survey3.medallia.com Open in urlscan Pro
147.75.243.92  Public Scan

Form analysis
1 forms found in the DOM

Name: surveyform — POST /?e86ts5t7xswnrs4btvb9

<form name="surveyform" action="/?e86ts5t7xswnrs4btvb9" method="post"><!-- react-empty: 4 -->
  <div><!-- react-empty: 6 --><input type="hidden" name="is_embedded" id="is_embedded" value="false">
    <header>
      <div class="progressbar_progressBar" role="progressbar" aria-label="Survey completion indicator" aria-valuenow="20" aria-valuemin="0" aria-valuemax="100">
        <div class="progressbar_progressBarIndicator" style="width: 20%;"></div>
      </div><a class="layout_skipNav" href="#content">Skip to Content</a>
      <div class="layout_layoutContainer">
        <div class="layout_mainHeader layout_clearfix">
          <div class="layout_mainHeaderLeft">
            <h1 class="layout_invisibleTitle" tabindex="0" aria-label="Survey"></h1><img id="pageLogo" class="layout_logo" src="https://brandcenter.anthem.com/downloads/5af1f3eacd3f1/lg_ABS_Process_201801.jpg.jpg" alt="Page_logo">
          </div>
          <div class="layout_mainHeaderRight"></div>
        </div>
      </div>
    </header>
    <div class="layout_layoutContainer"><input type="hidden" name="stay_main-pager" value="1"><input type="hidden" name="nodeId" value="survey3-fe5"><input type="hidden" name="ballotVer" value="130"><input type="hidden" name="currentPage"
        value="1"><input type="hidden" name="defPgrAction" value="next"><!-- react-empty: 24 --></div>
    <div role="main" id="content" class="layout_layoutContainer layout_layoutContainer_fadeInUp">
      <div class="htmlBlock"></div>
      <div class="longform_longformContainer questionBlock singleSelectQuestion">
        <fieldset>
          <legend class="question_questionTitle" id="1"><span class="validation_validationBlock validationMessage validation_requiredBlock"><i aria-hidden="true" class="medallicons_medallicons validation_validationIcon"></i><span
                class="validation_caption">Required</span></span><span class="questionCaption"><b>What was the <u>main</u> reason for your call? (Select one response).</b></span></legend>
          <div class="longform_groupContainer">
            <div class="layout_answers longform_group"><!-- react-text: 36 --><!-- /react-text -->
              <ul class="group_group">
                <li class="group_optionContainer">
                  <div class="layout_answer" data-test-name="option-benefits">
                    <div id="JAWS_CLICK_TARGET" class="table_table option_optionContainer table_table_hasFixedLayout">
                      <div class="row_row">
                        <div class="cell_cell option_indicatorContainer"><input type="radio" id="onf_q_postcall_provider_main_reason_alt_1" aria-describedby="1" aria-label="Benefits" class="option_input" data-mds-value="1"
                            name="onf_q_postcall_provider_main_reason_alt" value="1"><span class="indicatorRadio_indicatorRadioContainer option_indicator indicatorRadio"></span></div>
                        <div class="cell_cell option_captionContainer"><span aria-hidden="true" class="option_caption">Benefits</span></div>
                      </div>
                    </div>
                  </div>
                </li>
                <li class="group_optionContainer">
                  <div class="layout_answer" data-test-name="option-claims">
                    <div id="JAWS_CLICK_TARGET" class="table_table option_optionContainer table_table_hasFixedLayout">
                      <div class="row_row">
                        <div class="cell_cell option_indicatorContainer"><input type="radio" id="onf_q_postcall_provider_main_reason_alt_2" aria-describedby="1" aria-label="Claims" class="option_input" data-mds-value="2"
                            name="onf_q_postcall_provider_main_reason_alt" value="2"><span class="indicatorRadio_indicatorRadioContainer option_indicator indicatorRadio"></span></div>
                        <div class="cell_cell option_captionContainer"><span aria-hidden="true" class="option_caption">Claims</span></div>
                      </div>
                    </div>
                  </div>
                </li>
                <li class="group_optionContainer">
                  <div class="layout_answer" data-test-name="option-membership">
                    <div id="JAWS_CLICK_TARGET" class="table_table option_optionContainer table_table_hasFixedLayout">
                      <div class="row_row">
