2728, 2746 and 2744 Forms

2728 Form Instructions
Updated 12/16/2022 The 2728 Form (END STAGE RENAL DISEASE MEDICAL EVIDENCE REPORT MEDICARE ENTITLEMENT AND/OR PATIENT REGISTRATION) Is required to add a...
Tue, Jan 10, 2023 at 11:32 AM
2746 Form Submission in EQRS
Updated 3/14/2023 The CMS-2746 Form (Death Notification) is required by CMS to be submitted in EQRS within 14 days of the patient's date of death (D...
Tue, Mar 14, 2023 at 8:50 PM
2744 Form Instructions: Dialysis Facilities
Updated 2/1/2023 Corporate Support for 2744: American Renal Associates: ahannah@americanrenal.com Davita: 2744@davita.com DCI: Geraldine.bojarski@dc...
Wed, Feb 1, 2023 at 4:27 PM
2744 Form Instructions: Transplant Centers
Updated 2/1/2023 Medicare-certified transplant centers are required to complete the CMS Annual Facility Survey (Form 2744) each year. The 2744 collects tra...
Wed, Feb 1, 2023 at 4:28 PM
2744 Checking Status
Updated 12/27/2022 1. Log in to EQRS https://eqrs.cms.gov/ --> Facilities --> Form 2744 2. Select the correct Survey Year for the 2744 (the ...
Tue, Dec 27, 2022 at 6:10 PM
2744 Medicare Error
http://help.esrd.ipro.org/support/tickets/new Click Generate to refresh the data Run the “End of Survey” Report  Review the Medicare Status C...
Tue, Mar 29, 2022 at 1:57 PM