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Troubleshooting Patient Payments and Membership Issues in Elation EHR

Use this guide to diagnose and resolve common issues related to patient payments (one‑time charges, payment requests, cards on file) and membership subscriptions (recurring billing, status changes, and communications). Elation’s Patient Payments and Membership Management features are integrated into the EHR and powered by Stripe for secure processing.

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Understand how payments and memberships work in Elation

  • Elation Patient Payments enables secure, digital collection via Stripe, including payment requests, self‑service payments, charging cards on file, and full transaction history in the Patient Payments Report.
  • Membership Management lets you create plans, enroll patients or groups, bill on a schedule, notify members of charges/changes, and view membership status and payments in dedicated reports. A Stripe account (via Elation) is required.

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Start here: identify the issue

Payment issue examples:
  • Patient didn’t receive a payment request.
  • Card declined or HSA/FSA payment fails.
  • “Charge pending” is stuck.
  • Need to resend, void, or refund a payment.
  • Can’t locate a transaction or payout.
Membership issue examples:
  • Member shows “Past Due” or billing failed.
  • Auto‑charge didn’t run/no card on file.
  • Wrong member was charged in a group.
  • Need to change plan amount/frequency or pause/unenroll.

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Payment issues: step‑by‑step fixes

  1. Patient didn’t get a payment request Confirm the patient’s preferred contact method (SMS/email) and resend from the Patient Payments Report (Actions → Resend). Payment requests are sent from “Payment Notification sysadmin@elationemr.com” for email or short code 36331 for SMS. Share the Payment Site link so the patient can pay self‑service without a Passport login; add the link/QR to letters or your website.
  2. Card declined or HSA/FSA failure In Patient Payments Report, check status and have the patient update their card on file. You can “Request card info” from the patient’s Demographics → Insurance, Payment & Membership. For HSA/FSA declines, verify Stripe Industry is set to “Doctors and Physicians” (Settings → Patient Payments → Go to Stripe account).
  3. “Charge pending” is stuck A “Charge pending” appears when you charge a card on file; Stripe will collect automatically within ~24 hours. If it doesn’t settle, ask the patient to update their card on file and reattempt.
  4. Resend, void, or refund a payment Use the Patient Payments Report (Actions menu) to resend or void outstanding requests and refund paid requests. Partial refunds are not supported.
  5. Can’t locate a payment or payout Check Reports → Patient Payments Report; filter by patient or date. For payout timing, log into Stripe via Settings → Patient Payments → Go to Stripe account to view weekly payouts.

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Membership issues: step‑by‑step fixes

  1. Past Due, Paused, or billing failed Open the Membership Report to filter by plan or status (Active, Past Due, Paused, Other) and take actions via the Actions menu (edit enrollment, pause/resume, unenroll, view payments). If the failure was due to an expired/invalid card, request updated card info and resume billing.
  2. Auto‑charge didn’t run / No card on file At enrollment you choose whether to auto‑charge the card on file; if none is on file, Elation sends a payment request on the start and renewal dates. Verify the enrollment settings and ensure a card is saved, then enable auto‑charge if desired.
  3. Wrong group member charged or notified In group memberships, the primary member receives all membership notifications and charges; confirm the correct primary member is set.
  4. Change plan amount/frequency or pause/unenroll Edit plan details in Settings → Membership Management (plan amount/frequency). Changes to amount/frequency notify patients and take effect on renewals (unless an override exists). For a single member change in a group, edit the group from Patient Demographics or the Membership Report; unenrolling one member directly will warn you about unenrolling the group.
  5. Refund a membership payment Refund from the Patient Payments Report by locating the transaction and selecting Refund. Partial/pro‑rated refunds are not available.

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Verify setup and account status

  • Activation: Patient Payments requires activating a new Stripe account from Elation Settings; you cannot connect an external pre‑existing Stripe account.
  • Payment Site: Customize the Payment Site URL for easy patient access. Note: Elation Billing users collect via ElationPay and do not customize Payment Site here.
  • Membership prerequisite: Memberships require Patient Payments (Stripe) registration first.

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Alternative collection and documentation options

  • Accept cash/check and log in the Patient Payments Report, or record at check‑in/edit appointment details and in visit note billing to keep a single source of truth.
  • Generate patient invoices (including a QR/link to your Payment Site) for services or HSA/FSA reimbursement; Patient Invoicing can be enabled in Billing Settings.

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Patient communications: what they receive

  • Membership enrollment/changes trigger SMS or email confirmations per the patient’s communication preference, with plan, start date, billing amount/frequency, and payment method.
  • On auto‑charge, the patient is notified that their card on file will be charged; collection occurs automatically within ~24 hours.
  • Payment requests include a secure link to complete payment; receipts are sent automatically after payment.

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Quick reference: report statuses and actions

  • Patient Payments Report statuses: Paid, Card declined, Charge pending (auto‑settles if card on file is valid).
  • Common actions: Resend request, Void request, Refund payment, Request card info, Charge card on file.
  • Membership Report actions: Edit enrollment, Pause/Resume, Unenroll, View related payments; filter by plan, status, patient; download CSV.

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When to contact Elation Support

Contact us if:
  • You’ve confirmed the patient contact method, card status, and report actions above but charges still fail or members remain in Past Due unexpectedly.
  • Stripe activation or payout settings appear incorrect and you cannot adjust them via Settings → Patient Payments → Go to Stripe account.
Include patient name, plan (if membership), transaction date/time, amount, last 4 of card (if applicable), and screenshots of report entries or errors. Reach Support in‑product or at https://help.elationemr.com/s/contactsupport.