Editing a Submitted 2728 Form / 2746 Form

Updated 7/12/2023

IMPORTANT: 

• Any edit made to a 2728 Form more than 45 days after its 'DUE' date will cause that Form to no longer be EQRS Compliant with the 'submit 2728s within 45 days' CMS Guidance.
• Any edit made to a 2746 Form more than 14 days after its 'DUE' date will cause that Form to no longer be EQRS Compliant with the 'submit 2746s within 14 days' CMS Guidance.

If the Form impacts the patient's Medicare eligibility OR Transplant Waitlist Status then correcting the Form is a priority. This includes information about:

• Treatment & Training Start / End Dates
• Admit & Discharge Dates
• Name, Race, Ethnicity, Gender, Date of Birth (DOB), Date of Death (DOD)
• SSN
• Height, Weight, Labs
• Diagnosis / Cause of Death

!! Make these necessary updates on the Demographics page !!

If the information on the Form does NOT impact or include any of the above fields, we suggest that you leave it as-is or make the update on a printed copy.

Submit a Ticket if you would still like to proceed with the Form Edit - we will use the information you updated on the Demographics page to make the Form corrections. https://help.esrd.ipro.org/support/tickets/new

Please include in the Ticket: "We have made the necessary corrections on the Patient Demographics page and request for the Network to proceed with the Form Correction"