Get Ms-2126 Billing Instructions

The MS-2126 form is crucial for documenting the admission and discharge of residents in nursing facilities. This guide provides step-by-step instructions on how to accurately fill out the form online, ensuring compliance with the Kansas Medical Assistance Program requirements.

Follow the steps to complete the MS-2126 form correctly.

1. Begin by locating the MS-2126 form. Click the ‘Get Form’ button to download the document and open it in your preferred editor.
2. In Section I, enter the resident's information, including their full name, Social Security number, date of birth, and sex. Make sure to input the Client ID number and the responsible person's name and address.
3. Proceed to Section II to fill in the facility's information. Enter the facility name and location, phone, and fax numbers. Document the person placing the resident and whether a CARE screening was completed.
4. In Section III, indicate if this is an admission or discharge. Fill out the admission date and the anticipated length of stay, specifying the pay status on admission.
5. If completing the discharge information, provide the discharge date and the destination of the resident. Indicate if discharged to a facility or at home.
6. If applicable, complete Section IV regarding hospital leave information. Mention the hospital name and the expected duration of the leave.
7. Review all entries for accuracy. Ensure all sections are completed as needed before saving your progress.
8. Save the completed form and prepare it for submission to the local SRS office within five working days of the discharge or admission.

To ensure compliance, start filling out your MS-2126 form online today and submit it on time.