PRIVATE INSURANCE AND MEDIGAP SERIES
BOX_01
======
----------------------------------------------------
| IF THERE IS AT LEAST ONE ESTABLISHMENT-PERSON- |
| INSURER-TRIPLE WHERE THE ESTABLISHMENT IS PRIVATE |
| AND THE INSURER IS FLAGGED AS PROVIDING 'HOSPITAL |
| AND PHYSICIAN BENEFITS' OR IS FLAGGED AS PROVIDING|
| 'MEDICARE SUPPLEMENT/MEDIGAP BENEFITS', CONTINUE |
| WITH LOOP_01 |
----------------------------------------------------
----------------------------------------------------
| OTHERWISE, GO TO BOX_02 |
----------------------------------------------------
LOOP_01
=======
----------------------------------------------------
| FOR EACH ELEMENT IN RU-ESTABLISHMENT-PERSON- |
| INSURER-TRIPLES-ROSTER, ASK SP01-END_LP01 |
----------------------------------------------------
----------------------------------------------------
| LOOP DEFINITION: LOOP_01 COLLECTS SATISFACTION |
| INFORMATION ON ALL PRIVATE HEALTH INSURANCE PLANS |
| CURRENTLY HELD BY THE RU THAT PROVIDE HOSPITAL AND|
| PHYSICIAN BENEFITS OR MEDIGAP BENEFITS. THIS LOOP|
| CYCLES ON TRIPLES THAT MEET THE FOLLOWING |
| CONDITIONS: |
| - ESTABLISHMENT IS PROVIDER OF PRIVATE INSURANCE |
| WHICH PROVIDES HOSPITAL/PHYSICIAN BENEFITS OR |
| MEDICARE SUPPLEMENT OR MEDIGAP |
| AND |
| - PERSON IS A CURRENT RU MEMBER WHO IS THE |
| POLICYHOLDER OF THE PRIVATE HEALTH INSURANCE |
| OBTAINED THROUGH THIS ESTABLISHMENT |
| AND |
| - INSURER IS THE SOURCE OF THE BENEFITS PROVIDED |
| TO PERSON THROUGH THE ESTABLISHMENT (I.E., THE |
| INSURANCE COMPANY, HMO OR SELF-INSURED COMPANY) |
| AND IS FLAGGED AS 'SUPPLYING HOSPITAL/PHYSICIAN |
| BENEFITS' OR 'SUPPLYING MEDICARE SUPPLEMENT/ |
| MEDIGAP BENEFITS' |
| AND |
| - PERSON IS CURRENTLY INSURED BY THIS TRIPLE |
----------------------------------------------------
----------------------------------------------------
| NOTE: PRIVATE INSURANCE IS DEFINED AS: |
| - ESTABLISHMENTS FLAGGED AS 'EMPLOYER' AND |
| FLAGGED AS 'PROVIDES HEALTH INSURANCE' |
| (ESTABLISHMENTS FLAGGED AS 'SELF-EMPLOYED' WITH |
| A FIRM-SIZE-1 ARE TREATED AS DIRECT PURCHASED, |
| SEE NOTE BELOW) |
| - DIRECT PURCHASED INSURANCE, THAT IS, |
| ESTABLISHMENTS CREATED FROM THE HX23 SERIES |
----------------------------------------------------
----------------------------------------------------
| NOTE: HELD ON THE DATE OF THE CURRENT ROUND'S |
| INTERVIEW DATE: |
| - FOR PRIVATE SOURCES -- POLICYHOLDER HELD |
| INSURANCE AT THE TIME OF THE CURRENT ROUND'S |
| INTERVIEW DATE [HQ01 IS CODED '1' (WHOLE TIME) |
| OR HQ02 IS CODED '1' (YES, COVERED NOW) FOR THE |
| POLICYHOLDER] OR [OE01 OR OE12 OR OE26 IS CODED |
| '1' (YES) FOR THE PLAN] |
| - FOR PRIVATE SOURCES WHERE POLICYHOLDER IS |
| DECEASED OR THE POLICYHOLDER WAS ORIGINALLY |
| SELECTED AS 'POLICYHOLDER NOT IN RU/DU' -- AT |
| LEAST ONE DEPENDENT (SELECTED AT HP16) IS |
| COVERED BY THE INSURANCE AT THE TIME OF THE |
| CURRENT ROUND'S INTERVIEW DATE [HQ01 IS CODED |
| '1'(WHOLE TIME) OR HQ02 IS CODED '1' (YES, |
| COVERED NOW FOR THE COVERED PERSON] OR [OE01 OR |
| OE12 OR OE26 IS CODED '1' (YES)] FOR THE PLAN |
----------------------------------------------------
----------------------------------------------------
| NOTE: ESTABLISHMENTS WHICH ARE EMPLOYERS AND |
| PROVIDE HEALTH INSURANCE AND ARE FLAGGED AS |
| 'SELF-EMPLOYED' WITH A FIRM-SIZE=1 ARE TREATED AS |
| DIRECT PURCHASED INSURANCE, THAT IS, LOOP_01 WILL |
| CYCLE ON THE ESTABLISHMENT PROVIDING THE |
| INSURANCE, (I.E., CREATED FROM THE HX03 SERIES) |
| NOT THE EMPLOYER. |
----------------------------------------------------
----------------------------------------------------
| NOTE: '-7' (REFUSED) AND '-8' (DON'T KNOW) |
| RESPONSES AT ANY QUESTION LISTED ABOVE DOES NOT |
| MEET THE CRITERIA. |
----------------------------------------------------
SP01
====
{POLICYHOLDER FIRST MIDDLE LAST NAME} {NAME OF
ESTABLISHMENT.........}
PLAN NAME: {NAME OF INSURER BEING LOOPED ON}
The next questions ask about (POLICYHOLDER)'s (and other family
members') experience(s) with (PLAN NAME), that is,
(POLICYHOLDER)'s {hospital and physician/Medicare Supplement or
Medigap} coverage through (ESTABLISHMENT).
PRESS ENTER TO CONTINUE.
----------------------------------------------------
| DISPLAY 'hospital and physician' IF THIS INSURER |
| IS FLAGGED AS PROVIDING HOSPITAL AND PHYSICIAN |
| BENEFITS OR IF IT'S FLAGGED AS PROVIDING BOTH |
| HOSPITAL AND PHYSICIAN BENEFITS AND MEDICARE |
| SUPPLEMENT/MEDIGAP BENEFITS, DISPLAY 'Medicare |
| Supplement or Medigap'. |
----------------------------------------------------
SP02
====
{POLICYHOLDER FIRST MIDDLE NAME} {NAME OF
ESTABLISHMENT.........}
PLAN NAME: {NAME OF INSURER BEING LOOPED ON}
SHOW CARD SP-1.
Since (POLICYHOLDER) (and the family) joined (PLAN NAME), how
much of a problem, if any, was it to get a personal doctor or
nurse (POLICYHOLDER) (and the family) (are/is) happy with?
Would you say ...
a big problem, ......................... 1
a small problem, or .................... 2
not a problem? ......................... 3
IF VOLUNTEERED: DON'T HAVE PERSONAL
DOCTOR OR NURSE ..................... 95
REF ................................... -7
DK .................................... -8
[Code One.]
----------------------------------------------------
| NOTE: CAHPS ADULT CORE ITEM 6 |
----------------------------------------------------
SP03
====
{POLICYHOLDER FIRST MIDDLE NAME} {NAME OF
ESTABLISHMENT.........}
PLAN NAME: {NAME OF INSURER BEING LOOPED ON}
In the last 12 months, did (POLICYHOLDER) (or anyone in the
family) need approval from (PLAN NAME) for any care, tests, or
treatment?
YES .................................... 1
NO ..................................... 2 {SP05}
REF ................................... -7 {SP05}
DK .................................... -8 {SP05}
SP04
====
{POLICYHOLDER FIRST MIDDLE NAME} {NAME OF
ESTABLISHMENT.........}
PLAN NAME: {NAME OF INSURER BEING LOOPED ON}
SHOW CARD SP-1.
In the last 12 months, how much of a problem, if any, were delays
in health care while (POLICYHOLDER) (or anyone in the family)
waited for approval from (PLAN NAME)?
Would you say ...
a big problem, ......................... 1
a small problem, or .................... 2
not a problem? ......................... 3
IF VOLUNTEERED: NO VISITS IN LAST
12 MONTHS ........................... 95
REF ................................... -7
DK .................................... -8
[Code One.]
----------------------------------------------------
| NOTE: CAHPS ADULT CORE ITEM 23 |
----------------------------------------------------
SP05
====
{POLICYHOLDER FIRST MIDDLE NAME} {NAME OF
ESTABLISHMENT.........}
PLAN NAME: {NAME OF INSURER BEING LOOPED ON}
In the last 12 months, did (POLICYHOLDER) (or anyone in the
family) look for any information about how (PLAN NAME) works
in written material or on the Internet?
YES .................................... 1
NO ..................................... 2 {SP07}
REF ................................... -7 {SP07}
DK .................................... -8 {SP07}
----------------------------------------------------
| NOTE: CAHPS ADULT CORE ITEM 32 |
----------------------------------------------------
SP06
====
{POLICYHOLDER FIRST MIDDLE NAME} {NAME OF
ESTABLISHMENT.........}
PLAN NAME: {NAME OF INSURER BEING LOOPED ON}
SHOW CARD SP-1.
In the last 12 months, how much of a problem, if any, was it to
find or understand this information?
Would you say ...
a big problem, ......................... 1
a small problem, or .................... 2
not a problem? ......................... 3
REF ................................... -7
DK .................................... -8
[Code One.]
----------------------------------------------------
| NOTE: CAHPS ADULT CORE ITEM 33 |
----------------------------------------------------
SP07
====
{POLICYHOLDER FIRST MIDDLE NAME} {NAME OF
ESTABLISHMENT.........}
PLAN NAME: {NAME OF INSURER BEING LOOPED ON}
In the last 12 months, did (POLICYHOLDER) (or anyone in the
family) call (PLAN NAME)'s customer service to get information
or help?
YES .................................... 1
NO ..................................... 2 {SP09}
REF ................................... -7 {SP09}
DK .................................... -8 {SP09}
----------------------------------------------------
| NOTE: CAHPS ADULT CORE ITEM 34 |
----------------------------------------------------
SP08
====
{POLICYHOLDER FIRST MIDDLE NAME} {NAME OF
ESTABLISHMENT.........}
PLAN NAME: {NAME OF INSURER BEING LOOPED ON}
SHOW CARD SP-1.
In the last 12 months, how much of a problem, if any, was it to
get the help (POLICYHOLDER) (or anyone in the family) needed when
(POLICYHOLDER) called (PLAN NAME)'s customer service?
Would you say ...
a big problem, ......................... 1
a small problem, or .................... 2
not a problem? ......................... 3
REF ................................... -7
DK .................................... -8
[Code One.]
----------------------------------------------------
| NOTE: CAHPS ADULT CORE ITEM 35 |
----------------------------------------------------
SP09
====
{POLICYHOLDER FIRST MIDDLE NAME} {NAME OF
ESTABLISHMENT.........}
PLAN NAME: {NAME OF INSURER BEING LOOPED ON}
In the last 12 months, did (POLICYHOLDER) (or anyone in the
family) have to fill out any paperwork for (PLAN NAME)?
YES .................................... 1
NO ..................................... 2 {SP11}
REF ................................... -7 {SP11}
DK .................................... -8 {SP11}
----------------------------------------------------
| NOTE: CAHPS ADULT CORE ITEM 36 |
----------------------------------------------------
SP10
====
{POLICYHOLDER FIRST MIDDLE NAME} {NAME OF
ESTABLISHMENT.........}
PLAN NAME: {NAME OF INSURER BEING LOOPED ON}
SHOW CARD SP-1.
In the last 12 months, how much of a problem, if any, did
(POLICYHOLDER) (or anyone in the family) have with paperwork
for (PLAN NAME)?
Would you say ...
a big problem, ......................... 1
a small problem, or .................... 2
not a problem? ......................... 3
REF ................................... -7
DK .................................... -8
[Code One.]
----------------------------------------------------
| NOTE: CAHPS ADULT CORE ITEM 37 |
----------------------------------------------------
SP11
====
{POLICYHOLDER FIRST MIDDLE NAME} {NAME OF
ESTABLISHMENT.........}
PLAN NAME: {NAME OF INSURER BEING LOOPED ON}
SHOW CARD SP-2.
We want to know your rating of all (POLICYHOLDER)'s (and the
family's) experience with (PLAN NAME).
