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Troubleshooting Failed Lab Orders in Elation EHR

Use this guide to diagnose and resolve issues when a lab order fails to transmit electronically (eOrder) to a lab vendor, or when a lab can’t process an order due to missing or invalid information. It also covers safe fallback options (fax/print) and best practices to prevent future failures.

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How to recognize a failed electronic lab order

  • If any issue occurs while sending an electronic lab order (eOrder), Elation posts a notification in the patient’s chart under Requiring Action; review the message to identify the reason and next steps.
  • You can also monitor day-to-day issues from Practice Home; Requiring Action helps surface time-sensitive items needing follow-up.

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Quick fixes checklist

  • Confirm you used the electronic Lab Order Form and clicked eOrder or eOrder & Print; these actions immediately transmit the order to the lab and save the signed order in the patient’s chart.
  • Verify the correct lab vendor was selected and that your practice has a live bidirectional interface for eOrdering; if not live, use the regular Lab Order Form and fax/print workflows instead.
  • Ensure required fields are completed: Lab vendor, Tests (from the vendor’s compendium), Dx codes (order-level and/or test-level), Patient Condition (e.g., fasting), Site, and Bill Type, as applicable.
  • Re-check any test-specific ask-on-entry (AOE) questions and complete them; unanswered AOE often causes lab holds or follow-up calls from the vendor.

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Vendor and data requirements that commonly block eOrdering

  • Select tests from the lab vendor’s proprietary compendium. If you can’t find the test, try alternate terms (e.g., Labcorp CMP is “CMP”). Custom user-created tests cannot be used for eOrdering.
  • For Bill Type = Third Party, include the insurance and demographics required by the vendor:
    • Labcorp requires full patient, guarantor, and payer details (address, city, state, zip) and insurance identifiers (group ID, member ID, coverage type).
    • Quest requires Bill Type plus insurance carrier details and, if not “Self,” the policyholder’s name/relationship and member ID.
  • If Sign & Hold was used (e.g., in-house draw pending), the eOrder will not transmit until the specimen collection date/time is documented; add the collection date and sign to release the order.
  • For certain partners with unique requirements, follow vendor notes (example: Scarlet Health via BioReference requires a specific ancillary test and excludes extended-time or in-house-only specimen types).

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Check your interface status and lab configuration

  • Confirm the lab’s interface status in Settings → Labs. Only vendors showing Electronic Orders = Live support eOrdering; otherwise use fax/print.
  • Add or edit vendors in Settings → Labs, including locations for Site selection and compendium information to ensure test search uses the correct vendor data.
  • If you need a new interface, submit a request (and any vendor-specific steps, e.g., Genova setup) and track status until Live.

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If the lab order still fails to send

  • Open the failed order from Requiring Action, correct the missing data (e.g., diagnosis codes, AOE, insurance/guarantor details), and click eOrder again.
  • If your interface shows not Live or vendor inconsistencies persist, use the regular Lab Order Form workflow and transmit by fax:
    • Attach the signed lab order to a Provider Letter and send by fax to the vendor; or print and fax outside Elation.

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Alternative transmission options (when eOrdering is unavailable)

  • Fax the order: after signing, attach the order to a Provider Letter and fax to the vendor directly from Elation; this is recommended if no eOrder interface is live for that vendor.
  • Print the order to hand to the patient or fax outside Elation (regular Lab Order Form workflow).

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After you send: fulfillment and result routing

  • eOrdered lab orders are automatically associated with incoming electronic results; fulfillment can auto-update when results arrive in the chart via the interface.
  • Electronic lab results route to the ordering clinician for sign-off and appear in the patient’s chart; unmatched results can create a new chart, which you can merge into the correct chart to keep data complete.

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Prevent issues before they start

  • Use the electronic Lab Order Form for vendors with a live bidirectional interface, and the regular Lab Order Form plus fax/print for others.
  • Maintain complete patient demographics and insurance data, especially when using Third Party billing for Labcorp or Quest.
  • Build vendor-specific Order Sets and select tests only from the vendor’s compendium for eOrdering; re-create Order Sets when you go live with a new bidirectional vendor.
  • Complete AOE questions at order time to avoid vendor holds and downstream delays.

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When to contact Elation Support

Contact us if:
  • Your lab interface shows Live, you’ve completed all required fields (including vendor-specific data), answered AOE questions, and eOrdering still fails from the Lab Order Form.
  • You need assistance initiating or tracking a lab interface request, or you’re seeing persistent vendor compendium mismatches.
Include the patient name, vendor, order date/time, a screenshot of any error, and whether the issue persists after adding required insurance/guarantor details or AOE. Use the in‑product I need help → Contact Elation Support or visit https://help.elationemr.com/s/contactsupport.