Care Coordination Member Satisfaction Survey

1. Name of your Kepro Oregon Health Plan Care Coordination services representative *This question is required.

• Danielle
• Eric
• Katie
• Kreg
• Beatris
• Lisa
• Nicole
• Other - Write In Please enter an 'other' value for this selection.

2. My age group *This question is required.

• 17 & under
• 18-34
• 35-54
• 55 & older

3. I belong to  *This question is required.

• Native American
• Dual Eligibility
• Veteran
• Medically Frail
• Open Card
• Community or at Home Birth
• Other - Write In Please enter an 'other' value for this selection.

4. The Kepro Oregon Health Plan Care Coordination services representative offered me information about Case Management services *This question is required.

• Yes
• No
• Other - Write In Please enter an 'other' value for this selection.

5. The reason for the phone call was
  *This question is required.

• Quit Smoking
• Pharmacy Issue
• Nurse Advise Line
• Resources
• Needed a Provider or Service
• Hepatitis C Program
• Case Management Program Enrollment
• Other - Write In Please enter an 'other' value for this selection.

6. The Kepro Oregon Health Plan Care Coordination services representative was open to my questions and gave me answers that I could easily understand
  *This question is required.

• Yes
• No
• Other - Write In Please enter an 'other' value for this selection.

7. The Kepro Oregon Health Plan Care Coordination services representative has given me useful information regarding the choice of providers and services *This question is required.

• Yes
• No
• Other - Write In Please enter an 'other' value for this selection.

8. I would refer Kepro Oregon Health Plan Care Coordination services to my friends and family members or other Open Card members
  *This question is required.

• Yes
• No

9. I used Language Interpretation Services to talk to the Kepro Oregon Health Plan Care Coordination services representative *This question is required.

• Yes
• Name of the Language - Write In Please enter an 'other' value for this selection.
• No

12. Are you aware of the wildfire evacuation and safety situation in your area?

• Yes
• NO

13. Do you need a call to assist with your questions?

• Yes
• No