TRICARE Dual Eligible Fiscal Intermediary Contract Provider Satisfaction Survey

ICR 201001-0720-001

OMB: 0720-0045

Federal Form Document

Forms and Documents
ICR Details
0720-0045 201001-0720-001
Historical Active
DOD/DODOASHA
TRICARE Dual Eligible Fiscal Intermediary Contract Provider Satisfaction Survey
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 03/16/2011
Retrieve Notice of Action (NOA) 01/11/2010
Approved consistent with revisions to the survey instrument submitted by DoD and included in the public docket.
  Inventory as of this Action Requested Previously Approved
03/31/2014 36 Months From Approved
46,800 0 0
11,700 0 0
0 0 0

Wisconsin Physician Services (WPS) will use the survey to assess provider satisfaction, attitudes, and perceptions regarding the claims processing and customer services provided by WPS for the TDEFIC in order to improve internal operations and customer services to increase provider satisfaction. WPS will provide the government a monthly report indicating the satisfaction results of providers.

None
None

Not associated with rulemaking

  73 FR 12138 03/06/2008
73 FR 12138 03/06/2008
No

1
IC Title Form No. Form Name
TRICARE Dual Eligible Fiscal Intermediary Contract Provider Satisfaction Survey

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 46,800 0 0 46,800 0 0
Annual Time Burden (Hours) 11,700 0 0 11,700 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
New Collection

Yes Part B of Supporting Statement
No
No
No
No
Uncollected
Patricia Toppings 703 696-5284 PLToppings@whs.mil

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
01/11/2010


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