Using any number from 0 to 10, where 0 is the worst health plan
possible and 10 is the best health plan possible, what number
would you use to rate (PLAN NAME)?
ENTER RATING FROM 0-10:
[Enter Small Number] ...................
REF ................................... -7
DK .................................... -8
----------------------------------------------------
| RANGE CHECK: 0-10 |
----------------------------------------------------
----------------------------------------------------
| NOTE: CAHPS ADULT CORE ITEM 38 |
----------------------------------------------------
END_LP01
========
----------------------------------------------------
| CYCLE ON NEXT TRIPLE ON RU-ESTABLISHMENT-PERSON- |
| INSURER-TRIPLES-ROSTER THAT MEETS THE CONDITIONS |
| STATED IN THE LOOP DEFINITION |
----------------------------------------------------
----------------------------------------------------
| IF NO MORE TRIPLES MEET THE STATED CONDITIONS, |
| END LOOP_01 AND CONTINUE WITH BOX_02 |
----------------------------------------------------
MEDICARE HMO SERIES
BOX_02
======
----------------------------------------------------
| IF THERE IS AT LEAST ONE ESTABLISHMENT-PERSON PAIR|
| WHERE THE ESTABLISHMENT IS MEDICARE AND THE |
| MEDICARE BENEFITS ARE THROUGH AN HMO, CONTINUE |
| WITH LOOP_02 |
----------------------------------------------------
----------------------------------------------------
| OTHERWISE, GO TO BOX_03 |
----------------------------------------------------
LOOP_02
=======
----------------------------------------------------
| FOR EACH ELEMENT IN THE RU-ESTABLISHMENT-PERSON- |
| PAIRS ROSTER, ASK SP12-END_LP02 |
----------------------------------------------------
----------------------------------------------------
| LOOP DEFINITION: LOOP_02 COLLECTS SATISFACTION |
| INFORMATION ON ALL PERSON'S WITH MEDICARE HMO |
| PLANS. THIS LOOP CYCLES ON PAIRS THAT MEET THE |
| FOLLOWING CONDITIONS: |
| - ESTABLISHMENT IS MEDICARE |
| AND |
| - MEDICARE COVERAGE IS THROUGH AN HMO |
| AND |
| - PERSON IS CURRENTLY COVERED BY THE MEDICARE HMO |
----------------------------------------------------
----------------------------------------------------
| NOTE: MEDICARE HMO COVERAGE IS DEFINED AS: |
| - IF MEDICARE CREATED IN CURRENT ROUND, THEN HX31 |
| OR HX32 OR HX32A IS CODED '1' (YES) |
| - IF MEDICARE CREATED IN A PREVIOUS ROUND AND |
| THERE HAS BEEN NO CHANGE IN MEDICARE COVERAGE |
| (PR01 IS CODED '2' (NO), '7' (REFUSED), OR '-8' |
| (DON'T KNOW)), THEN HX31 OR HX32 OR HX32A WAS |
| CODED '1' (YES) WHEN THE INSURANCE WAS CREATED |
| OR PR02 OR PR03 OR PR03A WAS CODED '1' (YES) IN |
| A PREVIOUS ROUND |
| - IF MEDICARE CREATED IN A PREVIOUS ROUND AND |
| THERE HAS BEEN A CHANGE IN MEDICARE COVERAGE |
| (PR01 IS CODED '1' (YES)), THEN PR02 OR PR03 OR |
| PR03A IS CODED '1' (YES) DURING THE CURRENT |
| ROUND |
----------------------------------------------------
SP12
====
{PERSON FIRST MIDDLE LAST NAME......} {NAME OF
ESTABLISHMENT.........}
PLAN NAME: {NAME OF CURRENT ROUND MEDICARE HMO}
The next questions ask about (PERSON)'s experience with (PLAN
NAME), that is, (PERSON)'s coverage through Medicare.
PRESS ENTER TO CONTINUE.
----------------------------------------------------
| FOR 'NAME OF CURRENT ROUND MEDICARE HMO', DISPLAY |
| THE NAME OF THIS PERSON'S CURRENT ROUND'S MEDICARE|
| INSURER. THAT IS, DISPLAY THE NAME OF THE PLAN |
| SELECTED AT HX31OV OR ENTERED AT HX33 (IF MEDICARE|
| CREATED THIS ROUND OR IF UNCHANGED FROM A PREVIOUS|
| ROUND) OR THE PLAN SELECTED AT PR02OV OR ENTERED |
| AT PR04 (IF MEDICARE CREATED IN A PREVIOUS ROUND |
| AND COVERAGE HAS CHANGED OR IT IS THE MOST RECENT |
| INSURER ENTERED). |
----------------------------------------------------
----------------------------------------------------
| QUESTION FOR PROGRAMMERS: IS THERE A FLAG FOR THE |
| NAME OF THE CURRENT ROUND'S MEDICARE HMO INSURER? |
| IF SO, THEN THE ITEM NUMBERS ABOVE SHOULD NOT |
| NECESSARILY BE SPECIFIED, CORRECT? |
----------------------------------------------------
SP13
====
{PERSON FIRST MIDDLE LAST NAME......} {NAME OF
ESTABLISHMENT.........}
PLAN NAME: {NAME OF CURRENT ROUND MEDICARE HMO}
SHOW CARD SP-1.
Since (PERSON) joined (PLAN NAME), that is, (PERSON)'s coverage
through Medicare, how much of a problem, if any, was it to get a
personal doctor or nurse (PERSON) (are/is) happy with?
Would you say ...
a big problem, ......................... 1
a small problem, or .................... 2
not a problem? ......................... 3
IF VOLUNTEERED: DON'T HAVE PERSONAL
DOCTOR OR NURSE ..................... 95
REF ................................... -7
DK .................................... -8
[Code One.]
----------------------------------------------------
| SEE FILL SPECIFICATIONS FOR SP12 |
----------------------------------------------------
----------------------------------------------------
| NOTE: CAHPS ADULT CORE ITEM 6 |
----------------------------------------------------
SP14
====
{PERSON FIRST MIDDLE LAST NAME......} {NAME OF
ESTABLISHMENT.........}
PLAN NAME: {NAME OF CURRENT ROUND MEDICARE HMO}
In the last 12 months, did (PERSON) need approval from
(PLAN NAME), that is, (PERSON)'s coverage through Medicare, for
any care, tests or treatment?
