Elation Letters to Providers and Referrals is the easiest way to communicate about your patients with individuals outside your practice. Write a message, attach items from your patient's chart and then fax, print or send electronic messages with just one feature. You can also use Letters to communicate with patients via Patient Passport.

 

Recommended Reading

• Letters & Referrals Guide- Sharing clinical data outside of Elation
• How to Share a Patient's Entire Chart

Contents

• How to send a Letter/Message to a Patient
• How to send a Letter/Referral as a fax
• How to send a Letter/Referral as an email
• How to send a Letter/Referral to recipients with a *P in their profile
• How to send a Letter/Referral to recipients with a *E in their profile
• Frequently Asked Questions (FAQ)

   

How to send a Letter/Message to a Patient

The Letter to Patient feature allows you to communicate with your patient via Elation Patient Passport, a secure online patient communication portal. Learn more about Patient Passport in the Elation Passport for Patients Guide. If the patient does not have a Passport account yet, your first message to them will also invite them to register for an account.
 

1. Click "Letter" >>> "To Patient" to start a message to a patient
2. Type a Subject line and Body for your Letter/Referral
   • User Tip: If you include a website URL (address) in the body of your message, the URL will appear as a hyperlink (click-able link) for the patient and the patient will be able to go to the website from your message.
3. Select your Settings for the Letter/Referral
   • Post Date= Choose a date to send the message if you wish to send it after today. See Post Date a Message Guide- Reminders & Task Follow Up for more information about this feature.
   • Unread Alert= Alert yourself if the message has not be read by a specific timeframe
   • Print Header= Select the practice header you want to appear on this message
4. Attach patient data by
   1. Clicking the "Select Chart Items to Attach" button
      1. The Most Recent records you can attach will be displayed first. You can also choose specific records from the chart to attach by selecting on a record category in the left column.
         • User Tip: You cannot attach records that are still in Requiring Actions or Outstanding Items.
      2. Check off records you want to attach & then click "Attach Item

2. Clicking "Attach Everything in Chart" if you want to attach all records from the patient's chart

 

5. Specify whether or not you want the patient to respond to the letter/message
6. When you are ready to send the message, click "Sign & Send"
   • You will also see other options under "Sign & More" such as:
     • "Sign & Print"= Sends the message to patient's Passport account & prints a copy out
     • "Sign, Send & Create Follow-up Letter"= Sends the message to patient's Passport account & starts a new draft for follow up

 

 

 

  

 

How to send a Letter/Referral as a fax

If the recipient has a secure fax number, you can send them a fax directly within Elation.  

1. Click the "Referral" button or click "Letter" >>> "To Provider" to start a Letter or Referral draft

2. Enter a recipient in to "To" field

• User Tips:
  • When sending to a provider or medical organization, we recommend choosing from providers and/or organizations in the Elation Provider Directory and use the contact information in the database to send them patient records. We recommend reading this Provider Directory Guide  for more details on how to use contacts from the Provider Directory.
  • You can also create your own contacts for those whom are not providers or medical organizations but you frequently interact with them. Reference the Adding New Contacts for Letters and Referrals article for instructions on how to create your own contacts
  • For recipients who you do not frequently contact, you can enter any 10 digit national fax number in the "To:" field to send a fax. If your fax has more than 20 pages of attachments, you must create a contact for them. Reference the Adding New Contacts for Letters and Referrals article for instructions on how to create your own contacts

2. Type a Subject line and Body for your Letter/Referral
3. (Referral only) Fill out Referral details:
   • Auth For = What type of referral is this or what type of authorization did you obtain from the patient's insurance company?
   • Auth #= What is the referral or treatment authorization number you obtained from the patient's insurance company?
   • Add Dxs = Enter ICD-10 codes that support the referral
4. Select your Settings for the Letter/Referral
   • Post Date= Choose a date to send the Letter/Referral if you wish to send it after today. See Post Date a Message Guide- Reminders & Task Follow Up for more information about this feature.
   • Unread Alert= Alert yourself if the Letter/Referral has not be read by a specific timeframe
     • Note: This feature only works if the recipient is another Elation EHR or Provider Portal user. See the Notification section for more information.
   • Print Header= Select the practice header you want to appear on this Letter/Referral.
5. Attach patient data by
   1. Clicking the "Select Chart Items to Attach" button
      1. The Most Recent records you can attach will be displayed first. You can also choose specific records from the chart to attach by selecting on a record category in the left column.
         • User Tip: You cannot attach records that are still in Requiring Actions or Outstanding Items.
      2. Check off records you want to attach & then click "Attach Items"

2. Clicking "Attach Everything in Chart" if you want to attach all records from the patient's chart

7. (Contacts with fax numbers only) Choose whether or not you want to include attachments
   1. Default: Send a link to an interactive chart online + a faxed copy of the body of the Letter/Referral (attachments not included).

 

2. Optional: Check the option to "Also fax copies of the attachments." if you want the recipient to also receive attachments via fax.
   • Important Note: If you attached more than 20 pages of records, this option will not be available and the recipient can only view attachments online
     

• If you would like to automatically fax all attachments you can turn this setting on in the Settings page, under "Fax Usage & Settings".
  
• Important Note: Fax usage rates apply. Click here if you have any questions about fax usage.  

8. When you are ready to send the Letter/Referral, click "Sign & Send"
   • You will also see other options under "Sign & More" such as:
     • "Sign, Send & Print Pt Copy"= Sends the Letter/Referral & prints the body of the Letter/Referral without attachments
     • "Sign & Print w/attachments"= Sends the Letter/Referral & prints the entire Letter/Referral with attachments
     • "Sign, Send & Create Follow-up Letter"= Sends the Letter/Referral & starts a new draft for the same recipient to assist with follow up
   • Important Note: Only provider level users can sign Referrals. Staff level users cannot sign Referrals unless they are an authorized Referrals delegate.

All signed Letters and Referrals will be stored in the patient's chronological record.

 

 

How to send a Letter/Referral as an email

If the recipient has an email address, you can record their email address in Elation and use their email address to securely communicate with them.

• Note: The Referral or Letter to Provider feature is not recommended for patient communication. Use the Letter to Patient feature to communicate with patients via Patient Passport.

 

1. Click the "Referral" button or click "Letter" >>> "To Provider" to start a Letter or Referral draft

2. Select a recipient in the "To" field and make sure they have an email address on file by clicking "edit" next to their name
   • User Tips:
     • When sending to a provider or medical organization, we recommend choosing from providers and/or organizations in the Elation Provider Directory and use the contact information in the database to send them patient records. We recommend reading this Provider Directory Guide for more details on how to use contacts from the Provider Directory.
     • You can also create your own contacts for those whom are not providers or medical organizations but you frequently interact with them. Reference the Adding New Contacts for Letters and Referrals article for instructions on how to create your own contacts
3. Type a Subject line and Body for your Letter/Referral
4. (Referral only) Fill out Referral details:
   • Auth For = What type of referral is this or what type of authorization did you obtain from the patient's insurance company?
   • Auth #= What is the referral or treatment authorization number you obtained from the patient's insurance company?
   • Add Dxs = Enter ICD-10 codes that support the referral
5. Select your Settings for the Letter/Referral
   1. Post Date= Choose a date to send the Letter/Referral if you wish to send it after today. See Post Date a Message Guide- Reminders & Task Follow Up for more information about this feature.
   2. Unread Alert= Alert yourself if the Letter/Referral has not be read by a specific timeframe
      • Note: This feature only works if the recipient is another Elation EHR or Provider Portal user. 
   3. Print Header= Select the practice header you want to appear on this Letter/Referral.
6. Attach patient data by
   1. Clicking the "Select Chart Items to Attach" button
      1. The Most Recent records you can attach will be displayed first. You can also choose specific records from the chart to attach by selecting on a record category in the left column.
         • User Tip: You cannot attach records that are still in Requiring Actions or Outstanding Items.
      2. Check off records you want to attach & then click "Attach Items"

2. Clicking "Attach Everything in Chart" if you want to attach all records from the patient's chart 

7. When you are ready to send the Letter/Referral, click "Sign & Send"
   • You will also see other options under "Sign & More" such as:
     • "Sign, Send & Print Pt Copy"= Sends the Letter/Referral & prints the body of the Letter/Referral without attachments
     • "Sign & Print w/attachments"= Sends the Letter/Referral & prints the entire Letter/Referral with attachments
     • "Sign, Send & Create Follow-up Letter"= Sends the Letter/Referral & starts a new draft for the same recipient to assist with follow up
   • Important Note: Only provider level users can sign Referrals. Staff level users cannot sign Referrals unless they are an authorized Referrals delegate.

   

 

How to send a Letter/Referral to recipients with a *P in their profile

Recipients with a next to their name have registered for an Elation Provider Portal account to access the secure online portal. They can log in to the Provider Portal with a password to view records you share with them via Elation. This means you can share as many pages of records with the recipient as needed and you will not be limited by fax constraints.

• See the How my colleagues can access shared patient information from my faxes and emails article for more information.

 

1. Click the "Referral" button or click "Letter" >>> "To Provider" to start a Letter or Referral draft

2. Type in the name of a provider in the "To:" field, or search the Provider Directory, to find a recipient with a next to their name.
3. Type a Subject line and Body for your Letter/Referral
4. (Referral only) Fill out Referral details:
   • Auth For = What type of referral is this or what type of authorization did you obtain from the patient's insurance company?
   • Auth #= What is the referral or treatment authorization number you obtained from the patient's insurance company?
   • Add Dxs = Enter ICD-10 codes that support the referral
5. Select your Settings for the Letter/Referral
   1. Post Date= Choose a date to send the Letter/Referral if you wish to send it after today. See Post Date a Message Guide- Reminders & Task Follow Up for more information about this feature.
   2. Unread Alert= Alert yourself if the Letter/Referral has not be read by a specific timeframe
   3. Print Header= Select the practice header you want to appear on this Letter/Referral.
6. Attach patient data by
   1. Clicking the "Select Chart Items to Attach" button
      1. The Most Recent records you can attach will be displayed first. You can also choose specific records from the chart to attach by selecting on a record category in the left column.
         • User Tip: You cannot attach records that are still in Requiring Actions or Outstanding Items.
      2. Check off records you want to attach & then click "Attach Items"

2. Clicking "Attach Everything in Chart" if you want to attach all records from the patient's chart 

7. (Provider Passport users with fax numbers only) Choose whether or not you want to include attachments
   1. Default: Send a link to an interactive chart online + a faxed copy of the body of the Letter/Referral (attachments not included).

 

2. Optional: Check the option to "Also fax copies of the attachments." if you want the recipient to also receive attachments via fax.
   • Important Note: If you attached more than 20 pages of records, this option will not be available and the recipient can only view attachments online
     

• If you would like to automatically fax all attachments you can turn this setting on in the Settings page, under "Fax Usage & Settings".
  
• Important Note: Fax usage rates apply. Click here if you have any questions about fax usage.  

8. When you are ready to send the Letter/Referral, click "Sign & Send"
   • You will also see other options under "Sign & More" such as:
     • "Sign, Send & Print Pt Copy"= Sends the Letter/Referral & prints the body of the Letter/Referral without attachments
     • "Sign & Print w/attachments"= Sends the Letter/Referral & prints the entire Letter/Referral with attachments
     • "Sign, Send & Create Follow-up Letter"= Sends the Letter/Referral & starts a new draft for the same recipient to assist with follow up
   • Important Note: Only provider level users can sign Referrals. Staff level users cannot sign Referrals unless they are an authorized Referrals delegate.

 

 

How to send a Letter/Referral to recipients with a *E next to their profile

Recipients with a next to their name have their own Elation EHR account. This means you can share as many pages of records with the recipient as needed and your Letter/Referral and all of its attachments will be sent directly to the recipient's EHR. For more detailed information about this feature, see Letters & Referrals Guide- Sharing documents with other Elation EHR Users article.

 

1. Click the "Referral" button or click "Letter" >>> "To Provider" to start a Letter or Referral draft

2. Type in the name of a provider in the "To:" field, or search theProvider Directory, to find a recipient with a next to their name.
3. Type a Subject line and Body for your Letter/Referral
4. (Referral only) Fill out Referral details:
   • Auth For = What type of referral is this or what type of authorization did you obtain from the patient's insurance company?
   • Auth #= What is the referral or treatment authorization number you obtained from the patient's insurance company?
   • Add Dxs = Enter ICD-10 codes that support the referral
5. Select your Settings for the Letter/Referral
   1. Post Date= Choose a date to send the Letter/Referral if you wish to send it after today. See Post Date a Message Guide- Reminders & Task Follow Up for more information about this feature.
   2. Unread Alert= Alert yourself if the Letter/Referral has not be read by a specific timeframe
   3. Print Header= Select the practice header you want to appear on this Letter/Referral.
6. Attach patient data by
   1. Clicking the "Select Chart Items to Attach" button
      1. The Most Recent records you can attach will be displayed first. You can also choose specific records from the chart to attach by selecting on a record category in the left column.
         • User Tip: You cannot attach records that are still in Requiring Actions or Outstanding Items.
      2. Check off records you want to attach & then click "Attach Items"

2. Clicking "Attach Everything in Chart" if you want to attach all records from the patient's chart 

7. When you are ready to send the Letter/Referral, click "Sign & Send"
   • You will also see other options under "Sign & More" such as:
     • "Sign, Send & Print Pt Copy"= Sends the Letter/Referral & prints the body of the Letter/Referral without attachments
     • "Sign & Print w/attachments"= Sends the Letter/Referral & prints the entire Letter/Referral with attachments
     • "Sign, Send & Create Follow-up Letter"= Sends the Letter/Referral & starts a new draft for the same recipient to assist with follow up
   • Important Note: Only provider level users can sign Referrals. Staff level users cannot sign Referrals unless they are an authorized Referrals delegate.

