Healthcare Expenses Survey Template
A healthcare expenses survey can reveal where cost information is unclear and where patients struggle to find answers. Use these seven optional questions to review one recent cost conversation or billing interaction and choose a communication improvement.
A healthcare expenses survey can reveal where cost information is unclear and where patients struggle to find answers. Use these seven optional questions to review one recent cost conversation or billing interaction and choose a communication improvement.
A patient may receive an estimate but still not know whom to ask about it. Separate receiving information from understanding it and reaching the right contact. Create this questionnaire in SurveyLegend to examine that part of the service experience.
When to Use This Template
Use this version with adults who recently sought information about healthcare costs. It focuses on communication and practical support, not whether treatment was appropriate or a charge was correct. For broader visit experience, choose a different questionnaire from SurveyLegend's healthcare surveys .
7 Healthcare Expenses Survey Questions
Think about your most recent interaction about the cost of care in the past three months. Every question is optional. Do not include diagnoses, account numbers, bill amounts, payment details or personal identifiers. Use the organization's direct billing or care contact for help with your own situation.
A little feedback. A clearer picture.
Explore this 7-question example at your own pace. Every question is optional.
Healthcare Expenses Survey
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How to Adapt the Questionnaire
Name the provider or service and the three-month reference period. Use the terms patients actually see in estimates and bills, with a short explanation where needed. Keep financial and clinical records outside the survey. Use open-ended questions for communication suggestions, while reminding respondents not to enter account-specific details.
When to Ask
Invite feedback after a cost-information interaction, allowing enough time to reflect without relying on distant recall. Include people who tried unsuccessfully to find help. Do not imply that completing a feedback survey opens a billing case or changes a payment arrangement.
How to Use the Responses
Compare pre-care information requests with post-bill questions because they involve different tasks. Review missing information, unclear scope and difficulty finding a contact separately. Choose an improvement such as clearer terminology or a named follow-up route, then check it with intended users. Ratings do not determine whether a charge is correct, whether someone can afford care, or what treatment they should choose.
What the Research Adds
Henrikson and colleagues' 2017 survey of an insured Washington State population examined “patient preferences for communication about cost.” Read the study . The 2,200 responses support examining communication preferences separately from financial circumstances. That historical, insured sample does not establish current preferences in every setting, and this original survey is not a financial-distress measure.
Frequently asked questions
Should respondents enter their medical bills?
No. This version asks about communication. Direct account-specific questions and documents to an approved billing-support channel.
Can the answers determine affordability or eligibility?
No. The questionnaire does not assess finances, benefits, or eligibility.
Will completing it resolve a disputed charge?
No. It is service feedback, not a billing case or dispute submission. Provide the real support contact separately.
Printable Healthcare Expenses Survey
Offer the printed form through the service's established feedback process. Keep it separate from bills and clinical paperwork, and provide the direct support contact for personal questions. Paper responses need separate review or manual entry; they are not automatically added to online results.
Download the questionnaire AI Prompt: Healthcare Expenses Survey
Copy this healthcare expenses survey prompt into an AI assistant to prepare the questionnaire. Review the result, then build and customize it in SurveyLegend. It does not automatically create or transfer a survey.
Healthcare Expenses Survey Prompt
Copy the prompt into an AI assistant to draft the questions, then build your survey in SurveyLegend.
Sign in to SurveyLegend to build your healthcare expenses survey
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