QHP Enrollee Survey Minimum Business Requirements Survey vendors must meet all Minimum Business Requirements. Please for check “Yes” or “No” each item below to indicate whether your organization meets the following Minimum Business Requirements. Relevant Survey Experience Number of Years in Business Vendor has been in business for a minimum of four years. Yes No Survey Experience Vendor has a minimum of experience administering two years’ prior standardized patient experience surveys as an organization within the most Yes No recent three-year period. Vendor has a minimum of experience conducting two years’ prior (mail/telephone/Internet) survey protocols within the most recent Yes No period. Vendor has prior experience administering patient experience surveys for Yes No vulnerable populations. Vendor has a minimum of prior experience employing a statistical two years’ Yes No sampling process within the most recent three-year period. Vendor has prior experience submitting patient experience survey data to an Yes No external third-party organization. Vendor has a minimum of prior experience conducting large-scale two years’ patient experience survey projects using mixed-mode administration Yes No (mail/telephone/Internet) within the most recent three-year period. In reviewing applications, CMS will take into consideration the prior experience on applicant’s other CMS-sponsored surveys as a survey vendor. Prior Experience on CMS-Sponsored Surveys Vendor has been approved as a survey vendor to implement other Yes No or CAHPS surveys.
QHP Enrollee Survey Minimum Business Requirements Survey vendors must meet all Minimum Business Requirements. Please check “Yes” or “No” for each item below to indicate whether your organization meets the following Minimum Business Requirements. Relevant Survey Experience Number of Years in Business Vendor has been in business for a minimum of four years. Yes No Survey Experience Vendor has a minimum of two years’ prior experience administering standardized patient experience surveys as an organization within the most recent three-year period. Yes No Vendor has a minimum of two years’ prior experience conducting (mail/telephone/Internet) survey protocols within the most recent period. Yes No Vendor has prior experience administering patient experience surveys for vulnerable populations. Yes No Vendor has a minimum of two years’ prior experience employing a statistical sampling process within the most recent three-year period. Yes No Vendor has prior experience submitting patient experience survey data to an external third-party organization. Yes No Vendor has a minimum of two years’ prior experience conducting large-scale patient experience survey projects using mixed-mode administration (mail/telephone/Internet) within the most recent three-year period. Yes No In reviewing applications, CMS will take into consideration the applicant’s prior experience on other CMS-sponsored surveys as a survey vendor. Prior Experience on CMS-Sponsored Surveys Vendor has been approved as a survey vendor to implement other or CAHPS surveys. Yes No
2019-QHP-Survey-Vendor-Participation-Form.docx