                        <div class="cell_cell option_indicatorContainer"><input type="radio" id="onf_q_postcall_provider_main_reason_alt_3" aria-describedby="1" aria-label="Membership" class="option_input" data-mds-value="3"
                            name="onf_q_postcall_provider_main_reason_alt" value="3"><span class="indicatorRadio_indicatorRadioContainer option_indicator indicatorRadio"></span></div>
                        <div class="cell_cell option_captionContainer"><span aria-hidden="true" class="option_caption">Membership</span></div>
                      </div>
                    </div>
                  </div>
                </li>
                <li class="group_optionContainer">
                  <div class="layout_answer" data-test-name="option-digital-transactions">
                    <div id="JAWS_CLICK_TARGET" class="table_table option_optionContainer table_table_hasFixedLayout">
                      <div class="row_row">
                        <div class="cell_cell option_indicatorContainer"><input type="radio" id="onf_q_postcall_provider_main_reason_alt_5" aria-describedby="1" aria-label="Digital Transactions" class="option_input" data-mds-value="5"
                            name="onf_q_postcall_provider_main_reason_alt" value="5"><span class="indicatorRadio_indicatorRadioContainer option_indicator indicatorRadio"></span></div>
                        <div class="cell_cell option_captionContainer"><span aria-hidden="true" class="option_caption">Digital Transactions</span></div>
                      </div>
                    </div>
                  </div>
                </li>
                <li class="group_optionContainer">
                  <div class="layout_answer" data-test-name="option-network">
                    <div id="JAWS_CLICK_TARGET" class="table_table option_optionContainer table_table_hasFixedLayout">
                      <div class="row_row">
                        <div class="cell_cell option_indicatorContainer"><input type="radio" id="onf_q_postcall_provider_main_reason_alt_6" aria-describedby="1" aria-label="Network" class="option_input" data-mds-value="6"
                            name="onf_q_postcall_provider_main_reason_alt" value="6"><span class="indicatorRadio_indicatorRadioContainer option_indicator indicatorRadio"></span></div>
                        <div class="cell_cell option_captionContainer"><span aria-hidden="true" class="option_caption">Network</span></div>
                      </div>
                    </div>
                  </div>
                </li>
                <li class="group_optionContainer">
                  <div class="layout_answer" data-test-name="option-other">
                    <div id="JAWS_CLICK_TARGET" class="table_table option_optionContainer table_table_hasFixedLayout">
                      <div class="row_row">
                        <div class="cell_cell option_indicatorContainer"><input type="radio" id="onf_q_postcall_provider_main_reason_alt_7" aria-describedby="1" aria-label="Other" class="option_input" data-mds-value="7"
                            name="onf_q_postcall_provider_main_reason_alt" value="7"><span class="indicatorRadio_indicatorRadioContainer option_indicator indicatorRadio"></span></div>
                        <div class="cell_cell option_captionContainer"><span aria-hidden="true" class="option_caption">Other</span></div>
                      </div>
                      <div class="row_row">
                        <div class="cell_cell"></div>
                        <div class="cell_cell option_textfieldContainer">
                          <div aria-hidden="true" class="option_otherOptionTextfield option_otherOptionTextfield_isHidden"><span
                              class="validation_validationBlock otherOptionTextfield_textfieldValidationError otherOptionTextfield_textfieldValidationError_isHidden validationMessage validation_errorBlock"
                              aria-hidden="true"><i aria-hidden="true" class="medallicons_medallicons validation_validationIcon"></i><span class="validation_caption">Error: This is required.</span></span><input type="text"
                              id="1_spl_q_feedback_pcps_bwwtu_other_please_provide_text_input_nu__qwksXJ" aria-required="true" aria-label="Other" class="otherOptionTextfield_input input_textfield" data-mds-value=""
                              name="spl_q_feedback_pcps_bwwtu_other_please_provide_text_input" tabindex="-1" value=""></div>