YES .................................... 1
NO ..................................... 2 {SP16}
REF ................................... -7 {SP16}
DK .................................... -8 {SP16}
----------------------------------------------------
| SEE FILL SPECIFICATIONS FOR SP12 |
----------------------------------------------------
SP15
====
{PERSON FIRST MIDDLE LAST NAME......} {NAME OF
ESTABLISHMENT.........}
PLAN NAME: {NAME OF CURRENT ROUND MEDICARE HMO}
SHOW CARD SP-1.
In the last 12 months, how much of a problem, if any, were delays
in health care while (PERSON) waited for approval from (PLAN NAME),
that is, (PERSON)'s coverage through Medicare?
Would you say ...
a big problem, ......................... 1
a small problem, or .................... 2
not a problem? ......................... 3
IF VOLUNTEERED: NO VISITS IN LAST
12 MONTHS ........................... 95
REF ................................... -7
DK .................................... -8
[Code One.]
----------------------------------------------------
| SEE FILL SPECIFICATIONS FOR SP12 |
----------------------------------------------------
----------------------------------------------------
| NOTE: CAHPS ADULT CORE ITEM 23 |
----------------------------------------------------
SP16
====
{PERSON FIRST MIDDLE LAST NAME......} {NAME OF
ESTABLISHMENT.........}
PLAN NAME: {NAME OF CURRENT ROUND MEDICARE HMO}
In the last 12 months, did (PERSON) look for any information
about how (PLAN NAME), that is, (PERSON)'s coverage through
Medicare, works in written material or on the Internet?
YES .................................... 1
NO ..................................... 2 {SP18}
REF ................................... -7 {SP18}
DK .................................... -8 {SP18}
----------------------------------------------------
| SEE FILL SPECIFICATIONS FOR SP12 |
----------------------------------------------------
----------------------------------------------------
| NOTE: CAHPS ADULT CORE ITEM 32 |
----------------------------------------------------
SP17
====
{PERSON FIRST MIDDLE LAST NAME......} {NAME OF
ESTABLISHMENT.........}
PLAN NAME: {NAME OF CURRENT ROUND MEDICARE HMO}
SHOW CARD SP-1.
In the last 12 months, how much of a problem, if any, was it to
find or understand this information?
Would you say ...
a big problem, ......................... 1
a small problem, or .................... 2
not a problem? ......................... 3
REF ................................... -7
DK .................................... -8
[Code One.]
----------------------------------------------------
| SEE FILL SPECIFICATIONS FOR SP12 |
----------------------------------------------------
----------------------------------------------------
| NOTE: CAHPS ADULT CORE ITEM 33 |
----------------------------------------------------
SP18
====
{PERSON FIRST MIDDLE LAST NAME......} {NAME OF
ESTABLISHMENT.........}
PLAN NAME: {NAME OF CURRENT ROUND MEDICARE HMO}
In the last 12 months, did (PERSON) call (PLAN NAME)'s, that is,
(PERSON)'s coverage through Medicare, customer service to get
information or help?
YES .................................... 1
NO ..................................... 2 {SP20}
REF ................................... -7 {SP20}
DK .................................... -8 {SP20}
----------------------------------------------------
| SEE FILL SPECIFICATIONS FOR SP12 |
----------------------------------------------------
----------------------------------------------------
| NOTE: CAHPS ADULT CORE ITEM 34 |
----------------------------------------------------
SP19
====
{PERSON FIRST MIDDLE LAST NAME......} {NAME OF
ESTABLISHMENT.........}
PLAN NAME: {NAME OF CURRENT ROUND MEDICARE HMO}
SHOW CARD SP-1.
In the last 12 months, how much of a problem, if any, was it to
get the help (PERSON) needed when (PERSON) called (PLAN NAME)'s,
that is, (PERSON)'s coverage through Medicare, customer service?
Would you say ...
a big problem, ......................... 1
a small problem, or .................... 2
not a problem? ......................... 3
REF ................................... -7
DK .................................... -8
[Code One.]
----------------------------------------------------
| SEE FILL SPECIFICATIONS FOR SP12 |
----------------------------------------------------
----------------------------------------------------
| NOTE: CAHPS ADULT CORE ITEM 35 |
----------------------------------------------------
SP20
====
{PERSON FIRST MIDDLE LAST NAME......} {NAME OF
ESTABLISHMENT.........}
PLAN NAME: {NAME OF CURRENT ROUND MEDICARE HMO}
In the last 12 months, did (PERSON) have to fill out any
paperwork for (PLAN NAME), that is (PERSON)'s coverage through
Medicare?
YES .................................... 1
NO ..................................... 2 {SP22}
REF ................................... -7 {SP22}
DK .................................... -8 {SP22}
----------------------------------------------------
| SEE FILL SPECIFICATIONS FOR SP12 |
----------------------------------------------------
----------------------------------------------------
| NOTE: CAHPS ADULT CORE ITEM 36 |
----------------------------------------------------
SP21
====
{PERSON FIRST MIDDLE LAST NAME......} {NAME OF
ESTABLISHMENT.........}
PLAN NAME: {NAME OF CURRENT ROUND MEDICARE HMO}
SHOW CARD SP-1.
In the last 12 months, how much of a problem, if any, did
(PERSON) have with paperwork for (PLAN NAME), that is,
(PERSON)'s coverage through Medicare?
Would you say ...
a big problem, ......................... 1
a small problem, or .................... 2
not a problem? ......................... 3
REF ................................... -7
DK .................................... -8
[Code One.]
----------------------------------------------------
| SEE FILL SPECIFICATIONS FOR SP12 |
----------------------------------------------------
----------------------------------------------------
| NOTE: CAHPS ADULT CORE ITEM 37 |
----------------------------------------------------
SP22
====
{PERSON FIRST MIDDLE LAST NAME......} {NAME OF
ESTABLISHMENT.........}
PLAN NAME: {NAME OF CURRENT ROUND MEDICARE HMO}
SHOW CARD SP-2.
We want to know your rating of all (PERSON)'s experience with
(PLAN NAME), that is, (PERSON)'s coverage through Medicare.
Using any number from 0 to 10, where 0 is the worst health plan
possible and 10 is the best health plan possible, what number
would you use to rate (PLAN NAME)?
ENTER RATING FROM 0-10:
[Enter Small Number] ...................
