Patient Services,

Patient Resources,Social Work Services Quick Guide,Social Work Manual,Population Specific,Transplant,Kidney Transplant,Financial


2728 - Patient Resources, Social Work Services Quick Guide, Social Work Manual, Population Specific, Transplant, Kidney Transplant, Financial


When patients with end stage renal disease become eligible for Medicare based on dialysis or kidney transplantation, a form is sent to Medicare - CMS-2728.

Dialysis units send this form in and keep a copy. When patients are referred for transplant evaluation, we request a copy of this form, and it is scanned into our OnBase system.

When patients have a kidney transplant and are newly eligible for Medicare, Janna Reese sends a copy of this form to our admissions department.

Access to this form is helpful, as question #24 documents the date patient began "regular chronic dialysis". It is from this date that we should be calculating the 30 month coordination of benefits period.

In order to access this form, follow these steps:

  1. Log into OnBase
  2. Change "Document Retrieval" to "Custom Queries" using the arrow
  3. Click on "Retrieve Patient Documents"
  4. After "UWHC ID" type in their MR#
  5. Click on the binoculars near the bottom of the page
  6. Click on "Renal Document"

Permission to view this information is tied to your security. If you are unable to view this type of document, please contact the help desk.

If you use this information to change the date in Health Link after the patient is listed, be sure to let Kristi Bakken or Sara Pogue know as the date also needs to be changed in UNOS. It is very important that we have the same date in Health Link as we do in UNOS.