                        </div>
                      </div>
                    </div>
                  </div>
                </li>
              </ul>
            </div>
          </div>
        </fieldset>
      </div>
      <div class="longform_longformContainer questionBlock singleSelectQuestion lnf_hide">
        <fieldset>
          <legend class="question_questionTitle" id="2"><span class="questionCaption"><b>Please choose the option that most closely relates to your reason for
calling.</b></span></legend>
          <div class="longform_groupContainer">
            <div class="layout_answers longform_group"><!-- react-text: 106 --><!-- /react-text -->
              <ul class="group_group">
                <li class="group_optionContainer">
                  <div class="layout_answer" data-test-name="option-pre-service-benefit-quote">
                    <div id="JAWS_CLICK_TARGET" class="table_table option_optionContainer table_table_hasFixedLayout">
                      <div class="row_row">
                        <div class="cell_cell option_indicatorContainer"><input type="radio" id="onf_q_postcall_provider_reason_benefits_1" aria-describedby="2" aria-label="Pre-Service Benefit Quote" class="option_input" data-mds-value="1" value="1"
                            hidden-name="onf_q_postcall_provider_reason_benefits"><span class="indicatorRadio_indicatorRadioContainer option_indicator indicatorRadio"></span></div>
                        <div class="cell_cell option_captionContainer"><span aria-hidden="true" class="option_caption">Pre-Service Benefit Quote</span></div>
                      </div>
                    </div>
                  </div>
                </li>
                <li class="group_optionContainer">
                  <div class="layout_answer" data-test-name="option-confirming-if-cpt-is-covered">
                    <div id="JAWS_CLICK_TARGET" class="table_table option_optionContainer table_table_hasFixedLayout">
                      <div class="row_row">
                        <div class="cell_cell option_indicatorContainer"><input type="radio" id="onf_q_postcall_provider_reason_benefits_2" aria-describedby="2" aria-label="Confirming if CPT is covered" class="option_input" data-mds-value="2"
                            value="2" hidden-name="onf_q_postcall_provider_reason_benefits"><span class="indicatorRadio_indicatorRadioContainer option_indicator indicatorRadio"></span></div>
                        <div class="cell_cell option_captionContainer"><span aria-hidden="true" class="option_caption">Confirming if CPT is covered</span></div>
                      </div>
                    </div>
                  </div>
                </li>
                <li class="group_optionContainer">
                  <div class="layout_answer" data-test-name="option-requesting-pricing-estimate">
                    <div id="JAWS_CLICK_TARGET" class="table_table option_optionContainer table_table_hasFixedLayout">
                      <div class="row_row">
                        <div class="cell_cell option_indicatorContainer"><input type="radio" id="onf_q_postcall_provider_reason_benefits_3" aria-describedby="2" aria-label="Requesting pricing estimate" class="option_input" data-mds-value="3"
                            value="3" hidden-name="onf_q_postcall_provider_reason_benefits"><span class="indicatorRadio_indicatorRadioContainer option_indicator indicatorRadio"></span></div>
                        <div class="cell_cell option_captionContainer"><span aria-hidden="true" class="option_caption">Requesting pricing estimate</span></div>
                      </div>
                    </div>
                  </div>
                </li>
                <li class="group_optionContainer">
                  <div class="layout_answer" data-test-name="option-other-coverage">
                    <div id="JAWS_CLICK_TARGET" class="table_table option_optionContainer table_table_hasFixedLayout">
                      <div class="row_row">
                        <div class="cell_cell option_indicatorContainer"><input type="radio" id="onf_q_postcall_provider_reason_benefits_4" aria-describedby="2" aria-label="Other Coverage" class="option_input" data-mds-value="4" value="4"
                            hidden-name="onf_q_postcall_provider_reason_benefits"><span class="indicatorRadio_indicatorRadioContainer option_indicator indicatorRadio"></span></div>
