OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Health Eligibility Center (HEC) Correspondence Satisfaction Letter and Customer Modality Survey

ICR 201007-2900-004 · OMB 2900-0761 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Correspondence Letter.docx Supplementary Document Uploaded 2011-01-27 Available
Justification A_VHA CBO Modality survey.docx Supporting Statement A Uploaded 2011-01-27 Available
Justification B_VHA CBO Modality survey.docx Supporting Statement B Uploaded 2011-01-27 Available
Correspondence Letter.doc Supplementary Document Uploaded 2009-06-30 Available
IC Document Collections
IC IDCollectionTypeStatusForm
189770 Health Eligibility Center (HEC) Correspondence Satisfaction Letter and Customer Modality Survey Other-Web Survey Modified
ICR Details
2900-0761 201007-2900-004
Historical Active 200906-2900-016
VA
Health Eligibility Center (HEC) Correspondence Satisfaction Letter and Customer Modality Survey
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 01/30/2011
Retrieve Notice of Action (NOA) 08/12/2010
  Inventory as of this Action Requested Previously Approved
01/31/2014 36 Months From Approved
383,301 0 0
94,678 0 0
0 0 0
The HEC goal is to respond to Veterans correspondence, addressing their concerns in a concise and understandable manner. The correspondence survey will allow Veterans an opportunity to provide anonymous feedback on how well the HEC addressed their letter. HEC will use this feedback to improve the correspondence processes. The goal of the Customer Modality Survey is to implement a survey process that allows the organization to be proactive in caring for Veterans prior to them receiving services. The survey would focus on how employees assess the needs of the patient and outline internal processes to improve services prior to the veteran receiving care.
EO: EO 12862 Name/Subject of EO: Setting Customer Service Standards
  
None
Not associated with rulemaking
  74 FR 141 07/24/2009
74 FR 187 09/29/2009
No
1
IC Title Form No. Form Name
Health Eligibility Center (HEC) Correspondence Satisfaction Letter and Customer Modality Survey VA Form 10-0151 Customer Modality Administrative Survey
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 383,301 0 0 383,301 0 0
Annual Time Burden (Hours) 94,678 0 0 94,678 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a new collection. All burden hours are considered an increase.
$65,000
Yes Part B of Supporting Statement
No
No
No
No
Uncollected
Denise McLamb 202-565-8374 [email protected]
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
08/12/2010