The Centers for Medicare and Medicaid Services (CMS) has always required timely form submissions. This is a core responsibility as a Medicare-certified facility.
CMS designed the EQRS Facility Dashboard so that you would never be unaware that a form is coming due soon.
We are asking you to share this information in your QAPI meetings and review your internal processes to achieve this requirement.
2728 Forms
2728 Eligibility forms MUST be submitted in EQRS
no later than 45 days after the admit date.
Facilities report that a major roadblock for 2728 form submission is getting a physician's signature since the physician may only round in the clinic once a month. We strongly recommend that you fax the 2728 to the physician’s office for signatures, and they then fax the form back. The 2728 in EQRS is essentially an electronic form, so faxed signatures should not be a problem. Furthermore, Social Security has ended the blue ink signature requirement on the 2728. Please alert your physicians to expect faxed signatures.
Late Forms Should be Extremely Rare
2746 Forms
2746 Death forms MUST be submitted in EQRS
no later than 14 days from the date of death.
We strongly recommend that if the form is about to be late then you do the following:
Use code 99 “Unknown” for the cause of death.
Use “N/A” or “Unknown” on the other questions, as necessary, to complete the form.
The 2746 does NOT require a provider signature, just the name of the person completing the form in EQRS.
There should NEVER be a late 2746!
Revisions to Submitted Forms
When you request an edit to a previously submitted form that was submitted on time, and that form is now past it’s due date, then editing it causes it to be marked as late.
We have changed our policy on editing submitted 2728 forms. Edits will only be made if the changes affect patient identification or patient benefits.
The following is a partial list of things that do not affect benefits and will NOT be edited:
Labs
Primary diagnosis
Occupation
Co-morbid conditions
We will NOT be editing 2746 Death forms at all, as there is nothing there that affects benefits. The only exception would be if the patient is not actually deceased. In that case, we can delete the 2746 and remove the date and cause of death in EQRS.
This material was prepared by Qsource, an End-Stage Renal Disease (ESRD) Network under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (HHS). Views expressed in this material do not necessarily reflect the official views or policy of CMS or HHS, and any reference to a specific product or entity herein does not constitute endorsement of that product or entity by CMS or HHS. 25.ESRD.06.095
Qsource, 8245 Tournament Drive, Memphis, TN 38125, USA