                        <div class="cell_cell option_captionContainer"><span aria-hidden="true" class="option_caption">Other Coverage</span></div>
                      </div>
                    </div>
                  </div>
                </li>
                <li class="group_optionContainer">
                  <div class="layout_answer" data-test-name="option-discuss-member-accumulators">
                    <div id="JAWS_CLICK_TARGET" class="table_table option_optionContainer table_table_hasFixedLayout">
                      <div class="row_row">
                        <div class="cell_cell option_indicatorContainer"><input type="radio" id="onf_q_postcall_provider_reason_benefits_5" aria-describedby="2" aria-label="Discuss Member Accumulators" class="option_input" data-mds-value="5"
                            value="5" hidden-name="onf_q_postcall_provider_reason_benefits"><span class="indicatorRadio_indicatorRadioContainer option_indicator indicatorRadio"></span></div>
                        <div class="cell_cell option_captionContainer"><span aria-hidden="true" class="option_caption">Discuss Member Accumulators</span></div>
                      </div>
                    </div>
                  </div>
                </li>
                <li class="group_optionContainer">
                  <div class="layout_answer" data-test-name="option-behavioral-health">
                    <div id="JAWS_CLICK_TARGET" class="table_table option_optionContainer table_table_hasFixedLayout">
                      <div class="row_row">
                        <div class="cell_cell option_indicatorContainer"><input type="radio" id="onf_q_postcall_provider_reason_benefits_6" aria-describedby="2" aria-label="Behavioral Health" class="option_input" data-mds-value="6" value="6"
                            hidden-name="onf_q_postcall_provider_reason_benefits"><span class="indicatorRadio_indicatorRadioContainer option_indicator indicatorRadio"></span></div>
                        <div class="cell_cell option_captionContainer"><span aria-hidden="true" class="option_caption">Behavioral Health</span></div>
                      </div>
                    </div>
                  </div>
                </li>
              </ul>
            </div>
          </div>
        </fieldset>
      </div>
      <div class="longform_longformContainer questionBlock singleSelectQuestion lnf_hide">
        <fieldset>
          <legend class="question_questionTitle" id="3"><span class="questionCaption"><b>Please choose the option that most closely relates to your reason for
calling.</b></span></legend>
          <div class="longform_groupContainer">
            <div class="layout_answers longform_group"><!-- react-text: 168 --><!-- /react-text -->
              <ul class="group_group">
                <li class="group_optionContainer">
                  <div class="layout_answer" data-test-name="option-explain-claim-processing">
                    <div id="JAWS_CLICK_TARGET" class="table_table option_optionContainer table_table_hasFixedLayout">
                      <div class="row_row">
                        <div class="cell_cell option_indicatorContainer"><input type="radio" id="onf_q_postcall_provider_reason_claims_1" aria-describedby="3" aria-label="Explain claim processing" class="option_input" data-mds-value="1" value="1"
                            hidden-name="onf_q_postcall_provider_reason_claims"><span class="indicatorRadio_indicatorRadioContainer option_indicator indicatorRadio"></span></div>
                        <div class="cell_cell option_captionContainer"><span aria-hidden="true" class="option_caption">Explain claim processing</span></div>
                      </div>
                    </div>
                  </div>
                </li>
                <li class="group_optionContainer">
                  <div class="layout_answer" data-test-name="option-prior-authorization-question">
                    <div id="JAWS_CLICK_TARGET" class="table_table option_optionContainer table_table_hasFixedLayout">
                      <div class="row_row">
                        <div class="cell_cell option_indicatorContainer"><input type="radio" id="onf_q_postcall_provider_reason_claims_2" aria-describedby="3" aria-label="Prior Authorization Question" class="option_input" data-mds-value="2" value="2"
                            hidden-name="onf_q_postcall_provider_reason_claims"><span class="indicatorRadio_indicatorRadioContainer option_indicator indicatorRadio"></span></div>
