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Billing Survey


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:

How do you pay your monthly bills? Check all that Apply.

How long after your visit did you receive your billing statement?

My billing statement was clear and easy to understand:

After reading my billing statement, I understood what my account balance was;

After reading my billing statement, I feel all necessary information was included on my bill: