Attachment R - Dental Network Provider Satisfaction Survey_02_24_26 v2.pdf

Question # Measure

Revised and Final Questions

02-12-2026 Response Scale (If Applicable)

As the person taking this survey what is your role in your Dental practice?

Clinical

Administrative

[Branch question that launches survey type, clinical vs admin]

1 About your practice

Are you (the person responding to this survey) a clinician in one of the following specialties who provides care to VA patients through the VA’s Community

Care program?

Non Scale [ A list of ADA specialties will populate via a drop-down list in the survey itself. ]

Specialty Taxonomy

General Dentist-1223G0001X

Dental Anesthesiology-1223D0004X

Dental Public Health-1223D0001X

Endodontics- 1223E0200X

Oral and Maxillofacial Pathology-1223P0106X

Oral and Maxillofacial Radiology-1223X0008X

Oral and Maxillofacial Surgery-1223S0112X

Oral Medicine-125Q00000X

Orofacial Pain-1223X2210X

Orthodontics and Dentofacial Orthopedics-1223X0400X

Periodontics-1223P0300X

Prosthodontics -1223P0700X

2 About your practice What is your age? Non Scale

4 Communication

When you tried to communicate directly with the referring VA Community Care office, how often could you reach someone in the office in a timely manner?

Never

Rarely (About 25% of the time)

Sometimes (about 50% of the time)

Often (About 75% of the time)

Always

5 Communication

How often was the referring VA

Community Care office helpful in providing you further information or other assistance when you requested it?

Never

Rarely (About 25% of the time)

Sometimes (about 50% of the time)

Often (About 75% of the time)

Always

6 Communication

How often were you able to get your needs met when you tried to communicate with someone in VA about an issue related to clinical care?

Never

Rarely (About 25% of the time)

Sometimes (about 50% of the time)

Often (About 75% of the time)

Always

7 Data Transfer

The request for services process impacts my willingness to continue seeing Veterans.

Strongly Disagree

Disagree

Neither Agree or Disagree

Agree

Strongly

Agree

N/A, I have not experienced delays in the administrative processing

8 Data Transfer

How often did delays in receiving clinical information from VA impact your ability to provide timely care to patients?

Never

Rarely (About 25% of the time)

Sometimes (about 50% of the time)

Often (About 75% of the time)

Always

10 Data Transfer

How often did the referral request include sufficient medical history or other information to meet your immediate needs?

Never

Rarely (About 25% of the time)

Sometimes (about 50% of the time)

Often (About 75% of the time)

Always

Roles &

Responsibilities

When it was needed, how often did you feel that you and the referring provider worked well together in caring for patients?

Never

Rarely (About 25% of the time)

Sometimes (about 50% of the time)

Often (About 75% of the time)

Always

Roles &

Responsibilities

How often are the referrals you receive from the VA clinically appropriate for your specialty?

Never

Rarely (About 25% of the time)

Sometimes (about 50% of the time)

Often (About 75% of the time)

Always

Provider Satisfaction Survey Refresh (Pre-Decisional)

Roles &

Responsibilities

How often did you need to rely on patients to transfer important information between you and the VA referring provider, because you were not confident in being able to achieve this with other mechanisms.

Never

Rarely (About 25% of the time)

Sometimes (about 50% of the time)

Often (About 75% of the time)

Always

Roles &

Responsibilities

When you suggested that the VA referring provider place a referral to another specialty, how often were you confident that this recommendation would be carried through?

Never

Rarely (About 25% of the time)

Sometimes (about 50% of the time)

Often (About 75% of the time)

Always

Roles &

Responsibilities

How often do you clearly understand whether medications should be prescribed through VA or filled externally?

Never

Rarely (About 25% of the time)

Sometimes (about 50% of the time)

Often (About 75% of the time)

Always

15 Experience

How satisfied are you overall with your experience participating in the VA community care program?

Recommended Scale:

Very dissatisfied

Dissatisfied

Neutral

Satisfied

Very Satisfied

16 Experience How likely are you to continue accepting

VA referrals in the next year?

Recommended Scale:

Very Unlikely

Somewhat Unlikely

Neither Unlikely or Likely

Somewhat Likely

Very Likely

18 Experience

How likely are you to refer your colleagues to participate in the VA community care program?

Recommended Scale:

Very Unlikely

Somewhat Unlikely

Neither Unlikely or Likely

Somewhat Likely

Very Likely

Comment/Information about EPS to include a

Potential Link to EPS site (public facing website).