                        <div class="cell_cell option_captionContainer"><span aria-hidden="true" class="option_caption">Prior Authorization Question</span></div>
                      </div>
                    </div>
                  </div>
                </li>
                <li class="group_optionContainer">
                  <div class="layout_answer" data-test-name="option-locate-claim-or-payment">
                    <div id="JAWS_CLICK_TARGET" class="table_table option_optionContainer table_table_hasFixedLayout">
                      <div class="row_row">
                        <div class="cell_cell option_indicatorContainer"><input type="radio" id="onf_q_postcall_provider_reason_claims_3" aria-describedby="3" aria-label="Locate claim or payment" class="option_input" data-mds-value="3" value="3"
                            hidden-name="onf_q_postcall_provider_reason_claims"><span class="indicatorRadio_indicatorRadioContainer option_indicator indicatorRadio"></span></div>
                        <div class="cell_cell option_captionContainer"><span aria-hidden="true" class="option_caption">Locate claim or payment</span></div>
                      </div>
                    </div>
                  </div>
                </li>
                <li class="group_optionContainer">
                  <div class="layout_answer" data-test-name="option-request-an-adjustment">
                    <div id="JAWS_CLICK_TARGET" class="table_table option_optionContainer table_table_hasFixedLayout">
                      <div class="row_row">
                        <div class="cell_cell option_indicatorContainer"><input type="radio" id="onf_q_postcall_provider_reason_claims_4" aria-describedby="3" aria-label="Request an adjustment" class="option_input" data-mds-value="4" value="4"
                            hidden-name="onf_q_postcall_provider_reason_claims"><span class="indicatorRadio_indicatorRadioContainer option_indicator indicatorRadio"></span></div>
                        <div class="cell_cell option_captionContainer"><span aria-hidden="true" class="option_caption">Request an adjustment</span></div>
                      </div>
                    </div>
                  </div>
                </li>
                <li class="group_optionContainer">
                  <div class="layout_answer" data-test-name="option-status-request">
                    <div id="JAWS_CLICK_TARGET" class="table_table option_optionContainer table_table_hasFixedLayout">
                      <div class="row_row">
                        <div class="cell_cell option_indicatorContainer"><input type="radio" id="onf_q_postcall_provider_reason_claims_5" aria-describedby="3" aria-label="Status request" class="option_input" data-mds-value="5" value="5"
                            hidden-name="onf_q_postcall_provider_reason_claims"><span class="indicatorRadio_indicatorRadioContainer option_indicator indicatorRadio"></span></div>
                        <div class="cell_cell option_captionContainer"><span aria-hidden="true" class="option_caption">Status request</span></div>
                      </div>
                    </div>
                  </div>
                </li>
                <li class="group_optionContainer">
                  <div class="layout_answer" data-test-name="option-grievance/appeal-information">
                    <div id="JAWS_CLICK_TARGET" class="table_table option_optionContainer table_table_hasFixedLayout">
                      <div class="row_row">
                        <div class="cell_cell option_indicatorContainer"><input type="radio" id="onf_q_postcall_provider_reason_claims_6" aria-describedby="3" aria-label="Grievance/Appeal Information" class="option_input" data-mds-value="6" value="6"
                            hidden-name="onf_q_postcall_provider_reason_claims"><span class="indicatorRadio_indicatorRadioContainer option_indicator indicatorRadio"></span></div>
                        <div class="cell_cell option_captionContainer"><span aria-hidden="true" class="option_caption">Grievance/Appeal Information</span></div>
                      </div>
                    </div>
                  </div>
                </li>
              </ul>
            </div>
          </div>
        </fieldset>
      </div>
      <div class="longform_longformContainer questionBlock singleSelectQuestion lnf_hide">
        <fieldset>
          <legend class="question_questionTitle" id="4"><span class="questionCaption"><b>Please choose the option that most closely relates to your reason for
