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Troubleshooting EPCS (Controlled Substances) Prescription Errors in Elation EHR

Use this guide to resolve issues when a controlled substance prescription errors during sending or doesn’t arrive at the pharmacy. EPCS has additional compliance and authentication requirements compared to regular medications. Follow the steps below to recover quickly and safely.

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How EPCS works and who can send

  • Only a prescriber who has completed EPCS registration (identity proofing and two‑factor authentication) can electronically prescribe controlled substances in Elation. Staff delegates cannot send controlled substances.
  • EPCS requires entering your Token Password and a one‑time Security Code (via the VIP Access app or hardware token) each time you send controlled prescriptions.
  • If you changed phones, forgot your Token Password, or your token isn’t working, use the EPCS Token/Password Update steps to restore access.

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Recognize and confirm a failure

  • If the pharmacy reports they didn’t receive a controlled prescription sent from Elation, verify in the desktop EHR; Elation Go (mobile) does not show failed prescription notifications, so continue monitoring your Urgent inbox on desktop.

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Quick fixes checklist

  • Confirm the prescriber completed EPCS signup and is using their Token Password and current Security Code; then resend.
  • Verify the pharmacy was selected from the Surescripts directory, and you clicked Prescribe on the Prescription Summary (not just Save/Print). Elation cannot add pharmacies that aren’t in Surescripts; if a pharmacy is missing, use print or call workflows as permitted.
  • Ensure the practice location has a 10‑digit phone and fax on file; Elation prompts for missing values when ePrescribing.
  • Confirm the patient has a valid address on file; an address is required for electronic prescribing.
  • For urgent needs during downtime or integration degradation, call the pharmacy with a verbal order if allowed in your state; otherwise Save as draft and send when service returns to normal.

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Controlled‑substance‑specific rules that can block or delay sending

  • You cannot send the same controlled medication for the same patient with the same fill date to the same pharmacy more than once. If you need to correct an error, cancel the original eRx first; if the pharmacy can’t accept eCancel and the fill date is unchanged, send to a different pharmacy.
  • Schedule I and II: post‑dated prescriptions and refills are not allowed; set refills to 0 and do not post‑date for these schedules.
  • Refill requests for controlled substances cannot be approved electronically; you must either deny or renew by issuing a new prescription.
  • Custom/compound controlled medications cannot be ePrescribed through Elation; use permitted alternatives (e.g., print on secure paper) per state regulations.

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If the pharmacy says they never received it

  • Reopen the order in Elation, confirm you selected the correct pharmacy, reviewed the Prescription Summary, and completed the EPCS signing step (Token Password + Security Code), then resend.
  • Search for the exact store using name + city/ZIP/phone/store number to avoid misrouting; if the pharmacy isn’t listed in Surescripts, use print/call workflows.
  • For urgent fills when transmission is uncertain, call the pharmacy per state rules; for non‑urgent, Save as draft and send once services are normal.

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Mobile app considerations (Elation Go)

  • Elation Go supports sending new non‑controlled prescriptions only; use the desktop EHR for controlled substances and to monitor any failed prescription notifications.

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If EPCS authentication fails

  • Token or password problems (new phone, lost token, forgot password): follow the EPCS Token or Password Update Guide to re‑register your token or reset the Token Password.
  • If identity proofing or access control setup was not completed during EPCS signup, finish those steps before attempting to send controlled prescriptions.

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Prevent issues before they start

  • Complete the EPCS Sign Up process (identity proofing, two‑factor setup, and access controls) before attempting to send controlled prescriptions.
  • Complete Provider Account Authentication and keep provider profile details current (NPI, license, supervising provider if applicable) to ensure prescribing privileges are enabled and credentials transmit correctly.
  • Maintain complete patient demographics, including a valid address, to avoid eRx validation errors.
  • Always choose the exact destination pharmacy location from the Surescripts directory and verify details before sending.

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Safe fallback workflows

  • Urgent controlled prescriptions during downtime: call the pharmacy with a verbal order if allowed; otherwise draft and send once service resumes.
  • If a pharmacy cannot receive via Surescripts, print in compliance with state regulations or provide a verbal order when allowed.

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When to contact Elation Support

Contact us if you:
  • Completed EPCS, selected a valid pharmacy, validated practice/patient details, and still receive send errors or repeated non‑receipt reports. Include patient name, pharmacy name/location, timestamp of attempts, and any on‑screen errors.
  • Need help restoring your token or resolving identity proofing/access control issues blocking EPCS.
Reach Support in‑product or at https://help.elationemr.com/s/contactsupport.