Placemark language

HELP US CONNECT VETERANS TO CARE FASTER

External Provider Scheduling (EPS) is a cloud-based system that lets VA schedulers book appointments directly into your system, reducing the need for phone calls and faxes. While optional, using EPS can help you focus more on patient care. You can still use your current referral process if you prefer. For more information or to get started, email EPSProvider@va.gov and a VA representative will assist you.

Let's work together to improve care access for our Nation's Veterans.

Question

Measure

Revised and Final Questions

02-12-2026 Response Scale (If Applicable)

As the person taking this survey what is your role in your Dental practice?

Clinical

Administrative

[Branch question that launches survey typ, clinical vs admin]

1 About your practice Please select the primary specialty for your practice.

Non Scale [ A list of ADA specialties will populate via a drop-down list in the survey itself. ]

Specialty Taxonomy

General Dentist-1223G0001X

Dental Anesthesiology-1223D0004X

Dental Public Health-1223D0001X

Endodontics- 1223E0200X

Oral and Maxillofacial Pathology-1223P0106X

Oral and Maxillofacial Radiology-1223X0008X

Oral and Maxillofacial Surgery-1223S0112X

Oral Medicine-125Q00000X

Orofacial Pain-1223X2210X

Orthodontics and Dentofacial Orthopedics-1223X0400X

Periodontics-1223P0300X

Prosthodontics -1223P0700X

2 About your practice On average, how many VA referrals does your practice accept?

1-2 per week

3-5 per week

6-10 per week

More than 10 per week

3 Communication

When you tried to communicate directly with the VA Community Care staff, how often could you reach that office in a timely manner?

Never

Rarely (About 25% of the time)

Sometimes (about 50% of the time)

Often (About 75% of the time)

Always

4 Communication

How often was the referring VA Community

Care staff helpful in providing you further information or other assistance when you requested it?

Never

Rarely (About 25% of the time)

Sometimes (about 50% of the time)

Often (About 75% of the time)

Always

5 Communication

How often do you receive the information you need from VA (e.g., authorizations, documentation, referral details) in time to manage patient care efficiently?

Never

Rarely (About 25% of the time)

Sometimes (about 50% of the time)

Often (About 75% of the time)

Always

Completeness of Referral/

Request Packets

How often does the referral or authorization packet contain all required administrative information (e.g., coverage details, authorization numbers, contact info) to process the request without follow-up?

Never

Rarely (About 25% of the time)

Sometimes (about 50% of the time)

Often (About 75% of the time)

Always

Accuracy of Information Provided by VA

How often does the information received from VA (authorization details, dates, coverage) match what is needed to complete the request correctly?

Never

Rarely (About 25% of the time)

Sometimes (about 50% of the time)

Often (About 75% of the time)

Always

8 Data Transfer

Which methods listed below did you use to coordinate care with VA for Veterans in the last 3 months?

Phone

HSRM

Secure Email

Coordination

Mechanisms What method do you prefer?)

Phone

HSRM

Secure Email

Coordination

Mechanisms

How satisfied are you with your preferred method(s)?

Very Dissatisfied Dissatisfied Neutral Satisfied Very Satisfied

System

Connectivity

How often do technical issues ( HSRM issues, secure email bounce-backs) interfere with transferring administrative information to/from VA?

Never

Rarely (About 25% of the time)

Sometimes (about 50% of the time)

Often (About 75% of the time)

Always

12 Overall Burden

Overall, how easy is the administrative data transfer process between your organization and VA?

1 – Very difficult.

2 – Difficult.

3 – Neutral.

4 – Easy.

5 – Very easy.

13 Experience

How satisfied are you overall with your experience participating in the VA community care program?

Recommended Scale:

Very dissatisfied

Dissatisfied

Neutral

Satisfied

Very Satisfied

14 Trust I trust VA Community Care to coordinate referrals accurately and efficiently.

Strongly Disagree

Disagree

Neither Agree nor Disagree

Agree

Strongly Agree

Provider Satisfaction Survey Refresh (Pre-Decisional)

Comment/Information about EPS to include a

Potential Link to EPS site (public facing website).

Placemark language

HELP US CONNECT VETERANS TO CARE FASTER

External Provider Scheduling (EPS) is a cloud-based system that lets VA schedulers book appointments directly into your system, reducing the need for phone calls and faxes. While optional, using EPS can help you focus more on patient care. You can still use your current referral process if you prefer. For more information or to get started, email EPSProvider@va.gov and a VA representative will assist you.

Let's work together to improve care access for our Nation's Veterans.