International patients should be tracked in EQRS to allow them to be admitted to and treated at an ESRD facility. Below are some additional guidelines regarding international patients:
- International patients need to use an address from within the U.S. because their address more than likely doesn’t fit EQRS' format. It does not matter if they get a P.O. Box, a family member’s address who lives in the U.S., or use the facility’s address (note that no mail will be sent to that address).
- Per CMS directive, international patients that are receiving outpatient dialysis care within the US for the first time are to be admitted a facility as New ESRD Patient. Below is a screenshot of a CMS presentation validating this.
- Since these patients probably don’t have SSNs, you would check the SSN N/A check box and the Medicare Claim Number N/A check box. For the Medicare Enrollment field, you would select No Medicare Coverage
- For international patients that are admitted as a New ESRD Patient, a CMS-2728 would be completed. This form gives CMS permission to track the patient’s care. The 2728 is not just for Medicare benefits; it also serves as the ESRD patient registry form (regardless of benefits).
- When completing the 2728, enter that the patient is Not Applying for Medicare.
- If the patient does not bring any lab data with them, draw labs during their very first treatment at your facility. That will allow the CMS-2728 to be submitted in EQRS. Please make a note on the form in the remarks section that the patient started dialysis in another country on the appropriate date.
- The rest of the admits/discharges after the first record would be Transfers.
- You need to contact the Network to admit them as there is no SSN for these patients. The Network will use a dummy SSN to admit these patients as a transfer in to your facility. They would not be considered Transients. Transients should only be attached to a U.S. Medicare-certified facility who may visit other U.S. Medicare-certified facilities.
- For international patients who have visited your facility in the past and may continue to come to your facility off-and-on, the facility should have ALL of those admits/discharges entered in CROWNWeb.