ubhonline - Clinician Survey

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We want to know what you think. Please take a few seconds to complete the following survey so ubhonline can better serve you in the future.

1. What was the primary reason you came to ubhonline today?
	(a) Submit behavioral health or EAP claims
	(b) Request certification
	(c) Check claims status
	(d) Check patient eligibility and benefits
	(e) Inquire about a patient's certification
	(f) Other

2. Were you able to complete this activity successfully?
	(a) Yes
	(b) Partially
	(c) No

3. Did your activity save a call or paper submission you would otherwise have had to make?
	(a) Yes
	(b) No

4. At what speed did you connect to the ubhonline^® Web Site today?
	(a) <20k
	(b) 20k-40k
	(c) 40k-60k
	(d) 60k+
	(e) Cable Modem/DSL

5. How would you rate the speed of your ubhonline interaction today?
	(a) Excellent
	(b) Acceptable
	(c) Poor

6. Do you plan on coming back to ubhonline in the future?
	(a) Yes
	(b) No

Any comments? (please limit your comments to 250 characters)
For privacy purposes, please do not include any patient personal health information. Your survey responses and comments are anonymous unless you provide your email address below.

If you would like a response to your comments, please provide your email address: