SURVEY QUESTIONNAIRE

Dear Respondent,

The researchers are conducting a survey about “Proposed Branch

Automated Collection System” in Prudentialife Healthcare. I am hoping that you could

spare me some of your precious time to complete this survey form.

Please answer the following question clearly. Be rest assured that all the

information given, will be treated confidentially.

NAME: ____________________________ AGE: ____ GENDER: MALE FEMALE

DEPARTMENT: Information Technology Billing&Collection Human Resource Others

I. Direction: Read the following questions carefully and put a check inside the box

that corresponds to your response.

1. What are the problems encountered by the client of Prudentialife Healthcare

in terms of Service?

Plan Inquiry of Member

Payment Collection
Manual Issuance of OR
Generation of Billing Statements
Generation of Collection Reports

2. How do the above problems be improved?

 There should be a database that will hold members plan details.
There should be a system that can be installed to any Prudentialife Branch to
be more accessible to the members for paying their premium.

The system should also capture Issuance of computerized Official Receipt

(OR).

There should be a database that will capture member’s information and plan
details so that billing statement can be generate easily.

There should be a system that will hold each members file so that collection
reports can be generated quickly.
II. Direction: Rate the following statements as:

1 – Strongly disagree

2 – Disagree

3 – Neutral

4 – Agree
SD D N A SA

5 – Strongly Agree

1 2 3 4 5
Please encircle the number corresponding to your answer.

3. Proposed automated system will give more 1 2 3 4 5

benefits for the company than the existing

1 2 3 4 5
 system.

4. Proposed system can help the

company to make collection

process fast and ease.

5. Do you agree that proposed

automated collection really

feasible?

INTERVIEW QUESTIONNAIRE

1. What is your existing collection system?

• A manual system of collecting payment premium

2. In what term did you compute collection of payment?

• Payment collection can be computed via using a calculator. Cashiers

handled the manual computation and write it on the member ledger.

3. How many branches do you have? What branches?

• 10 branches

• PHI, Galleria, Gamboa, Angeles, Bacolod, Batangas, Biñan, Cabanatuan,

Cebu, Davao
4. How many staff prepares the collection reports?

• 3

5. How long will it take?

• 3 weeks to 1 month

6. What are the factors include in computations? And its formula?

• Formula: TERM * MODE = No. of installments to be paid

• Factors:

1. Contract price 5. Regular

Installment
2. Plan
6. Due date
3. Term
7. Status
4. Mode
8. Initial payment

9. Paycodes

7. What are the reports required?

• Official receipts summary and Health Plan Agreement report

Existing Process Flow

Start

Plan/Payment
Inquiry

Prepare Payment
Slip
 With No
SOA?

Yes

No Receive payments
Lapsed? and write it in Ledger

Yes

Prepare Payment Slip

End

Proposed Process Flow

Start

Plan/Payment
Inquiry

No Prepare Payment
Slip
 With
SOA?

Yes

Receive payments
Lapsed? No and create payments
using Branch
Automated Collection
System

Yes

Prepare Payment Slip

End