Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Medicare Administrative Contactors Customer Experience – Medical Review (CMS-10763) New 3000 150 0 Form and Instruction CMS-10763
Form and Instruction CMS-10763
CMS-10731(GenIC#1). Was This Page Helpful Survey New 2000 33 0 Form and Instruction CMS-10731. (GenIC#1)
CMS-10731.(GenIC#2) - CBR Feedback Survey New 300 25 0 Form and Instruction CMS-10731. (GenIC#2)
CMS-10731.(GenIC#8) - Centers Medicare & Medicaid Services Wasteful and Inappropriate Service Reduction (WISeR) Model Feedback New 500 17 0 Form and Instruction CMS-10731.(GenIC#8)
CMS-10731.GenIC#4 - Medicare Learning Network Provider Association Partnership Survey New 604 20 0 Form and Instruction CMS-10731.GenIC#4
CMS-10731.GenIC#5 - Medicare Administrative Contractor (MAC) Customer Experience (MCE) Program – Provider Contact Center - Palmetto Web Chat Library of Questions New 1925 96 0 Form and Instruction CMS-10731.GenIc#5
CMS-10731.GenIC#6 - Provider Type UX Study New 30 40 0 Form and Instruction CMS-10731.GenIC#6
Form and Instruction CMS-10731.GenIC#6
CMS-10941.Medicare Provider Trust Feedback Survey New 6000 200 0 Form and Instruction CMS-10941
Electronic Prior Authorization Feedback (CMS-10961) New 200 7 0 Form and Instruction CMS-10961
Medicare Administrative Contractor (MAC) Customer Experience (MCE) Program – Audit and Reimbursement (CMS-10812) New 5000 250 0 Form and Instruction CMS-10812
Form and Instruction CMS-10812
Medicare Administrative Contractor (MAC) Customer Experience (MCE) Program – Provider Contact Center - Telephone Library of Questions (CMS-10815) New 60000 2000 0 Form CMS-10815
Medicare Administrative Contractor (MAC) Customer Experience (MCE) Program – Provider Contact Center - Written Correspondence Survey (CMS-10814) New 10000 500 0 Form and Instruction CMS-10814
Medicare Administrative Contractor (MAC) Provider Customer Experience (CMS-10720) New 35000 1750 0 Form and Instruction CMS-10720
Form and Instruction CMS-10720
Form and Instruction CMS-10720
Form and Instruction CMS-10720
Medicare Administrative Contractor (MAC) Provider Experience Persistent Feedback (CMS-10721) New 45000 750 0 Form and Instruction CMS-10721
Form and Instruction CMS-10721
Form and Instruction CMS-10721
Form and Instruction CMS-10721
Overall Flu Campaign Feedback Survey (CMS-10760) New 4872 81 0 Form and Instruction CMS-10760
Total Burden Actually Used for Information Collections Under Currently Approved ICR: 174431 5919 0  
Total Burden Currently Requested for Information Collections Under Currently Approved ICR: 0 0 0  
To view an IC, click on IC Title