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Search:
Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
(CMS-10804) QPP Site Intercept Survey
New
1200
100
0
Form and Instruction
CMS-10804
QPP Intercept Survey
CCSQ Support Central Knowledge/Resource Center Survey (CMS-10886)
New
2000
167
4970
Form and Instruction
CMS-10886
CCSQ Support Central Knowledge Research Survey
CCSQ Support Central Live Chat and Virtual Agent Enhancement Survey (CMS-10896)
New
2000
167
4970
Form and Instruction
CMS-10896
CCSQ Support Central Live Chat and Virtual Agent Enhancement Survey
Center for Clinical Standards and Quality (CCSQ) Support Central Customer Satisfaction Survey (CMS-10818)
New
2800
93
0
Form and Instruction
CMS-10818
Call Scheduling
Form and Instruction
CMS-10818
Create a Ticket
Form and Instruction
CMS-10818
Live Chat
Form and Instruction
CMS-10818
Track Existing Ticket
Chat/CCSQ Support Central – Basic information questions (CMS-10832)
New
10155
508
0
Form and Instruction
CMS-10832
Support Central Screen shot
Customer Effort Scoring - Surveys (CMS-10833)
New
4800
400
0
Form and Instruction
CMS-10833
QualityNet-EQRS Help Desk Customer Feedback Survey
Form and Instruction
CMS-10833
QualityNet Help Desk Customer Feedback Survey
Form and Instruction
CMS-10833
QPP Customer Effort Questionnaire: 2020 Online Survey
Hospital Quality Reporting User Language Card Sort (CMS-10871)
New
75
18
0
Form and Instruction
CMS-10871
HQR User Language Card Sort
Hospital Quality Reporting User Research Participation Interest Survey (CMS-10817)
New
2000
67
0
Form and Instruction
CMS-10817
HQR User Research Participation Survey
Hospital Quality Reporting User Research Participation Interest Survey (CMS-10817 revised)
New
2000
67
0
Form and Instruction
CMS-10817
HQR User Research Participation Survey
Internet Quality Improvement and Evaluation System (IQIES) HCD User Research Form (CMS-10808)
New
2000
167
0
Form and Instruction
CMS-10808
iQies HCD User Research Form
Internet Quality Improvement and Evaluation System (IQIES) Idea Portal
New
1000
83
0
Form and Instruction
CMS-10810
Idea Portal
PY 23 QPP Submissions Intercept Survey (CMS-10838)
New
1500
125
0
Form and Instruction
CMS-10838
Submissions Intercept Survey Instrument
Form and Instruction
CMS-10838
Submissions Intercept Survey Instrument
QPP Submissions Intercept Survey (CMS-10838)
New
1500
125
0
Form and Instruction
CMS-10838
Submissions Intercept Survey Questions
Single Ease Question for User Insights on Hospital Quality Reporting (CMS-10800 revision))
New
2000
6
0
Form and Instruction
CMS-10800
Single Ease Question for User Insights on Hospital Quality Reporting
Single Ease Question for User Insights on Hospital Quality Reporting (CMS-10800)
New
2000
6
0
Form and Instruction
CMS-10800
HQR Touchpoints Survey
Total Burden Actually Used for Information Collections Under Currently Approved ICR:
37030
2099
9940
Total Burden Currently Requested for Information Collections Under Currently Approved ICR:
0
0
0
To view an IC, click on IC Title