Pay attention to Dashboard Notifications
Initial 2728 paperwork
Enter data in CW under patient attributes
Go to 2728 form and add the form. Complete the form and Save.
Print 2728 form for signatures (for Medical Doctor and Patient signatures)
Obtain signatures in blue ink. Send the form to SSA
Log back in to CW and enter dates on 2728 form.
Submit 2728 form
Supplemental 2728 Form
If patient receives a transplant within the first 3 months of first date of dialysis
This form will entitle the patient to receive benefits immediately rather than waiting for the 3 month coordination period to end
Click Add supplemental form and complete as above
Complete if a patient dies within 3 years of transplant (Patient is covered under Medicare so need to terminate benefits).
2744 Forms - Centers for Medicare and Medicaid Services (CMS) Annual Facility Survey
Usually asked to be completed and submitted by April 1 of current year for reporting of prior year. Submit 2744 form for data through December 31st of previous year.
Generate 2744 form first to populate numbers and data
Enter data for Field 51 and Field 52: patient’s awaiting transplant that are on dialysis and those that are not
Run reports on the left to confirm the data
Save completed 2744 form
Submit to Network acceptance
All staff changes should be updated and edited in CW within 5 days of staff change
For all personnel confirm:
REDCap – Secured Electronic Data Capture System
This system was established to give the Transplant Centers the ability to enter data for admissions, the Network will enter data into CW for the Transplant Centers (at this time, Transplant Centers do not have the ability to admit patients into CW). This reporting can be done upon each admission, weekly, or monthly.
The Network will send you a link to report patient information via REDCap
Enter data and information for patients per the fields requested in REDCap
Once the Transplant Center submits form the Network will receive an alert to review the data
Please allow the Network 48 hours to enter all data
Once the Network enters data, the Transplant Center will be able to see the patient in CW
Modified on: Tue, Mar 6, 2018 at 4:52 PM
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