REF ................................... -7
DK .................................... -8
----------------------------------------------------
| RANGE CHECK: 0-10 |
----------------------------------------------------
----------------------------------------------------
| SEE FILL SPECIFICATIONS FOR SP12 |
----------------------------------------------------
----------------------------------------------------
| NOTE: CAHPS ADULT CORE ITEM 38 |
----------------------------------------------------
END_LP02
========
----------------------------------------------------
| CYCLE ON NEXT PAIR ON THE RU-ESTABLISHMENT-PERSON-|
| PAIRS-ROSTER THAT MEETS THE CONDITIONS STATED IN |
| THE LOOP DEFINITION |
----------------------------------------------------
----------------------------------------------------
| IF NO MORE PAIRS MEET THE STATED CONDITIONS, END |
| LOOP_02 AND CONTINUE WITH BOX_03 |
----------------------------------------------------
MEDICAID AND HOSPITAL/PHYSICIAN SERIES
BOX_03
======
----------------------------------------------------
| IF AT LEAST ONE CURRENT RU MEMBER IS A COVERED BY |
| MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE |
| CURRENT ROUND, CONTINUE WITH SP23 |
----------------------------------------------------
----------------------------------------------------
| OTHERWISE, GO TO BOX_04 |
----------------------------------------------------
SP23
====
{NAME OF ESTABLISHMENT.........}
{PLAN NAME: {NAME OF CURRENT ROUND MEDICAID/GOVT-H/P INSURER}}
The next questions ask about the family's experience with
{(PLAN NAME), that is, their coverage through} {{Medicaid/{STATE
NAME FOR MEDICAID}/or {STATE CHIP NAME}}/the program sponsored by
a state or local government agency which provides hospital and
physician benefits}.
PRESS ENTER TO CONTINUE.
-----------------------------------------------------
| DISPLAY 'PLAN NAME: ... INSURER}' IF THERE IS AN |
| INSURER ASSOCIATED WITH THE FAMILY'S MEDICAID OR |
| GOV'T-HOSPITAL/PHYSICIAN INSURANCE DURING THE |
| CURRENT ROUND. OTHERWISE, USE A NULL DISPLAY. |
| |
| FOR 'NAME OF ... INSURER', DISPLAY THE NAME OF THE |
| CURRENT ROUND'S INSURER FOR THE FAMILY'S MEDICAID |
| OR GOV'T-HOSPITAL/PHYSICIAN INSURANCE. |
| |
| DISPLAY '(PLAN NAME), ... through' IF THERE IS AN |
| INSURER ASSOCIATED WITH THE FAMILY'S MEDICAID OR |
| GOV'T-HOSPITAL/PHYSICIAN INSURANCE DURING THE |
| CURRENT ROUND. OTHERWISE, USE A NULL DISPLAY. |
| |
| DISPLAY '{Medicaid/{STATE NAME FOR MEDICAID}/or |
| {STATE CHIP NAME}}' IF FAMILY HAS MEDICAID. |
| OTHERWISE, DISPLAY 'the program ... benefits'. |
| |
| DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS |
| BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY |
| 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL |
| STATE NAME FOR PROGRAM) IF THE STATE IN WHICH |
| INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME |
| 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY |
| STATE, SEE BOX ON HX06. |
| |
| DISPLAY 'or STATE CHIP NAME' (SUBSTITUTING THE |
| REAL STATE NAME FOR PROGRAM). FOR THE SPECIFIC |
| NAME TO USE BY STATE, SEE BOX ON HX06. |
-----------------------------------------------------
SP24
====
{NAME OF ESTABLISHMENT.........}
{PLAN NAME: {NAME OF CURRENT ROUND MEDICAID/GOVT-H/P INSURER}}
SHOW CARD SP-1.
Since the family joined {(PLAN NAME)/the coverage through}
{Medicaid/{STATE NAME FOR MEDICAID}/or {STATE CHIP NAME}}/the
program sponsored by a state or local government agency which
provides hospital and physician benefits}, how much of a
problem, if any, was it to get a personal doctor or nurse the
family is happy with?
Would you say ...
a big problem, ......................... 1
a small problem, or .................... 2
not a problem? ......................... 3
IF VOLUNTEERED: DON'T HAVE PERSONAL
DOCTOR OR NURSE ..................... 95
REF ................................... -7
DK .................................... -8
[Code One.]
-----------------------------------------------------
| DISPLAY 'PLAN NAME: ... INSURER}' IF THERE IS AN |
| INSURER ASSOCIATED WITH THE FAMILY'S MEDICAID OR |
| GOV'T-HOSPITAL/PHYSICIAN INSURANCE DURING THE |
| CURRENT ROUND. OTHERWISE, USE A NULL DISPLAY. |
| |
| FOR 'NAME OF ... INSURER', DISPLAY THE NAME OF THE |
| CURRENT ROUND'S INSURER FOR THE FAMILY'S MEDICAID |
| OR GOV'T-HOSPITAL/PHYSICIAN INSURANCE. |
| |
| DISPLAY '(PLAN NAME)' IF THERE IS AN INSURER |
| ASSOCIATED WITH THE FAMILY'S MEDICAID OR GOV'T- |
| HOSPITAL/PHYSICIAN INSURANCE DURING THE CURRENT |
| ROUND. OTHERWISE, DISPLAY 'the coverage through'. |
| |
| DISPLAY '{Medicaid/{STATE NAME FOR MEDICAID}/or |
| {STATE CHIP NAME}}' IF FAMILY HAS MEDICAID AND |
| THERE IS NO INSURER ASSOCIATED WITH THE FAMILY'S |
| MEDICAID INSURANCE DURING THE CURRENT ROUND. |
| DISPLAY 'the program ... benefits' IF THE FAMILY |
| HAS GOVT-HOSPITAL/PHYSICIAN AND THERE IS NO |
| INSURER ASSOCIATED WITH THE FAMILY'S GOVT-HOSPITAL/|
| PHYSICIAN INSURANCE DURING THE CURRENT ROUND. |
-----------------------------------------------------
-----------------------------------------------------
| DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS |
| BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY |
| 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL |
| STATE NAME FOR PROGRAM) IF THE STATE IN WHICH |
| INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME |
| 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY |
| STATE, SEE BOX ON HX06. |
| |
| DISPLAY 'or STATE CHIP NAME' (SUBSTITUTING THE |
| REAL STATE NAME FOR PROGRAM). FOR THE SPECIFIC |
| NAME TO USE BY STATE, SEE BOX ON HX06. |
-----------------------------------------------------
----------------------------------------------------
| NOTE: CAHPS ADULT CORE ITEM 6 |
----------------------------------------------------
SP25
====
{NAME OF ESTABLISHMENT.........}
{PLAN NAME: {NAME OF CURRENT ROUND MEDICAID/GOVT-H/P INSURER}}
In the last 12 months, did anyone in the family need approval from
{(PLAN NAME)/the coverage through} {Medicaid/{STATE NAME FOR
MEDICAID}/or {STATE CHIP NAME}}/the program sponsored by a state or
local government agency which provides hospital and physician
benefits} for any care, tests or treatment?
