--- generated_by: surveylegend-page-markdown title: Healthcare Expenses Survey Template | SurveyLegend description: Review how patients receive cost information and find help with billing questions. Adapt seven healthcare expense communication questions in SurveyLegend. canonical: https://www.surveylegend.com/survey-examples-templates/healthcare-and-hospital-surveys/healthcare-expenses-template/ --- # 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. [Try this template ](https://app.surveylegend.com/register/)[Preview template](https://www.surveylegend.com/survey-examples-templates/healthcare-and-hospital-surveys/healthcare-expenses-template/#try-template) Preview on a device Show the desktop survey layout Show the tablet survey layout Show the mobile survey layout ![](https://www.surveylegend.com/survey-template-media/demo-backgrounds/healthcare-expenses-template-background.avif) **SurveyLegend** 1 / 7 Healthcare Expenses Survey What was the main purpose of that interaction? Ask about expected costs before care Understand a bill after care Ask what a cost estimate included +4 more answer choices Next → Healthcare Expenses Survey [Preview](https://www.surveylegend.com/survey-examples-templates/healthcare-and-hospital-surveys/healthcare-expenses-template/#try-template) Share [Facebook ](https://www.facebook.com/sharer/sharer.php?u=https%3A%2F%2Fwww.surveylegend.com%2Fsurvey-examples-templates%2Fhealthcare-and-hospital-surveys%2Fhealthcare-expenses-template%2F)[LinkedIn ](https://www.linkedin.com/sharing/share-offsite/?url=https%3A%2F%2Fwww.surveylegend.com%2Fsurvey-examples-templates%2Fhealthcare-and-hospital-surveys%2Fhealthcare-expenses-template%2F)[X ](https://x.com/intent/tweet?url=https%3A%2F%2Fwww.surveylegend.com%2Fsurvey-examples-templates%2Fhealthcare-and-hospital-surveys%2Fhealthcare-expenses-template%2F\&text=Healthcare%20Expenses%20Survey%20Template)[Reddit](https://www.reddit.com/submit?url=https%3A%2F%2Fwww.surveylegend.com%2Fsurvey-examples-templates%2Fhealthcare-and-hospital-surveys%2Fhealthcare-expenses-template%2F\&title=Healthcare%20Expenses%20Survey%20Template) 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 ](https://www.surveylegend.com/survey-examples-templates/healthcare-and-hospital-surveys/). **Create your healthcare expenses survey in SurveyLegend** 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. ## 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. Try the survey ## A little feedback. A clearer picture. Explore this 7-question example at your own pace. Every question is optional. Preview on a device Show the survey at full desktop width Resize the survey to a tablet-width preview Resize the survey to a mobile preview with scrolling inside the frame Choose a look Use Classic: a white survey card over the background photo Use Light: dark text over a light tint covering the background photo Use Dark: light text over a dark tint covering the background photo SurveyLegend demo Question 1 of 7 ### Healthcare Expenses Survey 01 What was the main purpose of that interaction? Choose one answer, or skip this question. Ask about expected costs before care Understand a bill after care Ask what a cost estimate included Find the right billing contact Ask about available support information Another purpose No interaction in the past three months 02 At the time you needed it, how easy was it to find cost information? Choose one answer, or skip this question. Very difficult Somewhat difficult Neither easy nor difficult Somewhat easy Very easy I did not look for information Not applicable 03 How clear was the explanation of what the information did and did not cover? Choose one answer, or skip this question. Very unclear Somewhat unclear Neither clear nor unclear Somewhat clear Very clear No explanation was given Not applicable 04 How easy was it to find someone who could address your cost question? Choose one answer, or skip this question. Very difficult Somewhat difficult Neither easy nor difficult Somewhat easy Very easy I did not try Not applicable 05 After the interaction, how clear was your next step? Choose one answer, or skip this question. Very unclear Somewhat unclear Neither clear nor unclear Somewhat clear Very clear No next step was needed Not applicable 06 What would have been most useful during that interaction? Choose one answer, or skip this question. A plain-language explanation A written summary A clear contact for follow-up Information earlier in the process Language or format support Something else Nothing more was needed Not sure 07 What is one change that would make cost information easier to understand? Share your answer, or skip this question. #### One last look Review your answers before submitting this demo. 0 answered #### Thank you for trying the survey! You’ve tried the template from the respondent’s side. Make it your own with SurveyLegend. [Create your own survey](https://www.surveylegend.com/register/) Checking submission availability… This is a demo. We count starts and submissions only. Your answers stay in your browser and are never sent or saved. **—**Starts **—**Submissions Activity is temporarily unavailable. ## 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 ](https://www.surveylegend.com/customer-insight/open-ended-survey-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 ](https://pure.aah.org/en/publications/communication-with-physicians-about-health-care-costs-survey-of-a/). 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. ![First page of the printable Healthcare Expenses Survey Template with questions and answer spaces](https://www.surveylegend.com/survey-template-media/pdf-previews/healthcare-expenses-template-pdf-preview.avif) [![](https://www.surveylegend.com/user-guide-media/icons/download-pdf.svg) Download the questionnaire](https://www.surveylegend.com/downloads/survey-templates/healthcare-expenses-survey-template.pdf) Export Healthcare Expenses Survey as PDF ## 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 AI Prompt: Healthcare Expenses Survey [Create this survey in SurveyLegend](https://www.surveylegend.com/register/) Copy the prompt into an AI assistant to draft the questions, then build your survey in SurveyLegend. [Sign in](https://app.surveylegend.com/) to SurveyLegend to build your healthcare expenses survey Healthcare and Hospital Survey Templates 1. [![Preview of the Healthcare CAHPS® Visit Survey 2.0 Survey Template](https://www.surveylegend.com/survey-template-media/previews/template-healthcare-cahps-visit-survey-template-survey-preview.avif) Healthcare CAHPS® Visit v2.0 Survey Template Healthcare When a patient chooses to enter your hospital, the quality of the treatment they are going to receive is the most important thing. To reach a high quality in the treatment, several aspects have to be taken into consideration. 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Build the questionnaire in SurveyLegend, explain how responses will be used and keep participation separate from eligibility for other services.](https://www.surveylegend.com/survey-examples-templates/healthcare-and-hospital-surveys/smoking-template/) Free survey maker ## Start creating surveys today *for free* Create and bring your ideas to life with the survey tool used by people all over the world. [Get started for free ](https://app.surveylegend.com/register/)[Book a demo](https://www.surveylegend.com/schedule-a-demo-of-surveylegend/) Academic research survey ### Ready to collect better research data? Create academic surveys and questionnaires from ready-made templates. 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