Get Monthly Transplant Activity Report (tar) - Esrdnetwork

Filling out the Monthly Transplant Activity Report (TAR) is essential for documenting transplant activities and ensuring compliance with reporting requirements. This guide provides clear and concise steps to assist users in completing the form accurately and efficiently online.

Follow the steps to successfully complete your report.

1. Press the ‘Get Form’ button to access the form and open it within the editor.
2. Enter the CCN (CMS Certification Number) as either 45- or 67- within the specified field.
3. Input the facility name where the transplant activities took place.
4. Provide a contact phone number for further inquiries.
5. Clearly print the name of the person completing the form in the designated area.
6. Complete the required patient information, including the Medicare Claim Number, Social Security Number, first name, middle initial, last name, mailing address, phone number, date of birth, and gender.
7. Record the date of transplant and the name of the attending physician.
8. Indicate the current status of the transplant (functioning or non-functioning).
9. Select the patient's ethnicity and type of donor, ensuring to check the appropriate options for how the information was reported.
10. Indicate the patient's race by selecting all applicable options from the list provided.
11. Complete the citizenship field, noting whether the patient is a U.S. citizen or non-U.S. citizen.
12. Fill out the Medicare status, indicating if the patient is currently enrolled and providing any relevant enrollment dates.
13. Review all entries for completeness and accuracy, as incomplete forms will be returned unprocessed.
14. Once completed, you can save your changes, download the form, print it, or share it according to your needs.

Ensure your transplant activities are properly reported by completing the document online today.