calling.</b></span></legend>
          <div class="longform_groupContainer">
            <div class="layout_answers longform_group"><!-- react-text: 230 --><!-- /react-text -->
              <ul class="group_group">
                <li class="group_optionContainer">
                  <div class="layout_answer" data-test-name="option-confirm-if-member-active">
                    <div id="JAWS_CLICK_TARGET" class="table_table option_optionContainer table_table_hasFixedLayout">
                      <div class="row_row">
                        <div class="cell_cell option_indicatorContainer"><input type="radio" id="onf_q_postcall_provider_reason_membership_1" aria-describedby="4" aria-label="Confirm if Member Active" class="option_input" data-mds-value="1" value="1"
                            hidden-name="onf_q_postcall_provider_reason_membership"><span class="indicatorRadio_indicatorRadioContainer option_indicator indicatorRadio"></span></div>
                        <div class="cell_cell option_captionContainer"><span aria-hidden="true" class="option_caption">Confirm if Member Active</span></div>
                      </div>
                    </div>
                  </div>
                </li>
                <li class="group_optionContainer">
                  <div class="layout_answer" data-test-name="option-confirm-other-policy-eligibility">
                    <div id="JAWS_CLICK_TARGET" class="table_table option_optionContainer table_table_hasFixedLayout">
                      <div class="row_row">
                        <div class="cell_cell option_indicatorContainer"><input type="radio" id="onf_q_postcall_provider_reason_membership_2" aria-describedby="4" aria-label="Confirm Other Policy Eligibility" class="option_input" data-mds-value="2"
                            value="2" hidden-name="onf_q_postcall_provider_reason_membership"><span class="indicatorRadio_indicatorRadioContainer option_indicator indicatorRadio"></span></div>
                        <div class="cell_cell option_captionContainer"><span aria-hidden="true" class="option_caption">Confirm Other Policy Eligibility</span></div>
                      </div>
                    </div>
                  </div>
                </li>
                <li class="group_optionContainer">
                  <div class="layout_answer" data-test-name="option-coordination-of-benefits">
                    <div id="JAWS_CLICK_TARGET" class="table_table option_optionContainer table_table_hasFixedLayout">
                      <div class="row_row">
                        <div class="cell_cell option_indicatorContainer"><input type="radio" id="onf_q_postcall_provider_reason_membership_4" aria-describedby="4" aria-label="Coordination of Benefits" class="option_input" data-mds-value="4" value="4"
                            hidden-name="onf_q_postcall_provider_reason_membership"><span class="indicatorRadio_indicatorRadioContainer option_indicator indicatorRadio"></span></div>
                        <div class="cell_cell option_captionContainer"><span aria-hidden="true" class="option_caption">Coordination of Benefits</span></div>
                      </div>
                    </div>
                  </div>
                </li>
              </ul>
            </div>
          </div>
        </fieldset>
      </div>
      <div class="longform_longformContainer questionBlock singleSelectQuestion lnf_hide">
        <fieldset>
          <legend class="question_questionTitle" id="5"><span class="questionCaption"><b>Please choose the option that most closely relates to your reason for
calling.</b></span></legend>
          <div class="longform_groupContainer">
            <div class="layout_answers longform_group"><!-- react-text: 265 --><!-- /react-text -->
              <ul class="group_group">
                <li class="group_optionContainer">
                  <div class="layout_answer" data-test-name="option-availity-logon-issues">
                    <div id="JAWS_CLICK_TARGET" class="table_table option_optionContainer table_table_hasFixedLayout">
                      <div class="row_row">
                        <div class="cell_cell option_indicatorContainer"><input type="radio" id="onf_q_postcall_provider_reason_web_1" aria-describedby="5" aria-label="Availity logon issues" class="option_input" data-mds-value="1" value="1"
