UMMC Billing Survey

Your opinions help us serve you better. In an ongoing effort to improve the patient experience and gain a better understanding of how we are doing as a Revenue Cycle Team, we would like to know what you think about your billing statement. The survey below should be completed by the patient or patient’s guardian. Thank you in advance for your feedback and for choosing UMMC for your healthcare needs.

Check the box that most accurately reflects the patient.

* = Required Fields

Indicate the patient's age: Under 30 30-40 41-50 51-60 Older than 60
How do you pay your monthly bills? Check all that Apply. Mail Phone Online Other
How long after your visit did you receive your billing statement? Less than 30 days More than 30 days More than 60 days More than 90 days
My billing statement was clear and easy to understand: Strongly Disagree Disagree Agree Strongly Agree
After reading my billing statement, I understood what my account balance was; Strongly Disagree Disagree Agree Strongly Agree
After reading my billing statement, I feel all necessary information was included on my bill: Strongly Disagree Disagree Agree Strongly Agree
How could we better meet your billing needs?
If you would like to be contacted regarding your concern, provide your name and contact information.