ABA Satisfaction Survey for Providers

1. I am satisfied with the quality of services offered by Kepro ABA Services.

• Yes
• No
• If No, please explain- Please enter an 'other' value for this selection.

2. I found the Kepro Oregon Health Plan Care Coordination Program website helpful and user friendly

• Yes
• No
• Feedback - Please enter an 'other' value for this selection.

3. Do you or your staff know how to contact staff at Kepro when needed if you have questions or concerns regarding ABA services?

• Yes
• No

4. On a scale of 1-5, 5 being very pleased:

How easy is it for you or your staff to reach someone at the Kepro Oregon Health Plan Care Coordination Program?

• 1
• 2
• 3
• 4
• 5

5. On a scale of 1-5, 5 being very pleased:

How would you rate the overall quality of the Utilization Management services you received from the
nurse UM Nurse at the Kepro Oregon Health Plan Care Coordination Program?

• 1
• 2
• 3
• 4
• 5
• Other - Write In Please enter an 'other' value for this selection.

6. On a scale of 1-5, 5 being very pleased:

The Utilization Management Nurse working with us on ABA services and our patient was knowledgeable about Oregon Medicaid services, coverage issues, and navigation of the Oregon Health Plan.
 

• 1
• 2
• 3
• 4
• 5

7. How likely are you to recommend the Kepro Oregon Health Plan Care Coordination Program Case ABA services to other providers or patients?

• Very Likely
• Likely
• Less Likely
• Unsure
• N/A

8. Are you having any challenges to accept ABA requests from referrals or other sources? 

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

9. Are you interested in more information about how the ABA referral process works? We can set up a call with you.  

• Yes
• No
• Your Call Back Number Please enter an 'other' value for this selection.