 

Frequently Asked Questions (FAQ)

• My fax keeps failing but the recipient's fax number is correct. What should I do?
• Why does Elation limit faxing to 20 pages?
• What does the recipient see when they receive my Letter/Referral?
• The status of the Letter says "Sent" but the recipient said they never received it. Why?
• Can I allow my staff to sign off on Referrals for me?
• The "Sign" buttons are grayed out at the bottom of the Referrals form for me. Why?

 

My fax keeps failing but the recipient's fax number is correct. What should I do?

Elation uses Voice Over IP for faxing, which is the method of faxing documents using internet connection. Voice Over IP faxing breaks down the fax into “packets” of data, and sends them out in chunks. If the transmission is interrupted (which commonly occurs regardless of faxing method), it only takes a few consecutive interrupted packets to reach the failure threshold and this will cause the fax to fail. If the receiving line is busy receiving other faxes at the same time your fax is sent, this will increase the likelihood of the transmission failing which is why you may need to retry a few times.

If the recipient has a functioning fax number but faxing to them occasionally fails, we recommend trying the following:

1. Call the number to confirm a proper fax tone right before you attempt to send the fax.
   1. A healthy fax tone is clear, high pitched and devoid of static
   2. A healthy fax tone may ring like a normal telephone 2-3 times prior to the fax tone
2. If the fax continues to fail even though you have verified a healthy fax tone we recommend:
   1. Asking the recipient if they can adjust the settings on their fax machine to allow for longer fax transmissions
   2. Asking the recipient if they are having issues receiving faxes in general (i.e. line issues, jams, out of ink)

If you continue to have trouble faxing, please contact by clicking here and filling out our contact form.

 

Why does Elation limit faxing to 20 pages?

The reason we limit faxes to 20 pages in a single fax is because faxing via voice-over-IP fails more often when the fax transmission is too large. We do apologize for the inconvenience but this is not a feature we plan to change.

If you have a letter with 20 or more attachments, the recipient will only receive 2 pages; a cover page and a page with instructions on how to retrieve the documents online. Please reference this help center article for more details on how the recipient can view the records online. If you need to fax more than 20 pages, you must break up the documents into multiple faxes.

Limiting your faxes will also help you save money since each Standard Provider User is only allotted 1,500 pages in combined inbound and outbound faxes each month. Any additional pages used per month will be charged at $0.07 per page. Elation processes fax overage charges on the first business day of each month for last month's fax usage. Here is a helpful article about fax usage that you can use for reference.


 

What does the recipient see when they receive my Letter/Referral?

This article speaks from the recipient's point-of-view: How to access patient information securely faxed or emailed by an Elation EHR user. You can share the article with the recipient to guide them on accessing shared records as needed.

 

 

The status of the fax says "Sent" but the recipient said they never received it. Why?

The "Sent" status displays when our Fax Provider notifies us that the fax transmission was successfully completed (100% with no interruptions). This means the fax has reached the intended fax number on file.

Usually if the recipient says they did not receive the fax it is because they misplaced it or they did not recognize the communication is from your office. We recommend asking the recipient to check their fax inbox for the correspondences below.

This is what the cover letter and body of the letter looks like for the recipient:

 

Can I allow my staff to sign off on Referrals for me?

Yes, providers can allow staff to sign Referrals on their behalf by adding the individual to their Authorized Referrals Delegate settings from their own Elation accounts. Providers can assign Referrals delegates by following the instructions in this article: User Accounts Guide- Utilizing authorized staff delegate.

 

The "Sign" buttons are grayed out at the bottom of the Referral form for me. Why? 

Only provider level users can sign Referrals. Staff level users cannot sign Referrals unless they are an authorized Referrals delegate. If you are a staff level user, the "Sign" buttons will be grayed out and you can only draft Referrals for providers to sign. If you need permission to sign Referrals on behalf of a provider, ask the provider to make you a Referrals delegate by following the instructions in this article: User Accounts Guide- Utilizing authorized staff delegate.

 

 

 

Related Articles

• Letters & Referrals Introduction- Sharing clinical data outside of Elation
• Letters & Referrals Guide- Managing & searching the provider directory
• Letters & Referrals Guide- Share Documents With Other Elation EHR Users
• Letters & Referrals Guide- Creating New Contacts
• Letters & Referrals Guide- Faxing Lab and Radiology Orders
• How my colleagues can access shared patient information from my faxes and emails
• How to Share a Patient's Entire Chart
• Letters & Referrals Guide- Frequently Asked Questions
• Elation Passport for Patients Guide
• Elation Passport for Patients- Patient's Point of View
• Fax Usage - Frequently Asked Questions
• Direct Messaging Guide- Secure clinical direct messaging in Elation
• Referrals Guide- Best practices for tracking referrals