                            hidden-name="onf_q_postcall_provider_reason_web"><span class="indicatorRadio_indicatorRadioContainer option_indicator indicatorRadio"></span></div>
                        <div class="cell_cell option_captionContainer"><span aria-hidden="true" class="option_caption">Availity logon issues</span></div>
                      </div>
                    </div>
                  </div>
                </li>
                <li class="group_optionContainer">
                  <div class="layout_answer" data-test-name="option-availity-technical-issues">
                    <div id="JAWS_CLICK_TARGET" class="table_table option_optionContainer table_table_hasFixedLayout">
                      <div class="row_row">
                        <div class="cell_cell option_indicatorContainer"><input type="radio" id="onf_q_postcall_provider_reason_web_2" aria-describedby="5" aria-label="Availity technical issues" class="option_input" data-mds-value="2" value="2"
                            hidden-name="onf_q_postcall_provider_reason_web"><span class="indicatorRadio_indicatorRadioContainer option_indicator indicatorRadio"></span></div>
                        <div class="cell_cell option_captionContainer"><span aria-hidden="true" class="option_caption">Availity technical issues</span></div>
                      </div>
                    </div>
                  </div>
                </li>
                <li class="group_optionContainer">
                  <div class="layout_answer" data-test-name="option-could-not-find-needed-information-on-availity">
                    <div id="JAWS_CLICK_TARGET" class="table_table option_optionContainer table_table_hasFixedLayout">
                      <div class="row_row">
                        <div class="cell_cell option_indicatorContainer"><input type="radio" id="onf_q_postcall_provider_reason_web_3" aria-describedby="5" aria-label="Could not find needed information on Availity" class="option_input"
                            data-mds-value="3" value="3" hidden-name="onf_q_postcall_provider_reason_web"><span class="indicatorRadio_indicatorRadioContainer option_indicator indicatorRadio"></span></div>
                        <div class="cell_cell option_captionContainer"><span aria-hidden="true" class="option_caption">Could not find needed information on Availity</span></div>
                      </div>
                    </div>
                  </div>
                </li>
                <li class="group_optionContainer">
                  <div class="layout_answer" data-test-name="option-general-information-about-availity">
                    <div id="JAWS_CLICK_TARGET" class="table_table option_optionContainer table_table_hasFixedLayout">
                      <div class="row_row">
                        <div class="cell_cell option_indicatorContainer"><input type="radio" id="onf_q_postcall_provider_reason_web_4" aria-describedby="5" aria-label="General information about Availity" class="option_input" data-mds-value="4"
                            value="4" hidden-name="onf_q_postcall_provider_reason_web"><span class="indicatorRadio_indicatorRadioContainer option_indicator indicatorRadio"></span></div>
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RequiredWhat was the main reason for your call? (Select one response).
 * Benefits
 * Claims
 * Membership
 * Digital Transactions
 * Network
 * Other
   Error: This is required.

Please choose the option that most closely relates to your reason for calling.
 * Pre-Service Benefit Quote
 * Confirming if CPT is covered
 * Requesting pricing estimate
 * Other Coverage
 * Discuss Member Accumulators
 * Behavioral Health

Please choose the option that most closely relates to your reason for calling.
 * Explain claim processing
 * Prior Authorization Question
 * Locate claim or payment
 * Request an adjustment
 * Status request
 * Grievance/Appeal Information

Please choose the option that most closely relates to your reason for calling.
 * Confirm if Member Active
 * Confirm Other Policy Eligibility
 * Coordination of Benefits

Please choose the option that most closely relates to your reason for calling.
 * Availity logon issues
 * Availity technical issues
 * Could not find needed information on Availity
 * General information about Availity
 * Availity enrollment information

Please choose the option that most closely relates to your reason for calling.
 * Discuss Network Status
 * Find In-Network Specialist
 * Provider Demographic Information

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