CROWNWeb Notifications and Accretions
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What is a notification? A discrepancy in patient data between what a CMS/SSA database has on record and what
exists in CROWNWeb.
REMIS Identity Notification: (e.g., Last Name, First Name, Date of Birth, Gender, Social Security Number, or
Medicare Claim Number)
REMIS Event Notification: (e.g., Date of Death, Transplants, Transplant Failures, or Dialysis Treatments)
What is an accretion? A patient that exists in a CMS/SSA database and believes to be ESRD, but has not been
admitted into CROWNWeb as a patient. (An accretion may also occur for existing patients in CROWNWeb whose
key identifiers are missing or incorrect.)
Accretion
The Enrollment Database (EDB) shows billing for a patient from your facility but CROWNWeb has not been updated to
show that the patient is actually admitted to your facility. If this Accretion Record is true, meaning the patient did receive the
treatment on the date shown, accept the record; CROWNWeb will then prompt you to admit the patient to your facility. Once
the patient is admitted to your facility, you can create a discharge date if the patient is no longer dialyzing at the facility.
Reject the Accretion Record if the patient never treated at the dialysis unit OR if the Accretion Record has the wrong admit
date.
Date of Birth
There is a discrepancy in this patient’s date of birth. Verify with the patient and accept or reject the notification. If the
OTHER/EDB value is correct, accept the notification. Accepting the notification will update the patient's profile in
CROWNWeb to show the correct value. If the CROWNWeb value is correct, reject the notification. Rejecting the
notification will not change the patient's record and will keep the CROWNWeb value. If CROWNWeb and the OTHER/EDB
value are both wrong, reject the notification and manually update the patient's attributes with the correct date of birth. When
you accept a notification always verify the patient’s profile to make sure CROWNWeb shows the updated information.
Death
The Enrollment Database (EDB) thinks the patient expired on the date listed. Verify the date of death with your internal
records. If the EDB date is correct, create the death event and accept the notification. If the EDB date is incorrect, reject the
notification and create a death event with the correct date. When you accept a notification, go back to the patient’s profile to
make sure CROWNWeb shows the correct date of death. If the patient’s date of death is within 30 days of discontinuing
treatments, it is still the facility’s responsibility to report the death. Report the death by clicking on the Edit Patient tab and
enter the date of death and primary cause of death. DO NOT remove the discontinue reason and date listed on the
admit/discharge screen. Remember to submit a CMS-2746 form!
Dialysis Treatment
An outside source thinks the patient’s treatment changed (e.g., modality, sessions per week, time per sessions, or physician)
OR the patient was admitted to the facility on the date shown (OTHER/EDB value). Verify with your internal records and
ensure CROWNWeb has the correct admit date, treatment start date, and correct modality for the patient. If the facility agrees
with the OTHER/EDB value, accept the notification. If the OTHER/EDB value is incorrect, reject the notification then
update the patient's admit/discharge summary to reflect the most recent patient activity, if necessary.
First Name/Last Name
There is a discrepancy in the patient’s name. If the patient has Medicare, always go with the name on the Medicare Card. If
the patient does not have Medicare, verify with the patient before you accept or reject the notification.
If the OTHER/EDB value is correct, accept the notification. Accepting the notification will update the patient’s profile to
show the correct value. If the CROWNWeb value is correct, reject the notification. Rejecting the notification will not change
the patient’s record and will keep the information in CROWNWeb. However, if both sources are wrong, reject the
notification and manually update the patient’s attribute with the correct value. When you accept a notification, always go
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back to the patient’s profile to make sure CROWNWeb shows the updated information. If the patient has gotten married,
only update the last name if the patient has officially changed it with Social Security Administration.
Gender
There is a discrepancy in this patient’s gender. Verify with the patient and accept or reject the notification. If the
OTHER/EDB value is correct, accept the notification. Accepting the notification will update the patient's profile in
CROWNWeb to show the correct value. If the CROWNWeb value is correct, reject the notification. Rejecting the
notification will not change the patient's record and will keep the CROWNWeb value. If CROWNWeb and the EDB value
are both wrong, reject the notification and manually update the patient's attributes with the correct gender. When you accept a
notification, always verify the patient’s profile to make sure CROWNWeb shows the updated information. Note: The gender
should be reported as the gender at birth.
Medicare Claim Number
This notification was created because either CROWNWeb does not have a Medicare Claim Number on file while the
Enrollment Database (EDB) does OR the patient’s Medicare claim number currently changed and has not been updated in
CROWNWeb. If the facility agrees with the OTHER/EDB value, accept the notification. If the patient does not have a
Medicare number, reject the notification. However, first contact and ask the patient if he/she has received a Medicare Card
before rejecting the notification. If both sources are wrong, reject the notification and manually update the patient’s attributes
with the correct value. To change the Medicare effective date, go to View Patient Attribute History tab and make sure the
Medicare effective date is correct. If not, click on the Edit Patient Attribute History tab and make necessary changes.
Note: CROWNWeb is not asking if the patient has Part A or Part B (or Part D for that matter), only if the patient is enrolled
in Medicare.
Social Security Number
The notification exists because either CROWNWeb does not have a Social Security Number on file for the patient OR there
is a discrepancy in the patient’s SSN. Verify with the patient and request to see the patient’s Social Security Card for
accuracy. If the facility agrees with the OTHER/EDB value, accept the notification. If the facility does not agree with the
OTHER/EDB value or if the CROWNWeb value is correct, reject the notification. However, first confirm the SSN with the
patient before rejecting the notification. If both sources are wrong, reject the notification and manually update the patient’s
attributes with the correct value. Accepting a notification will update the patient’s profile to show the correct value. Rejecting
the notification will not change the patient's record.
CROWNWeb Notification/Accretion tutorial:
http://projectcrownweb.org/pcw_course/notifications-accretions-facility-role/
Note: Facilities should resolve all Notifications and Accretions within 30 days. You may have notifications that have
been open for more than 30 days, if so; visit the tutorial link to learn how to take action and remove the notification
from your Action List. Additionally, facilities must thoroughly research these notices, and should only “Escalate” a
Notification or Accretion when an answer cannot be found after extensive research.
If you have questions about Notifications & Accretions, please contact the Information Management Department at 972-5033215 ext. 326 or 318 or [email protected].
DO NOT email patient information to the Network office.
4040 McEwen Road, Suite 350, Dallas, Texas 75244
Phone: 972-503-3215 | Fax: 972-503-3219 | [email protected] | www.esrdnetwork.org
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