YES .................................... 1
NO ..................................... 2 {SP27}
REF ................................... -7 {SP27}
DK .................................... -8 {SP27}
----------------------------------------------------
| SEE FILL SPECIFICATIONS FROM SP24 |
----------------------------------------------------
SP26
====
{NAME OF ESTABLISHMENT.........}
{PLAN NAME: {NAME OF CURRENT ROUND MEDICAID/GOVT-H/P INSURER}}
SHOW CARD SP-1.
In the last 12 months, how much of a problem, if any, were delays
in health care while the family waited for approval from
{(PLAN NAME)/the coverage through} {Medicaid/{STATE NAME FOR
MEDICAID}/or {STATE CHIP NAME}}/the program sponsored by a state or
local government agency which provides hospital and physician
benefits}?
Would you say ...
a big problem, ......................... 1
a small problem, or .................... 2
not a problem? ......................... 3
IF VOLUNTEERED: NO VISITS IN LAST
12 MONTHS ........................... 95
REF ................................... -7
DK .................................... -8
[Code One.]
----------------------------------------------------
| SEE FILL SPECIFICATIONS FROM SP24 |
----------------------------------------------------
----------------------------------------------------
| NOTE: CAHPS ADULT CORE ITEM 23 |
----------------------------------------------------
SP27
====
{NAME OF ESTABLISHMENT.........}
{PLAN NAME: {NAME OF CURRENT ROUND MEDICAID/GOVT-H/P INSURER}}
In the last 12 months, did anyone in the family look for any
information about how {(PLAN NAME)/the coverage through}
{Medicaid/{STATE NAME FOR MEDICAID}/or {STATE CHIP NAME}}/the
the program sponsored by a state or local government agency
which provides hospital and physician benefits} works in
written material or on the Internet?
YES .................................... 1
NO ..................................... 2 {SP29}
REF ................................... -7 {SP29}
DK .................................... -8 {SP29}
----------------------------------------------------
| SEE FILL SPECIFICATIONS FROM SP24 |
----------------------------------------------------
----------------------------------------------------
| NOTE: CAHPS ADULT CORE ITEM 32 |
----------------------------------------------------
SP28
====
{NAME OF ESTABLISHMENT.........}
{PLAN NAME: {NAME OF CURRENT ROUND MEDICAID/GOVT-H/P INSURER}}
SHOW CARD SP-1.
In the last 12 months, how much of a problem, if any, was it to
find or understand this information?
Would you say ...
a big problem, ......................... 1
a small problem, or .................... 2
not a problem? ......................... 3
REF ................................... -7
DK .................................... -8
[Code One.]
----------------------------------------------------
| DISPLAY 'PLAN NAME: ... INSURER}' IF THERE IS AN |
| INSURER ASSOCIATED WITH THE FAMILY'S MEDICAID OR |
| GOV'T-HOSPITAL/PHYSICIAN INSURANCE DURING THE |
| CURRENT ROUND. OTHERWISE, USE A NULL DISPLAY. |
| |
| FOR 'NAME OF ... INSURER', DISPLAY THE NAME OF THE|
| CURRENT ROUND'S INSURER FOR THE FAMILY'S MEDICAID |
| OR GOV'T HOSPITAL/PHYSICIAN INSURANCE. |
----------------------------------------------------
----------------------------------------------------
| NOTE: CAHPS ADULT CORE ITEM 33 |
----------------------------------------------------
SP29
====
{NAME OF ESTABLISHMENT.........}
{PLAN NAME: {NAME OF CURRENT ROUND MEDICAID/GOVT-H/P INSURER}}
In the last 12 months, did anyone in the family call {(PLAN NAME)'s/
the coverage through} {Medicaid/{STATE NAME FOR MEDICAID}/or {STATE
CHIP NAME}}/the program sponsored by a state or local government
agency which provides hospital and physician benefits} customer
service to get information or help?
YES .................................... 1
NO ..................................... 2 {SP31}
REF ................................... -7 {SP31}
DK .................................... -8 {SP31}
----------------------------------------------------
| SEE FILL SPECIFICATIONS FROM SP24 |
----------------------------------------------------
----------------------------------------------------
| NOTE: CAHPS ADULT CORE ITEM 34 |
----------------------------------------------------
SP30
====
{NAME OF ESTABLISHMENT.........}
{PLAN NAME: {NAME OF CURRENT ROUND MEDICAID/GOVT-H/P INSURER}}
SHOW CARD SP-1.
In the last 12 months, how much of a problem, if any, was it to
get the help the family needed when they called this health
plan's customer service?
Would you say ...
a big problem, ......................... 1
a small problem, or .................... 2
not a problem? ......................... 3
REF ................................... -7
DK .................................... -8
[Code One.]
----------------------------------------------------
| DISPLAY 'PLAN NAME: ... INSURER}' IF THERE IS AN |
| INSURER ASSOCIATED WITH THE FAMILY'S MEDICAID OR |
| GOV'T-HOSPITAL/PHYSICIAN INSURANCE DURING THE |
| CURRENT ROUND. OTHERWISE, USE A NULL DISPLAY. |
| |
| FOR 'NAME OF ... INSURER', DISPLAY THE NAME OF THE|
| CURRENT ROUND'S INSURER FOR THE FAMILY'S MEDICAID |
| OR GOV'T HOSPITAL/PHYSICIAN INSURANCE. |
----------------------------------------------------
----------------------------------------------------
| NOTE: CAHPS ADULT CORE ITEM 35 |
----------------------------------------------------
SP31
====
{NAME OF ESTABLISHMENT.........}
{PLAN NAME: {NAME OF CURRENT ROUND MEDICAID/GOVT-H/P INSURER}}
In the last 12 months, did anyone in the family have to fill
out any paperwork for {(PLAN NAME)/the coverage through}
{Medicaid/{STATE NAME FOR MEDICAID}/or {STATE CHIP NAME}}/the
program sponsored by a state or local government agency which
provides hospital and physician benefits}?
YES .................................... 1
NO ..................................... 2 {SP33}
REF ................................... -7 {SP33}
DK .................................... -8 {SP33}
----------------------------------------------------
| SEE FILL SPECIFICATIONS FROM SP24 |
----------------------------------------------------
----------------------------------------------------
| NOTE: CAHPS ADULT CORE ITEM 36 |
----------------------------------------------------
SP32
====
{NAME OF ESTABLISHMENT.........}
{PLAN NAME: {NAME OF CURRENT ROUND MEDICAID/GOVT-H/P INSURER}}
SHOW CARD SP-1.
In the last 12 months, how much of a problem, if any, did the
family have with paperwork for this health plan?
Would you say ...
a big problem, ......................... 1
a small problem, or .................... 2
not a problem? ......................... 3
REF ................................... -7
DK .................................... -8
[Code One.]
----------------------------------------------------
| DISPLAY 'PLAN NAME: ... INSURER}' IF THERE IS AN |
| INSURER ASSOCIATED WITH THE FAMILY'S MEDICAID OR |
| GOV'T-HOSPITAL/PHYSICIAN INSURANCE DURING THE |
| CURRENT ROUND. OTHERWISE, USE A NULL DISPLAY. |
| |
| FOR 'NAME OF ... INSURER', DISPLAY THE NAME OF THE|
| CURRENT ROUND'S INSURER FOR THE FAMILY'S MEDICAID |
| OR GOV'T HOSPITAL/PHYSICIAN INSURANCE. |
----------------------------------------------------
----------------------------------------------------
| NOTE: CAHPS ADULT CORE ITEM 37 |
----------------------------------------------------
SP33
====
{NAME OF ESTABLISHMENT.........}
{PLAN NAME: {NAME OF CURRENT ROUND MEDICAID/GOVT-H/P INSURER}}
SHOW CARD SP-2.
We want to know your rating of all the family's experience with
{(PLAN NAME)/the coverage through} {Medicaid/{STATE NAME FOR
MEDICAID}/or {STATE CHIP NAME}}/the program sponsored by a state
or local government agency which provides hospital and physician
benefits}.
Using any number from 0 to 10, where 0 is the worst health plan
possible and 10 is the best health plan possible, what number
would you use to rate this health plan?
ENTER RATING FROM 0-10:
[Enter Small Number] ...................
REF ................................... -7
DK .................................... -8
----------------------------------------------------
| RANGE CHECK: 0-10 |
----------------------------------------------------
----------------------------------------------------
| SEE FILL SPECIFICATIONS FROM SP24 |
----------------------------------------------------
----------------------------------------------------
| NOTE: CAHPS ADULT CORE ITEM 38 |
----------------------------------------------------
TRICARE SERIES
BOX_04
======
----------------------------------------------------
| IF AT LEAST ONE CURRENT RU MEMBER IS COVERED BY |
| TRICARE/CHAMPUS DURING THE CURRENT ROUND, CONTINUE|
| WITH SP34 |
----------------------------------------------------
----------------------------------------------------
| OTHERWISE, GO TO BOX_05 |
----------------------------------------------------
SP34
====
{NAME OF ESTABLISHMENT.........}
{PLAN NAME: {NAME OF CURRENT ROUND TRICARE INSURER(S)}}
The next questions ask about the family's experience with {(PLAN
NAME), that is,} their coverage through TRICARE, which used to be
called CHAMPUS OR CHAMPVA.
PRESS ENTER TO CONTINUE.
----------------------------------------------------
| FOR' NAME OF ESTABLISHMENT...', DISPLAY 'TRICARE'.|
| |
| DISPLAY 'PLAN NAME: ... INSURER(S)}' IF THERE IS A|
| TRICARE INSURER ASSOCIATED WITH THE FAMILY'S |
| TRICARE INSURANCE (CHECK HX12A, PR19A, OR PR21A). |
| OTHERWISE, USE A NULL DISPLAY. |
| |
| FOR 'NAME OF CURRENT ROUND TRICARE INSURER(S)', |
| DISPLAY THE NAME(S) OF THE CURRENT ROUND'S |
| INSURER(S) FOR THE FAMILY'S TRICARE INSURANCE. |
| NOTE: IF MULTIPLE INSURERS ARE SELECTED AT HX12A,|
| PR19A, OR PR21A, SEPARATE THE INSURER NAMES WITH |
| A '/'. |
| |
| DISPLAY '(PLAN NAME), that is,' IF THERE IS A |
| TRICARE INSURER ASSOCIATED WITH THE FAMILY'S |
| TRICARE INSURANCE (CHECK HX12A, PR19A, OR PR21A). |
| OTHERWISE, USE A NULL DISPLAY. |
----------------------------------------------------
SP35
====
{NAME OF ESTABLISHMENT.........}
{PLAN NAME: {NAME OF CURRENT ROUND TRICARE INSURER(S)}}
SHOW CARD SP-1.
Since the family joined TRICARE, how much of a problem, if any,
was it to get a personal doctor or nurse the family is happy with?
Would you say ...
a big problem, ......................... 1
a small problem, or .................... 2
not a problem? ......................... 3
IF VOLUNTEERED: DON'T HAVE PERSONAL
DOCTOR OR NURSE ..................... 95
REF ................................... -7
DK .................................... -8
[Code One.]
----------------------------------------------------
| FOR' NAME OF ESTABLISHMENT...', DISPLAY 'TRICARE'.|
| |
| DISPLAY 'PLAN NAME: ... INSURER(S)}' IF THERE IS A|
| TRICARE INSURER ASSOCIATED WITH THE FAMILY'S |
| TRICARE INSURANCE (CHECK HX12A, PR19A, OR PR21A). |
| OTHERWISE, USE A NULL DISPLAY. |
| |
| FOR 'NAME OF CURRENT ROUND TRICARE INSURER(S)', |
| DISPLAY THE NAME(S) OF THE CURRENT ROUND'S |
| INSURER(S) FOR THE FAMILY'S TRICARE INSURANCE. |
| NOTE: IF MULTIPLE INSURERS ARE SELECTED AT HX12A,|
| PR19A, OR PR21A, SEPARATE THE INSURER NAMES WITH |
| A '/'. |
----------------------------------------------------
----------------------------------------------------
| NOTE: CAHPS ADULT CORE ITEM 6 |
----------------------------------------------------
SP36
====
{NAME OF ESTABLISHMENT.........}
{PLAN NAME: {NAME OF CURRENT ROUND TRICARE INSURER(S)}}
In the last 12 months, did anyone in the family need approval
from TRICARE for any care, tests or treatment?
