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Prior Authorization Patient Experience Survey

Measures patients' experiences with insurance prior authorization, capturing process clarity, wait times, care impacts, and pain points to identify systemic improvement opportunities.

What's Included

AI-Powered Questions

Intelligent follow-up questions based on responses

Automated Analysis

Real-time sentiment and insight detection

Smart Distribution

Target the right audience automatically

Detailed Reports

Comprehensive insights and recommendations

Template Overview

22

Questions

AI-Powered

Smart Analysis

Ready-to-Use

Launch in Minutes

This professionally designed survey template helps you gather valuable insights with intelligent question flow and automated analysis.

Sample Survey Items

Q1
Chat Message
Welcome to the Prior Authorization Experience Survey. This survey asks about your experience with insurance prior authorization (pre-approval) for medical care or medications. It should take approximately 7–10 minutes to complete. Your participation is entirely voluntary, and you may stop at any time. There are no right or wrong answers—we are interested in your honest opinions and experiences. All responses are confidential and will be reported only in aggregate. Please click 'Next' to begin.
Q2
Multiple Choice
Have you ever needed prior authorization (pre-approval from your health insurance) for medical care or medication?
  • Yes, within the last 3 months
  • Yes, 3–12 months ago
  • Yes, more than 12 months ago
  • No, I have never needed prior authorization
  • Not sure
Q3
Multiple Choice
Which types of services or treatments required prior authorization? Select all that apply.
  • Prescription medication
  • Imaging (e.g., MRI, CT scan)
  • Specialist visit or referral
  • Surgery or procedure
  • Durable medical equipment
  • Lab tests
  • Mental health or behavioral health services
  • Physical therapy or rehabilitation
  • Other (please specify)
Q4
Multiple Choice
Who primarily handled your most recent prior authorization request?
  • Doctor or clinic staff
  • Me (the patient)
  • A family member or caregiver
  • Health insurance plan
  • Pharmacy
  • Don't know
Q5
Multiple Choice
Which communication channels were used during your most recent prior authorization process? Select all that apply.
  • Phone calls
  • Patient portal messages
  • Paper forms
  • Fax
  • In person at the clinic
  • Email
  • Insurer website or app
  • Pharmacy system or app
  • Other (please specify)
Q6
Multiple Choice
What was the outcome of your most recent prior authorization request?
  • Approved without changes
  • Approved with an alternative (e.g., different drug or test)
  • Approved after appeal
  • Denied
  • Still pending
  • Don't know / Not sure
Q7
Opinion Scale
Overall, how clear was the prior authorization process (what was required of you and what steps to follow)?
Range: 1 7
Min: Very unclearMid: NeutralMax: Very clear
Q8
Multiple Choice
Approximately how long did it take from when the prior authorization was submitted to when a decision was made?
  • Same day (no delay)
  • 1–3 days
  • 4–14 days
  • 15–30 days
  • Over 30 days
  • Still pending
  • Don't know
Q9
Multiple Choice
Approximately how many total hours did you (or a caregiver) spend on your most recent prior authorization (e.g., phone calls, paperwork, follow-ups)?
  • Less than 1 hour
  • 1–3 hours
  • 4–6 hours
  • 7–10 hours
  • More than 10 hours
  • Don't know
Q10
Opinion Scale
To what extent did the prior authorization process delay your care or treatment?
Range: 1 7
Min: Not at allMid: NeutralMax: To a great extent
Q11
Opinion Scale
To what extent did the prior authorization process cause you emotional stress or anxiety?
Range: 1 7
Min: Not at allMid: NeutralMax: To a great extent
Q12
Opinion Scale
To what extent did the prior authorization process create a financial burden for you (e.g., unexpected costs, lost wages)?
Range: 1 7
Min: Not at allMid: NeutralMax: To a great extent
Q13
Opinion Scale
To what extent did the prior authorization process disrupt your daily activities or responsibilities?
Range: 1 7
Min: Not at allMid: NeutralMax: To a great extent
Q14
Ranking
Rank the following aspects of prior authorization from most frustrating (top) to least frustrating (bottom).
Drag to order (top = most important)
  1. Not knowing the status of the request
  2. Having to repeat information or submit forms multiple times
  3. Long phone wait times
  4. Conflicting information between insurer and provider
  5. Last-minute denials or changes
  6. Difficulty reaching the right person
Q15
Multiple Choice
Which of the following, if any, were helpful during your prior authorization process? Select all that apply.
  • Clear instructions from my provider
  • A staff member handled the process for me
  • Automatic status updates (text, email, or portal)
  • Support with filing an appeal
  • Financial assistance or copay card
  • A dedicated phone line or team for prior authorization
  • None of these
Q16
Long Text
If you could change one thing about the prior authorization process, what would it be?
Max chars
Q17
AI Interview
Based on your survey responses, we'd like to understand more about your prior authorization experience. What was the single most challenging part of the process for you?
AI InterviewLength: 2Personality: [Object Object]Mode: Fast
Reference questions: 6
Q18
Multiple Choice
What type of health insurance do you currently have?
  • Employer-provided insurance
  • Individual/marketplace plan (ACA)
  • Medicare
  • Medicaid
  • Military/VA (TRICARE, VA)
  • Uninsured
  • Other
  • Prefer not to say
Q19
Dropdown
What is your age?
  • 18–24
  • 25–34
  • 35–44
  • 45–54
  • 55–64
  • 65+
  • Prefer not to say
Q20
Multiple Choice
How do you describe your gender?
  • Woman
  • Man
  • Non-binary
  • Another gender identity
  • Prefer not to say
Q21
Dropdown
What is the highest level of education you have completed?
  • Less than high school
  • High school or equivalent
  • Some college or trade school
  • Associate degree
  • Bachelor's degree
  • Postgraduate or professional degree
  • Prefer not to say
Q22
Chat Message
Thank you for completing this survey. Your responses are confidential and will be used to help identify ways to improve the prior authorization experience for patients. If you have questions about this research, please contact the study team at the email provided in your invitation.

Frequently Asked Questions

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AI interviews conduct adaptive conversations with respondents. The AI asks follow-up questions based on what the respondent says, probing for clarity and depth. You control the personality, tone, model (Haiku, Sonnet, or Opus), and question mode (fixed count, AI decides when to stop, or time-based).
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