 1: MISC SCOPE OF SERVICES
S05. Provider Demographic Data can be updated at any time online at www.bcbsmt.com. Click on the Provider tab
and select “Update your information” under Network Participation.
Has your practice validated Provider Demographic Data in the provider directories for BCBSMT in the last 3
months (90 days) per federal requirements? [DO NOT READ LIST]
1. YES
2. NO
9. DON’T KNOW
S06. Do the providers in your practice currently have the ability to see patients virtually through some form of secure
telehealth platform? [READ LIST]
1. Yes, the majority or all of the providers
2. Yes, but only some of the providers
3. No, very few if any of the providers
4. No, none of the providers
9. Don’t know [DO NOT READ]
S07. Do any providers in your practice see patients via telehealth ONLY, and do not have plans in the near future to
see patients in person? [READ LIST]
1. Yes, the majority or all of the providers
2. Yes, but only some of the providers
3. No, very few if any of the providers
4. No, none of the providers
9. Don’t know [DO NOT READ]
(IF S01=3, THEN SKIP TO CLOSE)
(ASK SECTION 2 IF UDEF01=1 OR UDEF02=1, ELSE SKIP TO LOGIC BEFORE SECTION 3.)
Section 2: AFTER HOURS & 24/7 ACCESSIBILITY
Q01. Please tell me which of the following statements apply to your office about ‘24/7 Accessibility’. Select all that
apply: (ROTATE) [READ ENTIRE LIST]
a. Office provides after-hours answering services when office is closed
b. After-hours answering services connects patients directly with on-call provider or clinician, or allows
message to be left that can be returned by on-call provider or clinician within one hour
c. After-hours messaging directs callers what to do in case of an emergency
d. After-hours messaging gives callers hours the provider location is open and/or how to make an
appointment during regular business hours
e. Location is open 24 hours a day, 7 days a week
f. None of the above (EXCLUSIVE) (ANCHORED)
Q02. On-call providers or clinicians are required to contact the patients within how many minutes of being contacted
by the answering service? [READ LIST. IF NEED SAY “YOUR BEST ESTIMATE IS FINE”. STOP WHEN RESPONDENT
GIVES ANSWER – NO NEED TO CONTINUE READING THE LIST (APPLIES FOR REST OF SURVEY AS WELL)].
1. 0-15 minutes
2. 16-30 minutes
3. 31-60 minutes
4. 61+ minutes
5. No such requirement for after hours/on-call providers at this location
99. NOT ASCERTAINED (DO NOT READ)
Q02b. How long do patients wait in the clinic before seeing the provider? Waiting time begins at the time of the
scheduled appointment.
1. 0-15 minutes
2. 16-30 minutes
3. 31-60 minutes
4. 61+ minutes
99. NOT ASCERTAINED
(ASK SECTION 3 IF UDEF01=1, ELSE SKIP TO LOGIC BEFORE SECTION 4)
Section 3: PRIMARY CARE
Q03. When a patient calls for a routine primary care visit (aka annual check-up), they are seen within how many days?
[READ LIST. IF NEED SAY “YOUR BEST ESTIMATE IS FINE”.]
1. 0-5 business days
2. 6-10 business days
3. 11-15 business days
4. 16-30 business days
5. 31-45 business days
6. 46-60 business days
7. 61+ business days
8. This office does not provide primary care appointments [DO NOT READ] (SKIP TO LOGIC BEFORE
SECTION 4)
99. NOT ASCERTAINED [DO NOT READ]
Q04. When a patient calls for a primary care visit due to symptoms (aka sick visit), they are seen within how many
days? [READ LIST. IF NEED SAY “YOUR BEST ESTIMATE IS FINE”.]
1. 0-24 hours
2 24 hours-5 business days
3. 6-7 business days
4. 8-10 business days
5. 11-14 business days
6. 15-30 business days
7. 31-45 business days
8. 46-60 business days
9. 61+ business days
99. NOT ASCERTAINED [DO NOT READ]
Q05. When a patient calls for an urgent primary care appointment with their provider, they are seen within how
many hours? [READ LIST. IF NEED SAY “YOUR BEST ESTIMATE IS FINE”.]
