Member Satisfaction Survey

1) How long did it take to reach the office when you called for an appointment?

0-30 seconds

31-60 seconds

over 60 seconds

Placed on hold

1a) If over 60 seconds, did you call the office after routine business hours?

Yes

No

1i) If YES, did the office have an afterhours contact system?

Yes

No

1ii) if YES, did you receive a timely response/call back?

Yes

No

2) When was the first available appointment at this office?

0-4 weeks

4-8 weeks

Over 8 weeks

2a) If over 8 weeks, did you request a specific time or day for your appointment?

Yes

No

3) How long after your appointment time did you wait to be seen in the office?

0-10 minutes

10-20 minutes

20-30 minutes

Over 30 minutes

Over 60 minutes

3a) If over 30/60 minutes, did someone offer you an explanation for the extended wait time?

4) How satisfied were you with the appearance and cleanliness of the office?

Very satisfied

Somewhat satisfied

Neither satisfied nor dissatisfied

Somewhat dissatisfied

Very dissatisfied

4a) If not satisfied, why weren't you satisfied with the cleanliness of the office?

5) Did you use an interpreter during your appointment?

Yes

No

5a) How satisfied were you with the interpreter you used?

Very satisfied

Somewhat satisfied

Neither satisfied nor dissatisfied

Somewhat dissatisfied

Very dissatisfied

6) How satisfied were you with the professionalism and courteousness of office staff?

Very satisfied

Somewhat satisfied

Neither satisfied nor dissatisfied

Somewhat dissatisfied

Very dissatisfied

6a) If not satisfied, why weren't you satisfied with the professionalism and courteousness of the office staff?

7) How satisfied were you with the amount of time the doctor spent with you?

Very satisfied

Somewhat satisfied

Neither satisfied nor dissatisfied

Somewhat dissatisfied

Very dissatisfied

7a) If not satisfied, why weren’t you satisfied with the amount of time the doctor spent with you?

8) How satisfied were you with the staff explanation of the treatment and treatment options?

Very satisfied

Somewhat satisfied

Neither satisfied nor dissatisfied

Somewhat dissatisfied

Very dissatisfied

8a) If not satisfied, why weren’t you satisfied with the staff explanation of the treatment and treatment options?

9) How satisfied were you with the dental treatment services you received?

Very satisfied

Somewhat satisfied

Neither satisfied nor dissatisfied

Somewhat dissatisfied

Very dissatisfied

9a) If not satisfied, why weren’t you satisfied with the dental treatment services received?

10) How likely are you to recommend this office to a family member or friend?

Very likely

Somewhat likely

Neither likely nor unlikely

Somewhat unlikely

Very unlikely

10a) If unlikely, why are you unlikely to recommend the office to a family member or friend?

11) Rate your overall satisfaction with the office.

Very satisfied

Somewhat satisfied

Neither satisfied nor dissatisfied

Somewhat dissatisfied

Very dissatisfied

12) If you have contacted LIBERTY Dental Plan’s Member Services previously, how satisfied were you with your experience?

Very satisfied

Somewhat satisfied

Neither satisfied nor dissatisfied

Somewhat dissatisfied

Very dissatisfied

13) If you have used LIBERTY Dental Plan’s website, how easy was it to navigate the website?

Very easy

Somewhat easy

Neither easy nor difficult

Somewhat difficult

Very difficult

Not applicable

14) How likely are you to refer family or friends to LIBERTY Dental Plan?

Very likely

Somewhat likely

Neither likely nor unlikely

Somewhat unlikely

Very unlikely

Prior to appointment, how did you hear about LIBERTY Dental Plan?

Community Event

Family or Friends

Provider Office

State Agency

Employer/Group/Medical Group

Mailer

Social Media/Advertisement

Other

BCBSNC MEMBER SATISFACTION SURVEY

MEMBER SATISFACTION SURVEY