EQRS News Flash – CMS 2728 Form: Completion Process
October 7, 2021
The Centers for Medicare & Medicaid Services (CMS) reminds facilities that it is important to complete the correct steps when processing the CMS 2728 (End Stage Renal Disease (ESRD) Medical Evidence Report Medicare Entitlement and/or Patient Registration) form. Doing so ensures that patients’ Medicare benefits are activated and that the dialysis facility is reimbursed for services rendered to the patient.
Follow the steps below to correctly complete and process the CMS 2728 form:
Step 1: Enter and save all confirmed patient information into the CMS-2728 form in EQRS.
Step 2: Print the CMS-2728 form and have the nephrologist and patient sign the printed copy.
Step 3: Enter the date(s) that the nephrologist and the patient signed the CMS-2728 form in EQRS.
Step 4: Click Submit to electronically upload the completed form in EQRS.
Step 5: Mail the completed and signed CMS-2728 form to the local Social Security Administration office.
Please note: Step 5 ensures that Medicare benefits and facility reimbursements are quickly processed. Failure to do so may prevent and/or delay these important items.