Insurance Survey example

This is an example Insurance Survey survey. This survey includes questions like:

We hope this will help you create your own Insurance Survey survey. We have not tested the validitiy or reliability of this survey. However, you may use this as a starting point to help your own survey instrument. Feel free to change and edit any of our survey templates to help you get started.

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1) Does your office bill patient insurance?
2) Does your office participate in HMO or preferred provider programs?
3) Do you discuss insurance coverage for specific services with your patients prior to providing treatment?
4) How much do insurance company coverage determinations affect your decision-making in patient care?
  • Great Deal
  • Somewhat
  • Very Little
  • Not at All
5) How often have you personally dealt directly with an insurance company to get specific treatments or services covered for a patient?
  • Often
  • Sometimes
  • Rarely
  • Never
6) How often do you determine what the patient's insurance will cover prior to planning the course of treatment?
  • Often
  • Sometimes
  • Rarely
  • Never
7) How much do you feel insurance providers' determinations infringe upon your decision-making for patient treatment?
  • Great Deal
  • Somewhat
  • Very Little
  • Not at All
8) How much do you think insurance providers' determinations have affected how your patients approach their medical care?
  • Great Deal
  • Somewhat
  • Very Little
  • Not at All
9) What is your profession?
  • General Practice Physician
  • Medical Specialty Physician
  • Physician's Assistant
  • Nurse Practitioner
  • RN
  • LPN
  • General Dentistry
  • Dental Specialty
  • Other:
10) Are you male or female?
11) What is your age?
12) How long have you been in practice?
13) Do you work in private practice, clinic or medical group, or a hospital?
  • Private Practice
  • Clinic or Medical Group
  • Hospital
  • Other:
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