Skip Ribbon Commands
Skip to main content
Attach FileAttach File
* indicates a required field
Centra Online Billing Feedback
Please answer the following questions
Patient Billing Survey

Please rate your overall experience with Centra billing (consider the billing statement, on-line service, customer service):

Please check the service for which you were billed:

On a scale of 1 to 5, 1 being "not at all easy" and 5 being "extremely easy" please rate how easy it was to pay your bill on line:

On a scale of 1 to 5, 1 being “not at all easy to understand” and 5 being “extremely easy to understand” please rate how easy your bill was to understand:

On a scale of 1 to 5, 1 being “not at all helpful” and 5 being “extremely helpful” please rate your satisfaction with Centra’s customer service representative:

If you answered the questions above, we invite you to provide additional information.

Was Centra’s Customer Service Representative pleasant and courteous?

Comments about service reps courtesy:

Was Centra’s Customer Service Representative able to answer questions to your satisfaction:

Comments about service reps satisfactory answers to your questions:

Please enter additional comments or suggestions here:

You have volunteered to respond to this survey, and your responses are anonymous. If you would be willing to participate in a follow-up conversation with a Centra representative regarding your responses, please provide your contact information below. The information you provide in a follow-up conversation will be used to better understand your experience and to help Centra improve on their processes.


Enter your email address:

Enter your phone number:

Enter the preferred day and time for Centra to contact you: