4Discharge the Patient - 1 Search for the patient you wish to discharge, then click Search. CROWNWeb displays the search results.Click the CROWN UPI number of the patient to access the View Patient Attributes screen for that patient.
5Discharge the Patient - 2 Click the Admit/Discharge Summary link on the left side of the page.Click the date under the Admit Date column.
6Discharge the Patient - 3 On the left side of the screen, click the Edit Admit/Discharge link.Enter the Discharge Date for the patient, and note the Discharge Reason as Death, then click Submit.
7Note the Cause of Death - 1 Return to the View Patient Attributes screen for the patient.Click the Edit Patient link on the left side of the page. The Edit Patient attributes screen displays.
8Note the Cause of Death - 2 Scroll to the Medical Info section of the form (at the bottom) and specify the Date of Death, the Primary Cause of Death Code or the Primary Cause of Death Description for the patient, and the Effective Date.Click Submit to save the edits and update the death information for the patient.
9Complete the 2746 Form - 1Return to the View Patient Attributes screen for the patient. You will now see an Add 2746 link available on the left side of the screen.
10Complete the 2746 Form - 2Click the Add 2746 link. The Add a New Death Notice (2746) screen displays.Complete the required fields that are missing data.
11Complete the 2746 Form - 3When you have completed the form, click the Submit button. The form is processed by CROWNWeb, and (if no errors or warnings are detected) the View a Death Notice (2746) – Submitted screen displays.
12Print for Social Security – 1 Click the Print button at the bottom of the View Medical Evidence Form – Submitted screen. A pop-up window launches containing the completed form in PDF format.
13Print for Social Security - 2 In the upper-left corner of the pop-up window, click the Printer icon to print the form to our default printer. Your Print dialog box will display.
14Print for Social Security - 3 Set the print options (if necessary) then click Print. The form will be printed on the printer that you configured.Have the person who completed the form sign the form in blue ink, then submit the form to SSA.Note: Social Security does not accept electronic signatures at this time.
15The 2746 Form in CROWNWebTip: You can hover over some form items to get more info on that field!
16Appendix Alert!In the Appendix section of your handout, you can view a printed version of the CMS-2746 form that is available in CROWNWeb. You can also view a workflow of the process of submitting the form to CMS.