1. 0-12 hours
2. 13-24 hours
3. 25-36 hours
4. 37-48 hours
5. 49-72 hours
6. More than 72 hours
7. This office does not provide urgent care [DO NOT READ]
99. NOT ASCERTAINED (DO NOT READ)
(ASK SECTION 4 IF UDEF02=1, ELSE SKIP TO LOGIC BEFORE SECTION 5.)
Section 4: SPECIALTY CARE
Q06. When a patient calls for an outpatient consultation appointment, they are seen within how many days? [READ
LIST. IF NEED SAY “YOUR BEST ESTIMATE IS FINE”.]
1. 0-5 business days
2. 6-10 business days
3. 11-15 business days
4. 16-21 business days
5. 22-30 business days
6. 31-45 business days
7. 46-60 business days
8. 61+ business days
9. This office does not provide specialty care [DO NOT READ] (SKIP TO LOGIC BEFORE SECTION 5)
99. NOT ASCERTAINED [DO NOT READ]
Q07. When a patient calls for a follow-up appointment with a specialist, they are seen within how many days? [READ
LIST. IF NEED SAY “YOUR BEST ESTIMATE IS FINE”.]
1. 0-5 business days
2. 6-10 business days
3. 11-14 business days
4. 15-30 business days
5. 31-45 business days
6. 46-60 business days
7. 61+ business days
99. NOT ASCERTAINED [DO NOT READ]
(ASK SECTION 5 IF UDEF08=1 OR UDEF09=1, ELSE SKIP TO CLOSE.)
Section 5: Behavioral Health
Q08. When a patient calls for a non-urgent behavioral health visit, they are seen within how many days? [READ LIST.
IF NEED SAY “YOUR BEST ESTIMATE IS FINE”.]
1. 0-7 business days
2. 8-10 business days
3. 11-14 business days
4. 15-30 business days
5. 31-45 business days
6. 46-60 business days
7. 61+ business days
8. This office does not provide behavioral health care appointments [DO NOT READ] (SKIP TO CLOSE)
99. NOT ASCERTAINED [DO NOT READ]
Q09. When a patient calls for a follow-up, non-urgent behavioral health visit, they are seen within how many days?
[READ LIST. IF NEED SAY “YOUR BEST ESTIMATE IS FINE”.]
1. 0-7 business days
2. 8-14 business days
3. 15-20 business days
4. 21-30 business days
5. 31-45 business days
6. 46 business days to no more than 3 months
7. More than 3 months
99. NOT ASCERTAINED [DO NOT READ]
Q10. When a patient calls requesting a behavioral health outpatient appointment for an urgent condition (meaning
the patient calls reporting a need to be seen urgently and asks for appointment as soon as possible, but clinical
evidence does not show an emergency and lack of immediate action would not likely lead to death or serious
injury), they are seen within how many hours? [READ LIST. IF NEED SAY “YOUR BEST ESTIMATE IS FINE”.]
1. 0 - 12 hours
2. 13 - 24 hours
3. 25 - 36 hours
4. 37 - 48 hours
5. 49 - 72 hours
6. More than 72 hours
7. Patient is directed to go to the ER, Emergency Dept, or Behavioral health Crisis Unit
99. NOT ASCERTAINED (DO NOT READ)
Q11. When a patient calls requesting a face-to-face appointment for a non-life-threatening behavioral health crisis or
emergency (meaning clinical evidence shows that immediate face-to-face care is needed, but lack of care would
not likely lead to death or serious injury, unless left untreated), they are seen within how many hours? [READ
LIST. IF NEED SAY “YOUR BEST ESTIMATE IS FINE”.]
1. 0-90 minutes
2. 91 minutes to 2 hours
3. 2-4 hours
4. 4-6 hours
5. 7-12 hours
6. 13-24 hours
7. 25 or more hours
8 Patient is directed to go to the ER, Emergency Dept, or Behavioral health Crisis Unit
99. NOT ASCERTAINED (DO NOT READ)
(SHOW FOR ALL: CLOSING)
Those are all the questions we have. Thank you for your time!
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