YES .................................... 1
NO ..................................... 2 {SP38}
REF ................................... -7 {SP38}
DK .................................... -8 {SP38}
----------------------------------------------------
| SEE FILL SPECIFICATIONS FROM SP35 |
----------------------------------------------------
SP37
====
{NAME OF ESTABLISHMENT.........}
{PLAN NAME: {NAME OF CURRENT ROUND TRICARE INSURER(S)}}
SHOW CARD SP-1.
In the last 12 months, how much of a problem, if any, were delays
in health care while the family waited for approval from TRICARE?
Would you say ...
a big problem, ......................... 1
a small problem, or .................... 2
not a problem? ......................... 3
IF VOLUNTEERED: NO VISITS IN LAST
12 MONTHS ........................... 95
REF ................................... -7
DK .................................... -8
[Code One.]
----------------------------------------------------
| SEE FILL SPECIFICATIONS FROM SP35 |
----------------------------------------------------
----------------------------------------------------
| NOTE: CAHPS ADULT CORE ITEM 23 |
----------------------------------------------------
SP38
====
{NAME OF ESTABLISHMENT.........}
{PLAN NAME: {NAME OF CURRENT ROUND TRICARE INSURER(S)}}
In the last 12 months, did anyone in the family look for any
information about how their coverage through TRICARE works in
written material or on the Internet?
YES .................................... 1
NO ..................................... 2 {SP40}
REF ................................... -7 {SP40}
DK .................................... -8 {SP40}
----------------------------------------------------
| SEE FILL SPECIFICATIONS FROM SP35 |
----------------------------------------------------
----------------------------------------------------
| NOTE: CAHPS ADULT CORE ITEM 32 |
----------------------------------------------------
SP39
====
{NAME OF ESTABLISHMENT.........}
{PLAN NAME: {NAME OF CURRENT ROUND TRICARE INSURER(S)}}
SHOW CARD SP-1.
In the last 12 months, how much of a problem, if any, was it to
find or understand this information?
Would you say ...
a big problem, ......................... 1
a small problem, or .................... 2
not a problem? ......................... 3
REF ................................... -7
DK .................................... -8
[Code One.]
----------------------------------------------------
| SEE FILL SPECIFICATIONS FROM SP35 |
----------------------------------------------------
----------------------------------------------------
| NOTE: CAHPS ADULT CORE ITEM 33 |
----------------------------------------------------
SP40
====
{NAME OF ESTABLISHMENT.........}
{PLAN NAME: {NAME OF CURRENT ROUND TRICARE INSURER(S)}}
In the last 12 months, did anyone in the family call TRICARE's
customer service to get information or help?
YES .................................... 1
NO ..................................... 2 {SP42}
REF ................................... -7 {SP42}
DK .................................... -8 {SP42}
----------------------------------------------------
| SEE FILL SPECIFICATIONS FROM SP35 |
----------------------------------------------------
----------------------------------------------------
| NOTE: CAHPS ADULT CORE ITEM 34 |
----------------------------------------------------
SP41
====
{NAME OF ESTABLISHMENT.........}
{PLAN NAME: {NAME OF CURRENT ROUND TRICARE INSURER(S)}}
SHOW CARD SP-1.
In the last 12 months, how much of a problem, if any, was it to
get the help the family needed when they called TRICARE's
customer service?
Would you say ...
a big problem, ......................... 1
a small problem, or .................... 2
not a problem? ......................... 3
REF ................................... -7
DK .................................... -8
[Code One.]
----------------------------------------------------
| SEE FILL SPECIFICATIONS FROM SP35 |
----------------------------------------------------
----------------------------------------------------
| NOTE: CAHPS ADULT CORE ITEM 35 |
----------------------------------------------------
SP42
====
{NAME OF ESTABLISHMENT.........}
{PLAN NAME: {NAME OF CURRENT ROUND TRICARE INSURER(S)}}
In the last 12 months, did anyone in the family have to fill out
any paperwork for their coverage through TRICARE?
YES .................................... 1
NO ..................................... 2 {SP44}
REF ................................... -7 {SP44}
DK .................................... -8 {SP44}
----------------------------------------------------
| SEE FILL SPECIFICATIONS FROM SP35 |
----------------------------------------------------
----------------------------------------------------
| NOTE: CAHPS ADULT CORE ITEM 36 |
----------------------------------------------------
SP43
====
{NAME OF ESTABLISHMENT.........}
{PLAN NAME: {NAME OF CURRENT ROUND TRICARE INSURER(S)}}
SHOW CARD SP-1.
In the last 12 months, how much of a problem, if any, did the
family have with paperwork for their coverage through TRICARE?
Would you say ...
a big problem, ......................... 1
a small problem, or .................... 2
not a problem? ......................... 3
REF ................................... -7
DK .................................... -8
[Code One.]
----------------------------------------------------
| SEE FILL SPECIFICATIONS FROM SP35 |
----------------------------------------------------
----------------------------------------------------
| NOTE: CAHPS ADULT CORE ITEM 37 |
----------------------------------------------------
SP44
====
{NAME OF ESTABLISHMENT.........}
{PLAN NAME: {NAME OF CURRENT ROUND TRICARE INSURER(S)}}
SHOW CARD SP-2.
We want to know your rating of all the family's experience with
their coverage through TRICARE.
Using any number from 0 to 10, where 0 is the worst health plan
possible and 10 is the best health plan possible, what number
would you use to rate the coverage through TRICARE?
ENTER RATING FROM 0-10:
[Enter Small Number] ...................
REF ................................... -7
DK .................................... -8
----------------------------------------------------
| RANGE CHECK: 0-10 |
----------------------------------------------------
----------------------------------------------------
| SEE FILL SPECIFICATIONS FROM SP35 |
----------------------------------------------------
----------------------------------------------------
| NOTE: CAHPS ADULT CORE ITEM 38 |
----------------------------------------------------
BOX_05
======
----------------------------------------------------
| GO TO NEXT QUESTIONNAIRE SECTION |
----------------------------------------------------
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